摘要
目的对比研究计算机诊断系统复合性国际诊断交谈检查核心本(CIDIC)/国际疾病分类第10版(ICD10)、CIDIC/美国精神障碍诊断统计手册第3版修订本(DSMⅢR)、神经精神病学临床评定表(SCAN)/ICD10、SCAN/DSMⅢR对精神分裂症、心境(情感)障碍、神经症诊断的信度效度。方法培训5个单位研究者对其单位中符合中国精神疾病分类方案与诊断标准第2版(CCMD2)标准的三类患者按入院和门诊次序顺序进行CIDIC和SCAN测试,计精神分裂症156例、心境障碍50例、神经症30例。应用世界卫生组织提供的计算机诊断系统做出诊断;以CCMD2的诊断为金标准,比较它们的信度效度。结果心境障碍CIDIC/ICD10、CIDIC/DSMⅢR、SCAN/ICD10、SCAN/DSMⅢR诊断的信度分别为98.0%,98.0%,100.0%和64.0%,效度Kappa值分别为0.8,0.8,0.8和0.6;精神分裂症诊断的信度分别为85.3%,55.1%,93.0%和57.7%;效度Kappa值分别为0.8,0.5,0.9和0.5;神经症诊断的信度分别为36.6%,36.6%,?
Objective This study compared the reliability and the validity of Composite International Diagnostic InterviewCore Version (CIDIC)/The 10th Edition of International Classification of Diseases (ICD10), CIDIC/ The 3rd Edition Diagnostic and Statistical of Manual of Mental Disorder, Revised Edition (DSMⅢR), Schedules for clinical Assessment in Neuropsychiatry (SCAN)/ICD10 and SCAN/DSMⅢR for mental disorders. Methods Well trained raters from 5 centers interviewed 236 psychiatric patients who had consecutively admitted and met Chinese Classification and Diagnostic Criteria for Mental Disorders, the Second Revised Edition (CCMD2) for schizophrenia (156 cases), mood disorders (50 cases) and neuroses (30 cases) with CIDIC and SCAN. The diagnoses were made by the computer diagnostic system of CIDIC/ICD10、CIDIC/DSMⅢR、SCAN/ICD10 and SCAN/DSMⅢR supplied by World Health Organization (WHO), the reliability and validity were compared with CCMD2, which was used as a gold standard. Results It was found that the reliability of CIDIC/ICD10, CIDIC/DSMⅢR, SCAN/ICD10 and SCAN/DSMⅢR for mood disorders were 98.0%, 98.0%, 100.0% and 64.0% respectively, for schizophrenia were 85.3%, 55.1%, 93.0% and 57.7%. However, for neuroses were only 36.6%, 36.6%, 53.3% and 46.6%. The kappa values of the validity for mood disorders were 0.8, 0.8, 0.8 and 0.6, for schizophrenia were 0.8, 0.5, 0.9 and 0.5, and for neuroses were 0.5, 0.5, 0.7 and 0.6. Conclusion The results suggest that the reliability and validity of above four diagnostic systems for mood disorders were better than that for schizophrenia, and neuroses. The reliability and validity of SCAN/ICD10 for schizophrenia, mood disorders and neuroses were higher than those of CIDIC/IC D10, CIDIC/DSMⅢR and SCAN/DSMⅢR. SCAN/ICD10 diagnostic system should be more useful in China.
出处
《中华精神科杂志》
CSCD
1998年第3期169-171,共3页
Chinese Journal of Psychiatry
关键词
精神障碍
诊断
计算机辅助
对比研究
Mental disorders
Diagnosis
computerassisted
Comparative study