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PubMedDate not supplied

Sources of disagreement between clinical (ICD-9) and operational (RDC, DSM-III) diagnosis of endogenous depression (melancholia).

In a sample of 173 depressed in-patients, the sources of disagreement between the clinical ICD-9 diagnosis of endogenous depression (ED) and the corresponding operational definitions of RDC and DSM-III were analyzed. The RDC definition of ED gave a significantly higher degree of concordance with the ICD-9 diagnosis of ED, than that of DSM-III. This difference was mainly due to the algorithm used in DSM-III. When empirically derived algorithms were applied to the diagnostic criteria of DSM-III and RDC, both criteria lists reached a higher degree of concordance with the ICD-9 diagnosis of ED. When the criteria lists of RDC and DSM-III were supplemented with cross-sectional criteria (psychotic features, incapacitation) and by course-related criteria (recurrence, bipolarity, primary episode, adequate personality, no precipitating stress), this did not result in significant enhancement of the degree of concordance.

Adjustment Disorders↗
PubMed1995

Degradation of trans-ferulic and p-coumaric acid by Acinetobacter calcoaceticus DSM 586.

Cell suspensions of Acinetobacter calcoaceticus strain DSM 586 and DSM 590 were able to grow on benzoic, p-hydroxybenzoic and vanillic acid as sole carbon source. Testing the utilization of trans-ferulic and p-coumaric acid, we found that the sole A. calcoaceticus DSM 586 efficiently degraded the lignocellulose related monomers. Cells induced with trans-ferulic acid were able to oxidize trans-ferulic, p-coumaric, vanillic, p-hydroxybenzoic and protocatechuic acid at rates higher than the uninduced culture. The same activity was found in the p-coumaric acid induced culture. Two aromatic compounds, vanillic and p-hydroxybenzoic acid, were isolated from culture filtrates of trans-ferulic and p-coumaric acid grown cells, respectively, and further characterized by high performance liquid chromatography. 1H- and 13C-nuclear magnetic resonance and ultraviolet spectrophotometry. Cell extracts of trans-ferulic or p-coumaric acid induced cultures were shown to rapidly convert protocatechuic acid to beta-carboxymuconic acid. Moreover, A. calcoaceticus DSM 586 produced high levels of protocatechuic 3,4-dioxygenase compared to cathecol 1,2-dioxygenase and gentisate 1,2-dioxygenase in the degradation of trans-ferulic or p-coumaric acid. Based upon these results, a reaction sequence for the complete degradation of trans-ferulic and p-coumaric acid in A. calcoaceticus DSM 586 is proposed.

Acinetobacter calcoaceticus↗
PubMed1991

Agreement between DSM-III and III-R substance use disorders.

With proposed criteria for DSM-IV substance dependence imminent, an evaluation of the impact of changes from DSM-III to DSM-III-R would be informative. Recent admissions to St. Louis drug treatment centers were interviewed with the DIS-III-R, which covers criteria from both systems. Kappa values for system agreement, diagnostic overlap and percent positive agreement are reported by substance. The DSM-III-R system cast a wider net for dependence than DSM-III for alcohol, tobacco and amphetamines. Neither system predominated for cannabis, opioids and barbiturates/sedatives/hypnotics. Reasons for differences and implications of findings are discussed.

Adolescent↗
PubMed1993

Subjective reports of withdrawal among cocaine users: recommendations for DSM-IV.

