Zayas Luis H, Torres Luis R, Cabassa Leopoldo J
Washington University in St. Louis, Campus Box 1196, One Brookings Drive, St. Louis, MO 63130-4899, USA.
Community Ment Health J. 2009 Apr;45(2):97-105. doi: 10.1007/s10597-008-9156-5. Epub 2008 Jul 22.
With increased US Hispanic diversity come diagnostic challenges associated with culture, language, and expression of mental disorders. In a community-based clinic, we compared diagnostic agreement between Hispanic and non-Hispanic clinicians, and a structured diagnostic instrument, in live and videotaped interviews with Hispanic adults. Percentage agreement and kappas show low diagnostic reliability between clinicians, and between clinicians and instrument. Significant differences appeared in rates of various diagnoses. Non-Hispanic clinicians rated patients' functional capacity and symptom-severity as significantly worse than Hispanic clinicians. Findings match past research with Hispanic patients and raise questions about diagnostic reliability in multi-cultural community mental health practice.
随着美国西班牙裔人口多样性的增加，出现了与精神障碍的文化、语言和表达方式相关的诊断挑战。在一个社区诊所中，我们比较了西班牙裔和非西班牙裔临床医生之间以及一种结构化诊断工具在对西班牙裔成年人进行现场和录像访谈时的诊断一致性。一致性百分比和卡帕值显示临床医生之间以及临床医生与工具之间的诊断可靠性较低。各种诊断的发生率存在显著差异。非西班牙裔临床医生对患者功能能力和症状严重程度的评分明显低于西班牙裔临床医生。研究结果与过去对西班牙裔患者的研究相符，并对多元文化社区心理健康实践中的诊断可靠性提出了质疑。
