Hanssen M S S, Bijl R V, Vollebergh W, van Os J
Department of Psychiatry and Neuropsychology, EURON, azM/Mondriaan/Riagg/Vijverdal Academic Centre, Maastricht University, Maastricht, The Netherlands.
Acta Psychiatr Scand. 2003 May;107(5):369-77. doi: 10.1034/j.1600-0447.2003.00058.x.
To examine the diagnostic value of self-reported psychotic-like experiences for DSM-III-R psychotic disorders.
A general population sample of 7076 subjects aged 18-64 years was interviewed with the Composite International Diagnostic Interview (CIDI) and, if there was evidence of psychotic experiences, the Structured Clinical Interview for DSM-III-R.
The probability of having a psychotic disorder increased in a dose-response fashion with the level of self-reported psychotic experiences, but individual CIDI psychotic experience ratings had relatively low post-test probabilities (PPs) (range: 5.1-26.5%). However, limiting the sample to individuals who had been in contact with mental health services substantially improved PPs (range: 13.3-43.1%).
Screening for psychosis in the population carries a high risk of stigmatization in false-positive cases and violation of the right 'not to know' in true-positive cases. However, in mental health care users, self-reported psychotic experiences may be a useful screening tool in individuals who have already developed help-seeking.
探讨自我报告的类精神病体验对DSM-III-R精神病性障碍的诊断价值。
采用复合国际诊断访谈（CIDI）对7076名年龄在18至64岁的普通人群样本进行访谈，若有精神病体验的证据，则采用DSM-III-R结构化临床访谈。
患精神病性障碍的概率随自我报告的精神病体验水平呈剂量反应方式增加，但个体CIDI精神病体验评分的检验后概率（PPs）相对较低（范围：5.1%-26.5%）。然而，将样本限制为曾接触过精神卫生服务的个体可显著提高PPs（范围：13.3%-43.1%）。
在普通人群中筛查精神病，假阳性病例存在较高的污名化风险，而真阳性病例则侵犯了“不知情”的权利。然而，在精神卫生服务使用者中，自我报告的精神病体验可能是已产生求助行为个体的一种有用筛查工具。
