孤独症三种诊断标准的比较研究

A comparative study of three diagnostic criteria on 95 autism

目的探讨中国精神疾病分类方案与诊断标准第２版修订本（ＣＣＭＤ２Ｒ）、美国精神障碍诊断和统计手册第４版（ＤＳＭⅣ）和国际疾病分类第１０版（ＩＣＤ１０）３种诊断标准中孤独症的异同点。方法对临床诊断为孤独症的９５例患儿，分别用３种诊断标准再诊断。结果ＣＣＭＤ２Ｒ与临床诊断符合率为９０％（χ２＝７．１１，Ｐ＜０．０１），ＤＳＭⅣ、ＩＣＤ１０分别为９７％和９６％，与临床诊断的差异均无显著性（χ２Ｍ＝１．３３，χ２Ｍ＝２．２５；Ｐ＞０．０５）。ＣＣＭＤ２Ｒ与ＤＳＭⅣ、ＩＣＤ１０诊断符合率的一致程度不理想（Ｋ值分别为０．４８、０．５９）。结论有必要对ＣＣＭＤ２Ｒ中异常条目的项目标准进行修正。

Objective The design was to compare the diagnostic criteria of CCMD2R, DSMIV and ICD10 for childhood autism. Methods CCMD2R, DSMIV and ICD10 were used to rediagnose the 95 children who had been diagnosed as autism clinically. Results The accordance rate of diagnosis between CCMD2R and clinic was 90.5% (χ2=7.11, P<0.01). The accordance rate between CCMD2R and DSMIV or ICD10 was not high with K value of 0.48 and 0.59, respectively. Conclusion It is suggested that some items concerning autism in CCMD2R should be revised.