Consequences of the use of different classification systems: a comparison of the DSM-III-R and the ICD-10 for depression

This paper examines the consequences of applying two different psychiatric classification systems, DSM-III-R and ICD-10. Focusing on depression, the prevalence rates, the sociodemographic, personality and family history determinants and the consequences (quality of life, use of care, need for care) are compared. Data are from the Netherlands Mental Health Survey and Incidence Study (NEMESIS), a general population study among people 18–64 years of age. Depression was assessed by the Composite International Diagnostic Interview (CIDI). According to DSM-III-R, 15.7% of the population has suffered from depression at one point or another in their lives. For ICD-10, this percentage was 20.3%. The differences in prevalence rates appear to stem primarily from differences in the inclusion criteria. The DSMIII-R identifies a subset of more severe depressive categories and thereby produces lower prevalence rates, higher rates of comorbidity and stronger correlations between depression and its determinants and consequences. Copyright © 1999 Whurr Publishers Ltd.