Bryant K J, Rounsaville B, Spitzer R L, Williams J B
Department of Psychiatry, Yale University, New Haven, Connecticut 06519.
J Nerv Ment Dis. 1992 Apr;180(4):251-7. doi: 10.1097/00005053-199204000-00007.
The Structured Clinical Interview for DSM-III-R was used to examine the effects of the co-occurrence of psychiatric and substance dependence disorders on diagnostic reliability. The test-retest reliability over a 1-week period was studied in groups of: a) individuals with current substance abuse diagnoses (N = 97), b) individuals with past, but not current, drug histories (N = 146), and c) individuals without substance abuse diagnoses (N = 356; primarily psychiatric patients). A measurement of reliability (Kappa coefficients) was estimated for four general psychiatric categories (psychotic, mood, anxiety, and eating disorders), along with specific most-frequent diagnoses in each category (schizophrenia, major depression, panic disorders, and bulimia nervosa, respectively). Past use and non-drug-use groups were similar in their generally reliable reporting of current and past psychiatric disorders. However, current mood and psychotic disorders were less reliably diagnosed in the group with current substance use disorders.
使用《精神疾病诊断与统计手册》第三版修订本（DSM-III-R）的结构化临床访谈来检验精神疾病与物质依赖障碍共病对诊断可靠性的影响。在以下几组人群中研究了为期1周的重测信度：a）目前有物质滥用诊断的个体（N = 97），b）有既往但非目前药物使用史的个体（N = 146），以及c）无物质滥用诊断的个体（N = 356；主要为精神科患者）。针对四个一般精神科类别（精神病性、心境、焦虑和进食障碍）以及每个类别中最常见的特定诊断（分别为精神分裂症、重度抑郁症、惊恐障碍和神经性贪食症）估计了信度测量值（卡帕系数）。既往使用药物组和非药物使用组在对当前和既往精神疾病的总体可靠报告方面相似。然而，在目前患有物质使用障碍的组中，当前心境和精神病性障碍的诊断可靠性较低。
