A Spanish experience of DSM III in a Consultation-Liaison psychiatric service

The authors applied the DSM III diagnosis to 500 patients seen at a Consultation-Liaison psychiatric service. Compared with similar American studies there was a lower frequency of adjustment and somatoform disorders and a higher proportion of drug abuse cases. Several possible reasons for these differences are mentioned. Although the use of DSM III has clear advantages in a General Hospital context, important difficulties were found: the use of some diagnostic criteria, the absence of a code to relate Axes I and III, the poor systemization of scores in social Axes IV and V and the lack of a specific category for attempted suicide are but a few of the difficulties encountered. Finally, some modifications of DSM III are suggested in order to improve its clinical usefulness.