title: Comparison of DSM-5 Classifications of Alcohol Use Disorders With Those of DSM-IV, DSM-III-R, and ICD-10 in a General Population Sample in Sweden.
abstract: OBJECTIVE
  The purpose of this study was to employ the criteria for alcohol use disorder (AUD), according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), in a general population sample and to compare the diagnostic classifications and prevalence with those of DSM-IV, DSM-III-R, and the International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10).
  
  
  METHODS
  We used a stratified random sample of 1,091 participants (ages 18-64) in Stockholm County, who were interviewed between 1998 and 2002. A semistructured interview was conducted using Schedules for Clinical Assessment in Neuropsychiatry. Diagnoses were made according to DSM-5, DSM-IV, DSM-III-R, and ICD-10. Agreement was studied using Cohen's κ.
  
  
  RESULTS
  The prevalence of DSM-5 AUD was 11.0%, with corresponding dependence or abuse/harm diagnosis being 8.7% for DSM-IV, 8.5% for DSM-III-R, and 4.9% for ICD-10. With the shift from DSM-IV to DSM-5, 3.2% of those with no disorder were reclassified as mild AUD, whereas 28.9% of those with DSM-IV abuse were reclassified as having no disorder. The majority of the "new cases" had two DSM-IV dependence criteria, and few endorsed the new DSM-5 craving criteria. Cohen's κ between DSM-5 AUD and dependence or abuse/harm was as follows: DSM-IV, .84, DSM-III-R, .83, and ICD-10, .62. These findings were lower than the κ between the older systems: between DSM-IV and DSM-III-R, .98, between DSM-IV and ICD-10, .70, and between DSM-III-R and ICD- 10, .72.
  
  
  CONCLUSIONS
  In the present study population, there were more undiagnosed DSM-IV cases being diagnosed as AUD using DSM-5 than vice versa, but in total the number of cases increased moderately when going from DSM-IV to DSM-5. Concerning reliability, there are substantial to almost perfect agreements between DSM-5 classifications of AUDs and those of DSM-IV, DSM-III-R, and ICD-10.
authors.affiliation: Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Andreas
authors.initials: A
authors.lastname: Lundin
authors.affiliation: Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Mats
authors.initials: M
authors.lastname: Hallgren
authors.affiliation: Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Mikael
authors.initials: M
authors.lastname: Forsman
authors.affiliation: Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Forsell
mesh_terms: D000328:Adult; D019973:Alcohol-Related Disorders / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D038801:International Classification of Diseases; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D015203:Reproducibility of Results; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult