Richieri Raphaëlle, Boyer Laurent, Lancon Christophe
Hopitaux de Marseille, Marseille.
Sante Publique. 2011 Nov-Dec;23 Suppl 6:S31-8.
The future development of mental health funding in France will be based primarily on administrative data and a diagnostic classification: ICD-10.
The objective of this study was to investigate the inter-rater reliability of diagnoses of schizophrenia, schizoaffective disorder, bipolar disorder and unipolar depression based on the ICD-10 classification. A cross-sectional study was conducted on all of the patients admitted to a public psychiatric hospital on the same day in January 2010. Cohen's kappa coefficient was used to estimate inter-rater reliability and diagnostic congruence between the treating psychiatrist and an independent psychiatrist using a standardized interview. In total, 112 patients participated in the study. 56.3% of participants were male and the mean age was 43.4 years (SD = 15.0). The proportion of discordant diagnoses ranged from 14.3% (schizophrenia and bipolar disorder) to 42.9% (schizophrenia and schizoaffective disorder). The coefficient of congruence was 0.48 for schizoaffective disorder, 0.56 for unipolar depression, 0.80 for schizophrenia and 0.90 for bipolar disorder. The reliability of schizoaffective disorder and unipolar depression diagnoses may seem limited. Further research on larger samples is needed to confirm the results of this study and to determine the impact of poor diagnostic reliability on future mental health funding in France.
法国心理健康资金的未来发展将主要基于行政数据和一种诊断分类：国际疾病分类第10版（ICD - 10）。
本研究的目的是基于ICD - 10分类调查精神分裂症、分裂情感性障碍、双相情感障碍和单相抑郁症诊断的评定者间信度。对2010年1月同一天入住一家公立精神病医院的所有患者进行了一项横断面研究。使用科恩kappa系数来估计治疗精神科医生与一名独立精神科医生之间通过标准化访谈得出的评定者间信度和诊断一致性。共有112名患者参与了该研究。56.3%的参与者为男性，平均年龄为43.4岁（标准差 = 15.0）。不一致诊断的比例从14.3%（精神分裂症和双相情感障碍）到42.9%（精神分裂症和分裂情感性障碍）不等。分裂情感性障碍的一致性系数为0.48，单相抑郁症为0.56，精神分裂症为0.80，双相情感障碍为0.90。分裂情感性障碍和单相抑郁症诊断的信度可能看起来有限。需要对更大样本进行进一步研究，以证实本研究的结果，并确定诊断信度不佳对法国未来心理健康资金的影响。