The proposed DSM-IV criteria for substance use disorders have included, as an option, a subtyping for physiologic dependence, characterized by either tolerance or withdrawal. Even if this option is not chosen at this stage of system revision, this weighting scheme justifies wider surveillance of these symptoms, especially for the more newly described cocaine dependence disorder. Wider surveillance of withdrawal is possible with the CIDI Substance Abuse Module (SAM), a WHO/ADAMHA diagnostic interview which covers criteria of substance use disorders according to the DSM-III, III-R, ICD-10 and proposed DSM-IV systems. To aid in this effort, we used the SAM, which includes a master list of all symptoms (n = 16) in the DSM manuals related to withdrawal from any substance to assess withdrawal symptoms from all substances. In this study, we hypothesized that the persons who used opiates with cocaine might misattribute their symptoms to cocaine; thus, we compared the responses of persons who used cocaine and opiates (opiate users) with the responses of persons who used cocaine without opiates (non-opiate users). Data from two St. Louis studies were combined for these analyses, users not in treatment or newly enrolled to drug-free or methadone treatment from a NIDA demonstration project and users selected for the St. Louis DSM-IV Field Trial. Of the 196 persons included from the field trial, 80% reported lifetime cocaine use compared with 91% of the 412 persons from the demonstration project. The symptoms mentioned in the diagnostic manuals were among the most frequently endorsed by both cocaine use groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Construct validity of the abuse-dependence distinction as measured by DSM-IV criteria for different psychoactive substances.

This article used the diagnostic criteria of the Diagnostic and Statistical Manual-Fourth Edition (DSM-IV) to compare the validity of a qualitative and a quantitative model of the abuse-dependence distinction for different psychoactive substances in samples of drug users drawn from drug treatment inpatients, general psychiatric patients, and the community. The hypothesis that DSM-IV abuse criteria differ from dependence criteria in kind rather than degree (a qualitative model) was only occasionally supported by confirmatory factor analyses of DSM-IV diagnostic criteria, by patterns of correlations of the two kinds of criteria with Addiction Severity Score (ASI) composites and measures of frequency of substance abuse, and by concurrent/prognostic validity analyses. However, the findings were consistent with a quantitative model of the abuse-dependence distinction that posits that abuse is a mild form of dependence. Whether abuse and dependence categories of users were established from separate DSM-IV criteria for abuse and dependence or from scores from a severity-of-dependence scale based on the pooled DSM-IV dependence and abuse criteria, abusers generally used drugs less than users in the dependence category and reported less problems associated with substance abuse on the ASI.

Adolescent↗
PubMed2006

DSM-IV alcohol dependence and abuse: further evidence of validity in the general population.

BACKGROUND: In order to understand the validity of the Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV) alcohol abuse and dependence diagnoses, studies are needed in both clinical and general population samples. The purpose of this study was to examine the construct and criterion-oriented validity of DSM-IV alcohol dependence and abuse in the general population with respect to factor structure and their relationship to family history of alcoholism, treatment utilization, and psychiatric comorbidity. METHODS: This analysis is based on data from the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), in which nationally representative data were collected in personal interviews conducted with one randomly selected adult in each sample household or group quarters. A subset (n=26,946) of the NESARC sample (total n=43,093) who reported drinking one or more drinks during the year preceding the interview formed the basis of analyses. Latent variable modeling was used to assess the concurrent validity of DSM-IV alcohol abuse and dependence symptom items. RESULTS: The latent variable modeling yielded one major factor related to alcohol dependence, a second factor related to alcohol abuse and a third smaller factor defined by tolerance. The validity of alcohol dependence in general population samples was further supported by statistically significant associations with family history of alcoholism, treatment utilization, and psychiatric and medical comorbidities. CONCLUSIONS: The factor structure and relationship to external criterion variables observed in the study provide support for the further validity of DSM-IV alcohol dependence in the general population, whereas support for the validity of DSM-IV abuse was equivocal.

Adolescent↗
PubMed2006

The association between cigarette smoking and DSM-IV nicotine dependence among first year college students.

AIMS: This study was undertaken to evaluate the association between cigarette smoking behavior and DSM-IV nicotine dependence. DESIGN: Drawing on a sample of first year college students selected for representation across a continuum of smoking behavior, current DSM-IV nicotine dependence criteria were assessed among participants reporting any smoking in the preceding week on a web-based survey protocol. Logistic regression and receiver operator characteristic analyses were used to estimate the overall concordance between smoking and DSM-IV nicotine dependence. FINDINGS: Relationships were supported between both quantity and frequency of smoking in the past week and DSM-IV nicotine dependence showing higher prevalence of dependence at higher levels of use (p<0.05). While the highest prevalence of nicotine dependence was seen among those reporting the most frequent and heavy smoking, a substantial number of participants reporting daily and/or heavy smoking did not meet criteria for nicotine dependence. Conversely, nicotine dependence was seen among a subgroup of participants reporting relatively low levels of non-daily smoking. Diagnostic concordance was found to be moderate for both quantity and frequency and was not improved by combining information from these two indices. CONCLUSIONS: Aside from confirming DSM-IV nicotine dependence at relatively low levels of smoking, these results may be used to inform research aimed at identifying samples of nicotine dependent youth across the range of smoking levels.

