Addiction or dependence syndrome according to ICD-10 and DSM-5

The two psychiatric diagnostic manuals, the 2018 International Statistical Classification of Diseases and Related Health Problems (ICD-10) of the World Health Organization (WHO) and the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) of the American Psychiatric Association (APA), are the most influential classification systems.

In 1964, the WHO introduced the concept of dependence instead of addiction into the ICD in order to emphasize the nature of "dependence syndrome" as a disease and thereby counteract the stigmatization of those affected. The term addiction has problematic connotations due to its sometimes derogatory use in various historical and social contexts. If there are patterns of substance use that cause physical or mental health damage without a dependence syndrome, this is referred to as harmful use (cf. module on Drug dependence). 

Both the ICD-10 and the DSM-5 describe the dependence syndrome according to the following characteristics:

  1. Strong urge for consumption.
  2. Loss of control.
  3. Development of a tolerance.
  4. Withdrawal symptoms.
  5. Neglect of other interest in favor of substance consumption.
  6. Continuing substance consumption despite proof of distinctively harmful consequences.

Weiterführende Literatur:

ICD-10 Online Version

Rumpf, H.-J. / Mann, F. (2017): Die Verhaltenssüchte in der ICD-11: Ein Update. In: Sucht 63 (6), 305–306. Online Version (German)

Deutsche Schmerzgesellschaft e.V. (2019): Diagnostische Kriterien der Abhängigkeit von aus medizinischer Indikation verordneten Opioiden. Online Version (German)

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