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Objective: The aim of the present study was to examine the association between trauma and posttraumatic stress disorder (PTSD) and substance use disorders and to examine the correlates of substance use disorder plus PTSD comorbidity in the Australian general population. Method: Data were collected from a stratified sample of 10,641 participants as part of the Australian National Survey of Mental Health and Well-Being. A modified version of the Composite International Diagnostic Interview was used to determine the presence of DSM-IV anxiety, affective, and substance use disorders and ICD-10 personality disorders. Results: Substance use disorder plus PTSD was experienced by a significant minority of the Australian general population (0.5%). Among those with PTSD, the most common substance use disorder was an alcohol use disorder (24.1%), whereas among those with a substance use disorder, PTSD was most common among individuals with an opioid use disorder (33.2%). Consistent with U.S. clinical literature, individuals with substance use disorder plus PTSD experience significantly poorer physical and mental health and greater disability than those with substance use disorder alone. In contrast, individuals with PTSD alone and those with substance use disorder plus PTSD shared a remarkably similar clinical profile. Conclusions: It is important that individuals entering treatment for substance use disorder or PTSD be assessed for this comorbidity. The addition of either disorder may present complications that need to be considered for the provision of appropriate treatment. Further research is necessary to ascertain which treatments are most effective in treating comorbid substance use disorder plus PTSD.

This paper discusses the reliability of the Alcohol and Substance Abuse modules of the CIDI‐Auto in two countries, Australia and Puerto Rico, and two languages, English and Spanish. CIDI‐Auto is a computer‐assisted version of the CIDI. Reliability estimates for DSM/ICD are presented at the diagnostic and symptom level. In total, 286 subjects, ages 17–60 years, who had at least 12 drinks of alcohol in their lifetime participated in the study. A dequate to good test‐retest reliability estimates were obtained, with no major differences by nosology, site, substance, or time. Harmful use/ abuse showed lower kappas than dependence. Reliability estimates for dependence ranged from 0.70 to 0.95. For harmful use, k's ranged from 0.45 to 0.66. The findings are encouraging; CIDI‐Auto produces reliable classification across two settings and in two languages with an instrument that has good coverage of different manifestations of the illness.

The present study examined the diagnostic concordance between ICD‐10 and DSM‐IV in generalized anxiety disorder (GAD), obsessive‐compulsive disorder (OCD) and social phobia. The Composite International Diagnostic Interview was administered to 1504 people, in a sample derived from community and clinic cases, and discrepant diagnoses were identified for ICD‐10 and DSM‐IV GAD, OCD and social phobia. The initial analysis yielded 243 positive GAD, 41 positive OCD, and 190 positive social phobia diagnoses on one or the other classification, yet only 54%, 64%, and 39% of these respective diagnoses were concordant on both classifications. After removing potential errors with the ICD‐10‐DCR criteria for GAD and in the way the Composite International Diagnostic Interview (CIDI) and scorer operationalized the diagnostic criteria there were 426 diagnoses in the three disorders of which 298 (70%) were concordant. The residual discordance reflects the magnitude of the difference between the two diagnostic systems and researchers should be aware of this when they are making cross‐national comparisons of prevalence rates. Copyright © 1998 Whurr Publishers Ltd.

The present study assessed the utility of the International Personality Disorder Examination Questionnaire (IPDEQ) as a screener for ICD‐10 personality disorders in a sample of 76 subjects attending treatment for an anxiety disorder. The performance of the IPDEQ at different cut‐off points was compared to IPDE diagnoses of personality disorder using receiver operating characteristic analysis. As the majority of positive diagnoses were of ICD‐10 anxious (DSM‐IV avoidant) personality disorder the six IPDEQ items relating to anxious personality disorder were analysed. Sensitivities were very high and specificities were moderate indicating that the IPDEQ items relating to anxious personality disorder are good at discriminating between those with and those without anxious personality disorder. Furthermore, a cut‐off point of four or more anxious personality disorder items yielded the highest specificity given maximum sensitivity, a condition necessary for a screening instrument to be effective. Thus, at a cut‐off point of four or more screening items the IPDEQ appears to be a valid screening instrument for the detection of anxious personality disorder. The limitations of the study, including the generalizability of the results to other personality disorders and/or other samples, are discussed. Copyright © 1998 Whurr Publishers Ltd.

The relationship between and the inter-rater reliability of the Composite International Diagnostic Interview (CIDI) and the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) for anxiety and depressive disorders were explored. The CIDI and the SCAN were administered by trained interviewers in counterbalanced order. A subsample of interviews was observed to determine the inter-rater reliability of the instruments. Subjects were 101 patients accepted for treatment at an Anxiety Disorders Clinic; 29 of the 101 patients participated in the inter-rater reliability study. Concordance between the instruments as measured by canonical correlation analysis was moderate for current (r=0.69, p=0.05) and for lifetime (r=0.66, p=0.05) diagnoses. Inter-rater reliability of the CIDI was perfect (overall intraclass kappa = 1.00), and of the SCAN was good (overall intraclass kappa = 0.67). It is concluded that although the two instruments made similar diagnostic distinctions, the clinical judgement involved in administering the SCAN resulted in the more moderate levels of agreement between the interviewer and observer than those found for the CIDI.