The classification of anxiety disorders in ICD-10 and DSM-IV: a concordance analysis

Abstract

On the surface, the classifications of anxiety disorders in DSM-IV and ICD-10 appear quite similar. However, differences exist and are evident in four aspects of the diagnostic criteria: typology, identifying criteria, inclusion and exclusion criteria. The current study uses data from the Australian National Mental Health Survey to model the impact of these differences on the diagnosis of generalized anxiety disorder. The results show that the concordance between the current classifications would be improved with the removal of the criterion for uncontrollability from DSM-IV, a closer focus on the symptoms of hypervigilance and scanning as in DSM-IV and the removal of the clinical significance criterion from DSM-IV. Equivalency of the exclusion criteria between the two classification systems reduces the concordance, demonstrating that each classification systems is a set of interdependent diagnoses, and to ultimately achieve concordance, all diagnoses must be considered together.