Diagnostic and Statistical Manual of Mental Disord↗
PubMed2005

Lactobacillus harbinensis sp. nov., consisted of strains isolated from traditional fermented vegetables 'Suan cai' in Harbin, Northeastern China and Lactobacillus perolens DSM 12745.

Taxonomical analysis of two genetically distinguished Lactobacillus strains isolated from traditional Chinese fermented vegetables 'Suan cai' was performed. They formed L-lactate from glucose, were facultatively heterofermentative, and had a DNA G+C content of 53-54mol%. They fermented D- and L-arabinose. They produced lactate, ethanol and acetate from gluconate at a molar ratio of 1.1:0.4:0.7. Phylogenetic analysis of 16S rDNA revealed that the two strains were closely related to L. perolens. DNA-DNA hybridization analysis revealed that the two strains were different from L. perolens type strain DSM 12744 and formed a separate cluster with L. perolens DSM 12745. G + C molar content of DNA of the former is 51%, whereas those of the latter strains were in the range of 53-54%. Based on the results, we propose that the new species be named L. harbinensis sp. nov. and that L. perolens DSM 12745 be reclassified as L. harbinensis DSM 12745. The type strain of L. harbinensis DSM 16991T (= AHU 1762T = SBT 10908T).

Acetates↗
PubMed2004

Proposal to reclassify Paenibacillus larvae subsp. pulvifaciens DSM 3615 (ATCC 49843) as Paenibacillus larvae subsp. larvae. Results of a comparative biochemical and genetic study.

The bacterial pathogen Paenibacillus larvae subsp. larvae (P. l. larvae), is the etiological agent of American foulbrood, an extremely contagious and disastrous disease of honeybee brood. In case of American foulbrood the destruction of infected colonies is often considered the only workable control measure. Therefore, the ability to diagnose this disease properly is important to prevent unnecessary economic loss to beekeepers. The development of suitable methods for the early and reliable detection of P. l. larvae is hampered by the fact that the two subspecies of Paenibacillus larvae, P. l. larvae and Paenibacillus larvae subsp. pulvifaciens (P. l. pulvifaciens), seem to be indistinguishable by cultural characteristics as well as by PCR protocols. Here we present an extensive analysis of several P. larvae reference strains. We employed conventional culture techniques, morphological and biochemical identification, PCR-based methods and sequencing of the 16S rDNA. We found indeed that P. l. pulvifaciens strain DSM 3615 is indistinguishable from P. l. larvae (DSM 7030). We did not face any problems to discriminate between P. l. larvae and P. l. pulvifaciens strains DSM 8442 and DSM 8443. Therefore, classification of DSM 3615 as type strain of P. l. pulvifaciens seems not to be justified. We propose to reclassify this strain as P. l. larvae. Former problems in differentiating the two subspecies might have arisen from this misclassification. PCR-based methods as well as appropriate biochemical identification systems provide a reliable means for the discrimination between the two subspecies P. l. larvae and P. l. pulvifaciens.

Animals↗
PubMed1997

Diagnosing DSM-IV--Part II: Eysenck (1986) and the essentialist fallacy.

