Exclusion criteria of DSM-III. A study of co-occurrence of hierarchy-free syndromes.
The diagnostic criteria of the third edition of the DSM-III often state that one diagnosis cannot be made if it is "due to" another disorder. Using data from the National Institute of Mental Health Diagnostic Interview Schedule, with a sample of 11,519 subjects from a community population, we found that if two disorders were related to each other according to the DSM-III exclusion criteria, then the presence of a dominant disorder greatly increased the odds of having the excluded disorder. We also found that disorders, which DSM-III says are related to each other, were more strongly associated than disorders, which DSM-III says are unrelated. However, we also found there was a general tendency toward co-occurrence, so that the presence of any disorder increased the odds of having almost any other disorder, even if DSM-III does not list it as a related disorder. We concluded that empirical studies are needed to study the assumptions underlying the use of a diagnostic hierarchy.
D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008370:Manuals as Topic / Q000592:standards*; D001523:Mental Disorders / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology; D008875:Middle Aged; D009315:National Institute of Mental Health (U.S.); D011569:Psychiatric Status Rating Scales; D013223:Statistics as Topic; D014481:United States