健康问题与疾病定量测试法逻辑判别系统对精神分裂症的再诊断

Valiadtion of the Rating Test for Health and Disease and its logical verdict system for patients with schizophrenia.

目的探讨健康问题与疾病定量测试法逻辑判别系统(RTHD-LVS)对偏执型和未定型精神分裂症的再诊断及其效度。方法对临床符合中国精神障碍分类与诊断标准第三版(CCMD-3)诊断为精神分裂症偏执型和未定型的患者106例运用RTHD进行半定式评估,然后将数据输入RTHD-LVS数据库,再运用RTHD-LVS科研版和临床版对这些病例进行再诊断。以临床诊断作为金标准,比较两种版本诊断与临床诊断的符合率、两种版本对精神分裂症亚型的诊断与临床诊断的一致性以及两种版本之间诊断的一致性。结果①RTHD-LVS科研版轴1诊断为精神分裂症的患者99例,与临床诊断符合率为94.3%。RTHD-LVS临床版轴1诊断为精神分裂症偏执型和未定型两种亚型的诊断符合率为94.3%。②RTHD-LVS两种版本之间对于精神分裂症偏执型和未定型两种亚型的诊断一致性均较好(Kappa值分别为0.83和0.92)。③两种版本对精神分裂症未定型及偏执型的诊断与临床诊断的一致性较差(Kappa值为0.29-0.61)。结论能够满足于临床需要,可应用于临床。

Objective To validat the Rating Test for Health and Disease and its logical verdict system （RTHD-LVS）as an diagnostic instrument for assessing the patients with schizophrenia. Methods A total of 106 patients who met CCMD-3 criteria of paranoid or undifferentiated schizophrenia were assessed by using RTHD,and then were redlagnosed by RTHD-LVS. The logical diagnoses of research version（RV） and clinical version（CV） were compared. Results The number of patients had the RV Axis 1 diagnosis of schizophrenia was 99（93.4%） ,and the number of patients had the CV Axis 1 diagnosis of schizophrenia was 100（94.3%）. As to paranoid schizophrenia,KAPPA for the RV Axis 1 diagnosis and that of CV was 0.83. As to undifferentiated schizophrenia Kappa for RV and CV was 0. 92,Kappa for RV Axis 1 diagnosis or CV of Axis 1 diagnosis and that of clinical diagnosis were 0. 92-0. 61. Conclusion RTHD-LVS is a valid and reliable tool to evaluate the patients with schizophrenia. The logical diagnoses of both versions are consistent with the clinical diagnoses