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针对智障患者的情绪与焦虑半结构式访谈(MASS)的验证

Validation of the mood and anxiety semi-structured (MASS) interview for patients with intellectual disabilities.

作者信息

Charlot L, Deutsch C, Hunt A, Fletcher K, McLlvane W

机构信息

Department of Psychiatry, University of Massachusetts Medical School (UMMS), Worcester, MA 01655, USA.

出版信息

J Intellect Disabil Res. 2007 Oct;51(Pt 10):821-34. doi: 10.1111/j.1365-2788.2007.00972.x.

Abstract

BACKGROUND

When assessing people with intellectual disabilities (ID), using the DSM-IV-TR can be challenging. Frequently, significant clinical data must be obtained from interviews with key informants. A new semi-structured interview tool was developed including behavioural descriptions of each DSM-IV-TR symptom criterion for a number of mood and anxiety disorders. A goal was to provide mental health clinicians with an instrument easy to use in clinical practice that would increase reliable identification of diagnostically important mood and anxiety symptoms. This is especially important given the fact that many experts believe these 'internalizing' clinical syndromes may often be missed in this population, because of characteristic limitations in expressive language skills.

METHOD

To establish validity, the Mood and Anxiety Semi-structured (MASS) Interview-derived diagnoses were compared with clinical DSM-IV diagnoses derived from an extensive inpatient evaluation and classifications based on the Hamilton Depression Rating Scale for 93 psychiatric inpatients served on a specialized unit for people with ID and major mental health disorders.

RESULTS

Agreement with the MASS Interview was high yielding significant kappa coefficients ranging from 0.42 to 0.78.

CONCLUSIONS

The MASS Interview, a semi-structured interview containing behavioural descriptions of DSM-IV symptom criteria, shows promise as a potentially helpful tool in the psychiatric diagnostic evaluation of persons with ID and limited expressive language skills, in the detection of mood and anxiety disorders. The tool also yields a wide breadth of clinical information and is easy for mental health clinicians to use.

摘要

背景

在评估智力障碍(ID)患者时,使用《精神疾病诊断与统计手册》第四版修订版(DSM-IV-TR)可能具有挑战性。通常,必须通过与关键信息提供者的访谈来获取重要的临床数据。开发了一种新的半结构化访谈工具,其中包括针对多种情绪和焦虑障碍的每个DSM-IV-TR症状标准的行为描述。目标是为心理健康临床医生提供一种在临床实践中易于使用的工具,以提高对具有诊断重要性的情绪和焦虑症状的可靠识别。鉴于许多专家认为,由于表达语言技能的特征性限制,这些“内化”临床综合征在该人群中可能经常被漏诊,这一点尤为重要。

方法

为了确定效度,将基于情绪和焦虑半结构化(MASS)访谈得出的诊断结果与基于对93名在专门为患有ID和严重精神健康障碍的患者设立的科室住院的精神科患者进行的广泛住院评估以及基于汉密尔顿抑郁量表得出的临床DSM-IV诊断结果进行比较。

结果

与MASS访谈的一致性很高,kappa系数在0.42至0.78之间,具有统计学意义。

结论

MASS访谈是一种包含DSM-IV症状标准行为描述的半结构化访谈,在对ID患者和表达语言技能有限的患者进行精神科诊断评估、检测情绪和焦虑障碍方面显示出有望成为一种潜在有用的工具。该工具还能产生广泛的临床信息,并且心理健康临床医生易于使用。

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