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April 1990

Alcoholism—North America and AsiaA Comparison of Population Surveys With the Diagnostic Interview Schedule

Author Affiliations

From the Department of Psychiatry, Washington University School of Medicine, St Louis, Mo (Dr Helzer); the University of Puerto Rico School of Medicine and the Mental Health Secretariat of Puerto Rico, San Juan (Dr Canino); Taipei City (Taiwan) Psychiatric Center (Dr Yeh), and the Department of Psychiatry, National Taiwan University (Drs Yeh and Hwu), Taipei City, Taiwan; the Department of Psychiatry, University of Alberta, and Alberta Mental Health Services, Edmonton, Canada (Drs Bland and Newman); and the Department of Neuropsychiatry, Seoul (Korea) National University Medical College (Dr Lee).

Arch Gen Psychiatry. 1990;47(4):313-319. doi:10.1001/archpsyc.1990.01810160013002

• The Diagnostic Interview Schedule (DIS) is a highly structured instrument that enables lay examiners to gather the clinical information necessary to generate psychiatric disorders according to the DSM-III, Feighner, and Research Diagnostic Criteria. It was developed originally as the diagnostic interview for the Epidemiologic Catchment Area (ECA) survey. Because it adheres to DSM-III and can be used by lay interviewers, thus making it practical for studies involving large samples, it has been used for other population surveys in North and South America, Europe, and Asia. This investigation compares the epidemiology of DSM-III—defined alcohol abuse and addiction in DIS-based population surveys cross-nationally (in St Louis, Mo; Edmonton, Canada; Puerto Rico; Taipei City, Taiwan; and South Korea). We found considerable variation in the lifetime prevalence of alcoholism but a similarity in the age of onset, the symptomatic expression, and the associated risk factors. We also found an inverse correlation between the prevalence of alcoholism and the strength of the association of the risk factors we examined. The work described herein demonstrates the utility of consistent definition and method in cross-cultural psychiatric research. The substantive findings have implications for the definition of alcoholism and for a better understanding of genetic and environmental interactions in its etiology.