Alcohol dependence in the 1990 US National Alcohol Survey: operationalizing and comparing two nosological systems.

The criteria for alcohol dependence in both the ICD-10 and DSM-III-R nosologies were measured in a national general population survey, using 24 stem items and follow-ups. For current (12-month) dependence (at the criterion of 3+ components), the rate was 3.2% according to DSM-III-R criteria, and 5.4% according to ICD-10. The Kappa coefficient of agreement between the two systems for classification of individuals as currently dependent was 0.62, and for lifetime diagnosis the Kappa coefficient was 0.68. Prevalence for the individual components of each diagnosis and for the underlying items are given, and the contribution of each component to the overall dependence score is examined. Implications of the results for future epidemiological work with the two classifications are discussed.