CCMD-3与DSM-Ⅳ儿童孤独症两种诊断标准的比较

A Comparative Study of Diagnostic Criteria of CCMD-3 and DSM-Ⅳ on Childhood Autism

目的:比较中国精神疾病分类方案与诊断标准第三版(CCMD-3)与美国精神障碍诊断和统计手册第四版(DSM-Ⅳ)儿童孤独症诊断的一致性,探讨CCMD-3儿童孤独症诊断中存在的问题,确定诊断标准中各症状条目的出现频率。方法:运用CCMD-3和DSM-Ⅳ儿童孤独症诊断标准对连续首次就诊的255名可疑发育障碍儿童进行诊断。结果:两种诊断系统儿童孤独症、不典型孤独症、非孤独症诊断的总体一致率为96.08%;诊断差异主要来自于儿童孤独症和不典型孤独症的诊断不一致;个别症状在孤独症儿童中出现频率较低。结论:CCMD-3和DSM-Ⅳ儿童孤独症诊断标准具有较好的诊断一致性;为进一步提高诊断一致性,对CCMD-3中个别症状条目予以调整有所必要。

Objective： Comparing the diagnostic criteria of CCMD - 3 and DSM - IV on childhood autism, finding problems in the diagnosis of childhood Autism with CCMD - 3 and ascertaining the emerging frequency of symptoms in both criteria. Methods： 255 children with suspected developmental disorder were diagnosed with criteria of CCMD -3 and DSM -Ⅳ on childhood autism. Results： The total accordance of diagnosis of both criteria on childhood autism, atypical autism and non-autism was 96.08% , the discrepancy mainly came from the diagnostic difference of both criteria on childhood autism and atypical childhood autism. The emerging frequency of some symptoms in both criteria was low. Conclusions ： The accordance of diagnosis of both criteria on childhood autism was well. Minority of items in criteria of CCMD - 3 on autism should be revised in order to improve the diagnostic accordance with DSM - Ⅳ.