Agreement between DSM-IV and ICD-10 criteria for opioid use disorders in two Iranian samples Mohammad Javad Tarrahi a,b , Afarin Rahimi-Movaghar c, ⁎, Hojjat Zeraati a , Masoumeh Amin-Esmaeili c , Abbas Motevalian d , Ahmad Hajebi e , Vandad Sharifi f , Reza Radgoodarzi c , Mitra Hefazi c , Akbar Fotouhi a a School of Public Health, Tehran University of Medical Sciences, Tehran 15168-46514, Iran b Department of Epidemiology & Biostatistics, School of Public Health, Lorestan University of Medical Sciences, Khorramabad, Iran c Department for Mental Health and Substance Use, Iranian Research Center for HIV/AIDS (IRCHA), Iranian Institute for Reduction of High-risk Behaviors, Tehran University of Medical Sciences, Tehran 14197-33141, Iran d Iranian National Center for Addiction Studies, Iranian Institute for Reduction of High-risk Behaviors, Tehran University of Medical Sciences, Tehran 13366-16357, Iran e Mental Health Research Centre, Tehran Psychiatric Institute, Iran University of Medical Sciences, Tehran 15745-344, Iran f Department of Psychiatry and Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran 13337-95914, Iran HIGHLIGHTS • The agreement between DSM-IV and ICD-10 on opioid dependence was excellent. • In the clinical samples, the agreement between abuse and harmful use was excellent. • In the general population, a fair agreement was observed in this regard. • The inter-rater reliability was perfect or excellent for both systems. abstract article info Keywords: DSM-IV ICD-10 Opioid-related disorders Classification Iran The aim of this study was to determine the agreement between the two systems in opioid users in the general population and a clinical sample. Two series of data were used in this study. The first was the data of 236 home-residing opioid abusers aged 15–64, who had previously participated in the Iran Mental Health Survey (IranMHS) in 2011, and the second was the data of 104 general psychiatry patients from inpatient or outpatient wards of two psychiatry hospitals in Tehran. Opioid use disorders were evaluated with CIDI-version 2.1. The disorders were assessed in all participants who used opioid substances for at least 5 times during the past 12 months. In the sample from the general population, the agreement between the two systems on the diagnosis of dependence was excellent (0.81). The agreement between the two systems on the diagnosis of abuse and harmful use was 0.41. In the clinical sample, the agreement between the two systems on the diagnosis of depen- dence or any opioid use disorder was 0.96 and 0.93, respectively. The agreement between abuse and harmful use was 0.9 and -0.02 with and without regarding hierarchy, respectively. The inter-rater reliability of both DSM-IV and ICD-10 systems for all diagnosis was more than 0.95. The results of the diagnosis of dependence in the two systems had a weak concordance with treatment. The diagnostic criteria of DSM-IV and ICD-10 regarding dependence are very similar and the diagnosis produced by each system is concordant with the other system. However, the two systems have noticeable discrepancies in the diagnosis of abuse and harmful use. The discrepancies result from their conceptual differences and necessitate further revision in the definition of these disorders in the two systems. © 2013 Elsevier Ltd. All rights reserved. 1. Introduction Nowadays, two systems are majorly used for the diagnosis of sub- stance use related disorders. The first system is “Diagnostic and Statisti- cal Manual of Mental Disorders, 4th Edition (DSM-IV)”, developed by the American Psychological Association (American Psychiatric Association, 1994). It was published in 1994 and is used in the United States and a number of other countries. The first edition of DSM was developed in Addictive Behaviors 39 (2014) 553–557 ⁎ Corresponding author at: Department for Mental Health and Substance Use, Iranian Research Center for HIV/AIDS (IRCHA), Iranian Institute for Reduction of High-risk Behaviors, Tehran University of Medical Sciences, Imam Khomeini Hospital, Keshavarz Blvd., Tehran 14197-33141, Iran. Tel.: +98 21 66918899; fax: +98 21 66947984. E-mail addresses: tarrahi_mj@yahoo.com (M.J. Tarrahi), rahimia@tums.ac.ir (A. Rahimi-Movaghar), dr.m.a.esmaeeli@gmail.com (M. Amin-Esmaeili), amotevalian@tums.ac.ir (A. Motevalian), hajebi.ahmad@gmail.com (A. Hajebi), vsharifi@sina.tums.ac.ir (V. Sharifi), rezaradus@gmail.com (R. Radgoodarzi), mitra_hefazi@yahoo.com (M. Hefazi), afotouhi@sina.tums.ac.ir (A. Fotouhi). 0306-4603/$ – see front matter © 2013 Elsevier Ltd. All rights reserved. http://dx.doi.org/10.1016/j.addbeh.2013.10.032 Contents lists available at ScienceDirect Addictive Behaviors