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[从国际疾病分类第九版(ICD - 9)过渡到国际疾病分类第十版(ICD - 10)过程中功能性精神病的诊断变化]

[Diagnostic shifts of functional psychoses in the transition from ICD-9 to ICD-10].

作者信息

Jäger M, Bottlender R, Wegner U, Strauss A, Möller H J

机构信息

Psychiatrische Klinik, Ludwig-Maximilians-Universität, Nussbaumstrasse 7, 80336 München.

出版信息

Nervenarzt. 2003 May;74(5):420-7. doi: 10.1007/s00115-002-1298-z.

Abstract

In order to identify diagnostic changes caused by the transition from ICD-9 to ICD-10, in a sample of 218 first hospitalised patients from the years 1980 and 1981, ICD-9 diagnoses were compared with ICD-10 diagnoses. For this comparison, functional psychoses were classified into five main diagnostic groups. Results showed a decreased frequency of the diagnostic groups schizophrenia, schizoaffective psychoses, and paranoid psychoses and an increased frequency of the diagnostic groups acute psychoses and affective psychoses. With the exception of acute psychoses and schizoaffective psychoses, a high agreement between ICD-9 and ICD-10 diagnoses was found, and the Kappa value was 0.70. With regard to the homogeneity of psychopathological symptoms, ICD-10 diagnoses showed no improvement over ICD-9 diagnoses. Nevertheless, ICD-10 diagnoses have gained in predictive validity because schizophrenia was further narrowed to cases with a more unfavourable outcome.

摘要

为了确定从国际疾病分类第九版(ICD - 9)过渡到国际疾病分类第十版(ICD - 10)所引起的诊断变化,在1980年和1981年首次住院的218例患者样本中,对ICD - 9诊断与ICD - 10诊断进行了比较。对于此次比较,功能性精神病被分为五个主要诊断组。结果显示,精神分裂症、分裂情感性精神病和偏执性精神病诊断组的频率降低,而急性精神病和情感性精神病诊断组的频率增加。除急性精神病和分裂情感性精神病外,ICD - 9与ICD - 10诊断之间具有高度一致性,卡帕值为0.70。关于精神病理症状的同质性,ICD - 10诊断相对于ICD - 9诊断并无改善。然而,ICD - 10诊断在预测效度方面有所提高,因为精神分裂症被进一步限定为预后更差的病例。

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