采用定式检查套用CCMD-3与DSM-IV抑郁发作诊断标准的异同

Use of a Structured Questionnaire to Assess the Concordance of the Diagnosis of Depression Based on DSM-IV and the Chinese Classification of Mental Disorders(CCMD-3)

目的:在定式检查中考察CCMD-3与DSM-Ⅳ两个诊断系统在抑郁诊断上的异同。方法:由受过培训的精神科护士采用可以同时做出CCDM-3标准的抑郁发作与DSM-Ⅳ标准的重性抑郁发作诊断的定式抑郁评估量表,对分层、随机整群抽样的北京50家综合医院年龄≥15岁、病情允许且交流无明显困难的2877例顺序就诊的门诊病人和调查期间在院的2925例住院病人进行现况调查。结果:5802例就诊病人中,同时符合DSM-Ⅳ"重性抑郁发作"与CCMD-3"抑郁发作"标准的有181例,仅符合两个诊断之一的有20例,两个诊断系统在抑郁诊断上的Kappa值为0.946。结论:尽管两个诊断标准有所不同,但CCMD-3和DSM-Ⅳ两个诊断系统在抑郁诊断上的实际差异不大。

Objective： Assess the concordance of the diagnosis of depression using the American （DSM-Ⅳ） and Chinese （CCMD-3） diagnostic systems. Method： Trained psychiatric nurses administered a depressive symptom scale that simultaneously determined the presence of a depressive episode as defined by CCMD-3 and by DSM-Ⅳ to 2, 877 sequential outpatients and 2, 925 inpatients from 50 randomly selected general hospitals in Beijing who were 15 years of age or older, well enough to participate, and were able to communicate clearly. Results ： Among the 5, 802 participants, 181 simultaneously met CCMD-3 criteria for ＂depressive episode＂ and DSM-Ⅳ criteria for haajor depressive episode＇; only 20 cases met depressive criteria of only one of the diagnostic systems （ Kappa = 0. 946 ） . Conclusion： Despite differences in the diagnostic criteria, the actual difference of the depressive diagnosis for CCMD-3 and DSM-Ⅳ is slight.