Kessing Lars Vedel
Department of Psychiatry, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark.
Psychopathology. 2005 Jan-Feb;38(1):32-7. doi: 10.1159/000083968. Epub 2005 Feb 15.
The diagnostic stability of the ICD-10 diagnosis of depressive disorder has not been investigated in clinical practice.
All patients who were diagnosed with depressive disorder at least once in a period from 1994 to 2002 in psychiatric out- or inpatient settings in Denmark were identified in a nationwide register.
A total of 39,741 patients were diagnosed with depressive disorder at least once; among these, 81% were diagnosed at the first contact. In approximately 56% of patients, the initial diagnosis of depressive disorder eventually changed during follow-up mainly to the schizophrenic spectrum (16%), but also to personality disorders (9%), neurotic, stress-related and somatoform disorders (8%) and to bipolar disorder (8%). Among the 18% of patients who were later diagnosed with depressive disorder, 23% initially had a diagnosis of adjustment disorder.
When the ICD-10 diagnoses are used in clinical practice, the diagnosis of depressive disorder has a low stability over time. These findings emphasize the need for a longitudinally based diagnostic process in the diagnostic systems.
在临床实践中，国际疾病分类第十版（ICD - 10）对抑郁症的诊断稳定性尚未得到研究。
在丹麦全国范围内的登记系统中，识别出1994年至2002年期间在精神科门诊或住院部至少被诊断为抑郁症一次的所有患者。
共有39741名患者至少被诊断为抑郁症一次；其中，81%在首次就诊时被诊断。在大约56%的患者中，抑郁症的初始诊断在随访期间最终发生了变化，主要转变为精神分裂症谱系障碍（16%），但也有转变为人格障碍（9%）、神经症性、应激相关及躯体形式障碍（8%）和双相情感障碍（8%）的情况。在后来被诊断为抑郁症的18%的患者中，23%最初被诊断为适应障碍。
在临床实践中使用ICD - 10诊断时，抑郁症的诊断随时间推移稳定性较低。这些发现强调了诊断系统中基于纵向的诊断过程的必要性。