In Part I (Wakefield, 1997, Behaviour Research and Therapy, 35, 633-649) of this two-article series, I used the harmful dysfunction analysis of the concept of disorder (Wakefield, 1992a, American Psychologist, 47, 373-388) to 'diagnose' a problem with DSM-IV. I argued that DSM-IV diagnostic criteria often violate the 'dysfunction' requirement by invalidity classifying harms not caused by dysfunctions as disorders. In Part II, I examine Eysenck's (Eysenck, 1986, Contemporary directions in psychopathology: Toward the DSM-IV) argument that DSM commits a 'categorical fallacy' and should be replaced by dimensional diagnoses based on Eysenckian personality traits. I argue that Eysenck's proposed diagnostic criteria violate the 'harm' requirement by invalidly classifying symptomless conditions as disorders. Eysenck commits an 'essentialist fallacy'; he misconstrues 'disorder' as an essentialist theoretical concept when in fact it is a hybrid theoretical-practical or 'cause-effect' concept. He thus ignores the harmful effects essential to disorder that are captured in DSM's symptom-based categories.

Humans↗
PubMedDate not supplied

DSM-IV panic attacks and panic disorder in a community sample of adolescents and young adults: how specific are panic attacks?

The study investigates the lifetime and 12-month prevalence, symptoms, age of onset and comorbidity patterns of DSM-IV panic attacks and panic disorder in a community sample of 3021 adolescents and young adults aged 14-24 years. Findings are based on DSM-IV symptoms and diagnoses assessed by interviews using a computerised, extended version of the Munich Composite International Diagnostic Interview (M-CIDI). Lifetime prevalence of DSM-IV panic disorder among 14-24 year-olds was 1.6% (0.8% with and 0.8% without agoraphobia). Panic symptoms were found to be quite frequent (13.1%) in the community, with lifetime prevalence of DSM-IV panic attack at 4.3% (12-month prevalence, 2.7%), with first onset rarely before puberty. Women were considerably more likely to have panic disorder and to have an earlier age of onset than males. Occurrence of DSM-IV panic attacks was strongly related to the subsequent development of various forms of mental disorders--not only panic disorder and agoraphobia. The conditional probability in those with panic attacks to develop other forms of mental disorders was 63% in males and 40% in females. Particularly 'late onset' panic attacks (after the age of 18 years) are associated strongly with the development of multimorbidity of mental disorders. This suggests that panic attacks are generally highly indicative for more severe psychopathology and not only for panic disorder and agoraphobia.

Adolescent↗
PubMed1998

Epidemiologic and phenomenological aspects of post-traumatic stress disorder: DSM-III-R diagnosis and diagnostic criteria not validated.

The aim of this cohort study was: (i) to validate the diagnostic criteria for post-traumatic stress disorder (PTSD) of the DSM-III-R; and (ii) to examine the incidence rate of PTSD in a study population exposed to two different traumatic events, i.e. a fire in a hotel ball-room and a multiple collision car-crash on a Belgian highway. One hundred and eighty-five victims (130 fire and 55 car accident victims) were assessed between 7 and 9 months after the traumatic event using the Composite International Diagnostic Interview (CIDI), PTSD Module, a fully structured diagnostic interview for the assessment of PTSD according to DSM-III-R criteria. Twenty-three percent of the study population met DSM-III-R criteria for PTSD. By means of unsupervised and supervised multivariate statistical analyses we were unable to validate the three-factorial structure, i.e. criteria B, C and D, of the DSM-III-R PTSD diagnosis. The latter relies heavily on the C diagnostic criteria, which appear to be too restrictive. Women were more likely to develop symptoms of reexperience (B) and arousal (D) than men. There was a significantly higher incidence of criteria B, C and D, but not of PTSD, in fire than in car-accident victims. Between 42 and 57% of the victims developed the first PTSD symptoms on the day of the trauma; within the next week these incidence rates increased to 77.1, 57.8 and 73.5% for criteria B, C and D, respectively. In conclusion, this study was unable to demonstrate the validity of the diagnostic criteria for PTSD according to DSM-III-R. The present cohort study has defined a number of factors that may predict new occurrences of PTSD symptoms after a traumatic event, i.e. gender, type of trauma and time delay between the trauma and the assessment of the diagnostic criteria.

Accidents, Traffic↗
PubMed2002

Spectrum and nosology: implications for DSM-V.

