Diagnosis of Abuse and Addiction



Psychiatric symptoms are caused by significantly different biological, psychological and social dimensions, and the multidimensional approach is accepted everywhere. Since 150 years, France, then “Weltenbund” and nowadays the World Health Organization, defines international classificatory systems for psychiatric disorders. The tenth revision (ICD-10) has become important for a better comparison of the frequency of disturbances between countries and cultures. It is also used for payoff for the National Insurances. It does not correspond to long-term courses and does not give enough information for the necessary therapies. Therefore, the eleventh revision has been undertaken. These facts have been delineated already in the German version introduction by the authors Dilling, Mombour and Schmidt: “ICD-10 is only a descriptive diagnostic procedure and it relates to only one part, though to an important one, for the nosological understanding. Important aspects of psychopathology, of psychodynamics and of psychophysiology should be regarded. Especially the individual and personal biographic developmental facts should not be neglected” (The ICD 10 classification of mental and behavioural disorders: psychiatric adaption. Geneva: WHO, 1993). Also personal future perspectives play an important role.

ICD-11 focuses, besides on the severity degree, also on the long-term course. This represents a major improvement. DSM-5 converged to ICD-11 because it newly included craving as a central symptom. DSM-5 defined three severity degrees. Moderate and severe in ICD-11 correspond to the term dependence. Therapy research according to DSM-IV and ICD-10 showed very divergent results. Therefore, as we know from research and clinical work, it is necessary to define subgroups of dependent patients for more sufficient therapy (Humphreys and Lingford-Hughes. Edwards’ treatment of drinking problems: a guide for the helping professions, 6th edition. Cambridge Press. 2016; UNODC and WHO. International standards for the treatment of drug use disorders — draft for field testing. 2016, see Chap.  6).


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© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Clinical Division of Social PsychiatryMedical University Vienna, Department of Psychiatry and PsychotherapyViennaAustria
  2. 2.Caritas der Erzdiözese WienViennaAustria
  3. 3.Department of PsychiatryUniversity of Connecticut Health CenterFarmingtonUSA
  4. 4.Neuroscience DepartmentHospital de Santa MariaLisboaPortugal

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