Okasha A, Seif el Dawla A
Department of Neuropsychiatry, Ain Shams University, Cairo, Egypt.
Acta Psychiatr Scand. 1992 Dec;86(6):484-8. doi: 10.1111/j.1600-0447.1992.tb03302.x.
Within a broader World Health Organization (WHO) collaborative research around the ICD-10 diagnostic criteria for research, the Regional Office for the Eastern Mediterranean (EMRO) ICD-10 research coordinating center at the Ain Shams Institute of Psychiatry presented the data collected from 8 Arab centers, which investigated a total of 233 patients using the local psychiatric interview schedules and diagnosed according to ICD-10 criteria. Interrater reliability was found to range between an almost perfect (0.81-1) to substantial agreement (0.61-0.80) (using the kappa coefficient) in diagnosing organic mental disorders, substance use disorders, schizophrenic, schizotypal and delusional disorders, affective disorders and neurotic and stress-related disorders. The categories of psychological development and child and adolescent disorders were diagnosed less frequently and the agreement between raters was lower. Though no culture-bound syndromes were encountered in any of the centers, difficulties in diagnosis using the research criteria were identified in the domain of simple schizophrenia and dissociative versus conversion disorders. These difficulties are discussed in consideration of the experience of our psychiatrists.
在世界卫生组织（WHO）围绕国际疾病分类第十版（ICD - 10）研究诊断标准开展的一项更广泛的合作研究中，位于艾因夏姆斯精神病学研究所的东地中海区域办事处（EMRO）ICD - 10研究协调中心展示了从8个阿拉伯中心收集的数据。这些中心使用当地的精神病学访谈量表共对233名患者进行了调查，并根据ICD - 10标准进行诊断。在诊断器质性精神障碍、物质使用障碍、精神分裂症、分裂型及妄想性障碍、情感障碍以及神经症和与应激相关的障碍时，发现评定者间信度在几乎完美（0.81 - 1）到实质性一致（0.61 - 0.80）之间（使用kappa系数）。心理发展以及儿童和青少年障碍类别的诊断频率较低，评定者之间的一致性也较低。尽管在任何一个中心都未遇到文化相关综合征，但在单纯型精神分裂症以及分离性障碍与转换性障碍领域，使用研究标准进行诊断时发现了困难。结合我们精神科医生的经验对这些困难进行了讨论。
