Exclusion Criteria of DSM-III: A Study of Co-occurrence of Hierarchy-Free Syndromes

Jeffrey H. Boyd, Jack D. Burke, Ernest Gruenberg, Charles E. Holzer, Donald S. Rae, Linda K. George, Marvin Karno, Roger Stoltzman, Larry McEvoy, Gerald Nestadt

Research output: Contribution to journalArticlepeer-review

419 Scopus citations


The diagnostic criteria of the third edition of the DSM-III often state that one diagnosis cannot be made If It is “due to” another disorder. Using data from the National Institute of Mental Health Diagnostic Interview Schedule, with a sample of 11,519 subjects from a community population, we found that if two disorders were related to each other according to the DSM-III exclusion criteria, then the presence of a dominant disorder greatly increased the odds of having the excluded disorder. We also found that disorders, which DSM-III says are related to each other, were more strongly associated than disorders, which DSM-III says are unrelated. However, we also found there was a general tendency toward co-occurrence, so that the presence of any disorder increased the odds of having almost any other disorder, even if DSM-III does not list it as a related disorder. We concluded that empirical studies are needed to study the assumptions underlying the use of a diagnostic hierarchy.

Original languageEnglish (US)
Pages (from-to)983-989
Number of pages7
JournalArchives of general psychiatry
Issue number10
StatePublished - Oct 1984

ASJC Scopus subject areas

  • Arts and Humanities (miscellaneous)
  • Psychiatry and Mental health


Dive into the research topics of 'Exclusion Criteria of DSM-III: A Study of Co-occurrence of Hierarchy-Free Syndromes'. Together they form a unique fingerprint.

Cite this