Herron W G, Schultz C L, Welt A G
Psychology Dept., St. John's University, Brooklyn, NY 11439.
J Clin Psychol. 1992 Nov;48(6):711-21.
Sixteen diagnostic classification systems were compared to determine the degree of agreement on the diagnosis of schizophrenia. Data were collected by a structured interview method with 284 patients, 52 first admissions, and 196 readmissions. The kappa coefficient was used to calculate interrater reliability and concordance of the systems. Adequate reliability was found for 12 of the systems. However, concordance was generally low; 11 of 120 combinations reached kappa of .40 or higher for the total sample, 16 of 120 for first admissions, and only 6 of 120 for readmissions. These results indicate the restriction of generalization and raise questions as to the empirical validity of the construct of schizophrenia.
比较了16种诊断分类系统，以确定在精神分裂症诊断上的一致程度。通过结构化访谈方法收集了284名患者的数据，其中52名是首次入院患者，196名是再次入院患者。kappa系数用于计算各系统之间的评分者信度和一致性。发现12种系统具有足够的信度。然而，一致性普遍较低；对于总样本，120种组合中有11种达到kappa值为0.40或更高，首次入院患者中120种组合里有16种达到，再次入院患者中120种组合里只有6种达到。这些结果表明了普遍性的限制，并对精神分裂症概念的实证有效性提出了疑问。