The authors attempt to show similarities and differences between a spectrum and the DSM-IV perspective in how psychopathology is best represented to clinicians and clinical researchers. Subthreshold symptoms are given little or no attention in DSM; noncriterion symptoms are given none at all. Not otherwise specified disorders may be a widely used category in DSM-IV, but in a spectrum diagnosis there is no similar designation, because use of the whole spectrum of symptoms is possible. Although a DSM-IV categorical disorder may not be the best representation of psychopathology, it is clearly defined and is efficient for the purposes of communication and labeling. Both systems of nosology are essentially atheoretical; comorbidity exists in both, although to a lesser degree in some spectrum models. Data are summarized that clearly demonstrate the need for designers of DSM-V to create a nosology that is, at least in part, dimensional.

Humans↗
PubMed1998

Prevalence of dementia in a rural Netherlands population and the influence of DSM-III-R and CAMDEX criteria for the prevalence of mild and more severe forms.

To obtain estimates of the prevalence of mild and moderate/severe dementia among people age 65 and over, applying criteria for severity of both DSM-III-R and CAMDEX, a two-stage community-based study was conducted in a rural area of the Netherlands. In the first stage, 2191 subjects (out of the target population of 2655) participated in an interview which included the Mini-Mental State Examination (MMSE). Based on MMSE score, a non-proportional random sample (n=496) was drawn for the second stage. A total of 421 subjects responded and were subsequently examined using the Cambridge Examination for Mental Disorders of the Elderly (CAMDEX). In determining the severity of dementia, criteria of both DSM-III-R and CAMDEX were applied. Overall prevalence for both classification systems was 6.5%. There was a large discrepancy between the two classification systems with regard to the criteria for rating severity. The prevalence of moderate/severe dementia using DSM-III-R criteria was twice as high as the prevalence using CAMDEX criteria. These findings reflect the differences between DSM-III-R and CAMDEX in descriptions of dementia severity. Rating according to CAMDEX predicts institutionalization in specialized nursing homes somewhat better than staging according to DSM-III-R. Both content analysis and institutionalization data suggest that the CAMDEX operationalization of rating severity seems preferable.

Aged↗
PubMed1996

A comparison of DSM-III-R and ICD-10 personality disorder criteria in an out-patient population.

This study reports the results of a comparison of DSM-III-R and ICD-10 personality disorder criteria by application of both sets of criteria to the same group of patients. Despite the clinical relevance of these disorders and the need for reliable diagnostic criteria, such a comparison has not previously been reported. DSM-III-R and ICD-10 have converged in their classification of personality disorders, but some important differences between the two systems remain. Personality disorder diagnoses from both systems were obtained in 52 out-patients, using the Standardized Assessment of Personality (SAP), a brief, informant-based interview which yields diagnoses in both DSM-III-R and ICD-10. For individual personality disorder diagnoses, agreement between systems was limited. Thirty-four subjects received a personality disorder diagnosis that had an equivalent form in both systems, but only 10 subjects (29%) received the same primary diagnosis in each system. There was a difference in rate of diagnosis, with ICD-10 making significantly more personality disorder diagnoses. The lower diagnostic threshold of the ICD-10 contributed most of this effect. Further modifications in ICD-10 Diagnostic Criteria for Research (DCR) and DSM-IV to the personality disorder category have been considered. The omission in DSM-IV of three categories unique to that system and the raising of the threshold in ICD-10 DCR, do seem to have been helpful in promoting convergence.

Adolescent↗
PubMed2002

DSM-IV generalized anxiety disorder in the Australian National Survey of Mental Health and Well-Being.

