Substance use disorders:: Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) and International Classification of Diseases, tenth edition (ICD-10)
Substance use disorders:: Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) and International Classification of Diseases, tenth edition (ICD-10)
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DOI：
10.1111/j.1360-0443.2006.01584.x
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发表时间：
2006-09-01
期刊：
影响因子：
6
通讯作者：
Ogburn, Elizabeth
中科院分区：
文献类型：
--
作者：
Hasin, Deborah;Hatzenbuehler, Mark L.;Ogburn, Elizabeth
目标 精神疾病诊断和统计手册第四版 (DSM-IV) 和国际疾病分类第十版 (ICD-10) 这两个主要术语目前为具有不同培训、经验和兴趣的广大用户定义了物质使用障碍。尚未对这些定义及其对 DSM-V 和 ICD-11 的影响进行比较。方法回顾了依赖性概念以及滥用、有害使用、戒断、物质引起的疾病和缓解以及其他物质相关病症的背景。提供了可靠性证据，以及心理测量、遗传学和动物研究等方法的有效性证据。考虑了 DSM-IV 和 ICD-10 与替代系统（例如成瘾严重程度指数）相比的相关性。结果 物质依赖的可靠性和心理测量有效性证据始终很强，但滥用和有害使用的证据则更加复杂。关于酒精障碍遗传学的研究结果支持了依赖概念的有效性，而动物研究则强调了继续使用酒精的重要性，尽管对依赖概念有负面影响。虽然对物质引起的疾病进行的研究很少，但当 DSM-IV 和 ICD-10 的要素相结合时，已发表的研究显示出良好的可靠性和有效性。结论 应保留 DSM-V 和 ICD-11 的依赖性，标准化这两个标准集并添加严重性衡量标准。过度使用的后果应独立于依赖性来衡量；如果进一步的研究支持现有证据，则增加大麻戒断；对物质诱发的精神病类别进行进一步研究；在 DSM-V 和 ICD-11 中标准化他们的标准；为更好的缓解标准奠定理论基础；考虑将物质“滥用”改为物质“功能障碍”；并对临床医生进行有关诊断标准价值的教育。
Aims Two major nomenclatures, Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) and International Classification of Diseases, tenth edition (ICD-10), currently define substance use disorders for broad audiences of users with different training, experience and interests. A comparison of these definitions and their implications for DSM-V and ICD-11 has not been available. Methods The background for the dependence concept and abuse, harmful use, withdrawal, substance-induced disorders and remission and other substance-related conditions is reviewed. Reliability evidence is presented, as is validity evidence from approaches including psychometric, genetic and animal studies. The relevance of the DSM-IV and ICD-10 compared to alternative systems (e.g. the Addiction Severity Index) is considered. Results Reliability and psychometric validity evidence for substance dependence is consistently strong, but more mixed for abuse and harmful use. Findings on the genetics of alcohol disorders support the validity of the dependence concept, while animal studies underscore the centrality of continued use despite negative consequences to the concept of dependence. While few studies on substance-induced disorders have been conducted, those published show good reliability and validity when elements of DSM-IV and ICD-10 are combined. Conclusions Dependence in DSM-V and ICD-11 should be retained, standardizing both criteria sets and adding a severity measure. The consequences of heavy use should be measured independently of dependence; add cannabis withdrawal if further research supports existing evidence; conduct further studies of the substance-induced psychiatric categories; standardize their criteria across DSM-V and ICD-11; develop a theoretical basis for better remission criteria; consider changing substance 'abuse' to substance 'dysfunction disorder'; and conduct clinician education on the value of the diagnostic criteria.