Generalized anxiety disorder, obsessive-compulsive disorder and social phobia: Sources of dissonance between ICD-10 and DSM-IV

The present study examined the diagnostic concordance between ICD- J 0 and DSM-/V in generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD) and social phobia. The Composite International Diagnostic Interview was administered to 1504 people, in a sample derived from community and clinic cases, and discrepant diagnoses were identified for ICD-W and DSM-IV GAD, OCD and social phobia. The initial analysis yielded 243 positive GAD, 41 positive OCD, and 190 positive social phobia diagnoses on one or the other classification, yet only 54%, 64%, and 39% of these respective diagnoses were concordant on both classifications. After removing potential errors with the ICD10-DCR criteria for GAD and in the way the Composite International Diagnostic Interview (CIDl) and scorer operationalized the diagnostic criteria there were 426 diagnoses in the three disorders of which 298 (70%) were concordant. The residual discordance reflects the magnitude of the difference between the two diagnostic systems and researchers should be aware of this when they are making cross-national comparisons of prevalence rates.