BACKGROUND: This paper reports population data on DSM-IV generalized anxiety disorder from the Australian National Survey of Mental Health and Well-Being. METHODS: The data were obtained from a nationwide household survey of adults using a stratified multi-stage sampling process. A response rate of 78.1% resulted in 10,641 persons being interviewed. Diagnoses were made using the Composite International Diagnostic Interview. The interview was computerized and conducted by trained lay interviewers. RESULTS: Prevalence in the total sample was 2.8% for 1-month GAD and 36% for 12-month GAD. Persons over 55 years of age were less likely to have GAD than those in the younger age groups. Logistic regression analysis also showed that a diagnosis of GAD was significantly associated with being of younger to middle age, being separated divorced or widowed, not having tertiary qualifications or being unemployed. Co-morbidity with another affective, anxiety, substance use or personality disorders was common, affecting 68% of the sample with 1-month DSM-IV GAD. GAD was associated with significant disablement, and 57% of the sample with DSM-IV GAD had consulted a health professional for a mental health problem in the prior 12 months. CONCLUSIONS: The survey provides population data on DSM-IV GAD and its correlates. GAD is a common disorder that is accompanied by significant morbidity and high rates of co-morbidity with affective and anxiety disorders, and is associated with marital status, education, employment status, but not sex. Changes to DSM-IV diagnostic criteria did not appear to affect the prevalence rate compared to previous population surveys.

Adolescent↗
PubMed2002

Exclusion criteria in the diagnostic classifications of DSM-IV and ICD-10: revisiting the co-occurrence of psychiatric syndromes.

BACKGROUND: Exclusion criteria are present in almost all diagnostic categories in both DSM-IV and ICD-10. These exclusion criteria state that one diagnosis is not made if it is 'due to' another disorder. However, there is little empirical evidence demonstrating that the hierarchy imposed by the exclusion criteria is meaningful. The current study examines associations between ten common mental disorder pairs to determine whether they are higher for disorder pairs that are classified in DSM-IV and/or ICD-10 as having a hierarchical relationship, than for those that are not hierarchically related. METHOD: Data were analysed from the Australian National Survey of Mental Health and Wellbeing, a large (N = 10,641) epidemiological survey of mental disorders. Bivariate odds ratios between disorder pairs were calculated from logistic regression analyses. Multivariate odds ratios were also calculated from separate logistic regression analyses in which the sample was restricted to likely positive cases, and co-morbid mental disorders and neuroticism scores were both controlled. RESULTS: The odds ratios between disorder pairs related according to the exclusion criteria were higher than those of unrelated disorders, for both DSM-IV and ICD-10. When constraints were placed on the data to control for the effects of co-morbid disorders and neuroticism the same pattern was evident in DSM-IV, but not in ICD-10. CONCLUSION: The patterns of association between disorder pairs found in the exclusion criteria for DSM-IV appear to more closely mirror the patterns of association found in epidemiological data. While this does not guarantee that the exclusion criteria are valid it is argued that identifying significant associations should be the first step in establishing meaningful exclusion criteria.

Comorbidity↗
PubMed2004

Co-morbidity and stability of melancholic features in DSM-IV major depressive disorder.

BACKGROUND: The descriptive validity of the melancholic features specifier of the DSM-IV major depressive disorder (MDD) is uncertain. Little is known about its relationship to psychiatric co-morbidity, stability across episodes, or strength in predicting course of illness. METHOD: The Vantaa Depression Study (VDS) is a prospective, naturalistic cohort study of 269 patients with a new episode of DSM-IV MDD who were interviewed with SCAN and SCID-II between 1 February 1997 and 31 May 1998, and again at 6 and 18 months. Ninety-seven (36%) MDD patients met DSM-IV criteria for the melancholic features specifier, and were contrasted with 172 (64 %) subjects with a non-melancholic MDD. The duration of the index episode was examined using a life chart. RESULTS: We found no difference in rates of any current co-morbid Axis I or II disorders between melancholic and non-melancholic depressed patients. Of those who had melancholic features at the index episode and subsequent episodes during the 18-month follow-up, only 22 % (5/23) presented melancholic features during the latter. The non-melancholic subtype switched to melancholic in 25 % (8/32) of cases. Differences in the course of melancholic and non-melancholic depression were very minor. CONCLUSIONS: The descriptive validity of the DSM-IV melancholic features specifier may be questionable in MDD. There appear to be no major differences in current co-morbidity, or course of depression between melancholic and non-melancholic patients. The consistency of DSM-IV melancholic features across episodes appears weak.

Adult↗