Concordances and discrepancies between ICD-10 and DSM-IV criteria for anxiety disorders in childhood and adolescence

Abstract

BackgroundMental disorders are classified by two major nosological systems, the ICD-10 and the DSM-IV-TR, consisting of different diagnostic criteria. The present study investigated the diagnostic concordance between the two systems for anxiety disorders in childhood and adolescence, in particular for separation anxiety disorder (SAD), specific phobia, social phobia, and generalized anxiety disorder (GAD).MethodsA structured clinical interview, the Kinder-DIPS, was administered to 210 children and 258 parents. The percentage of agreement, kappa, and Yule’s Y coefficients were calculated for all diagnoses. Specific criteria causing discrepancies between the two classification systems were identified.ResultsDSM-IV-TR consistently classified more children than ICD-10 with an anxiety disorder, with a higher concordance between DSM-IV-TR and the ICD-10 child section (F9) than with the adult section (F4) of the ICD-10. This result was found for all four investigated anxiety disorders. The results revealed low to high levels of concordance and poor to good agreement between the classification systems, depending on the anxiety disorder.ConclusionsThe two classification systems identify different children with an anxiety disorder. However, it remains an open question, whether the research results can be generalized to clinical practice since DSM-IV-TR is mainly used in research while ICD-10 is widely established in clinical practice in Europe. Therefore, the population investigated by the DSM (research population) is not identical with the population examined using the ICD (clinical population).

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“…61 Similarly, there are differences in the criteria for anxiety disorders across the two major classification systems, the DSM 9 and International Classification of Diseases (ICD) 62 resulting in differing prevalence estimates. 63,64 Further empirical investigation on the comparability of these two systems is, however, needed. 64 Finally, the data in this meta-analysis were largely reliant on cross-sectional research.…”

“…63,64 Further empirical investigation on the comparability of these two systems is, however, needed. 64 Finally, the data in this meta-analysis were largely reliant on cross-sectional research. Longitudinal SCI research is important to determine the incidence and the development of mental disorders over time.…”

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