Escola Paulista de Medicina, Universidade Federal de São Paulo, Brasil.
Cad Saude Publica. 2012 Jul;28(7):1312-8. doi: 10.1590/s0102-311x2012000700009.
The objective was to study the accuracy of the post-traumatic stress disorder (PTSD) section of the Composite International Diagnostic Interview (CIDI 2.1) DSM-IV diagnosis, using the Structured Clinical Interview (SCID) as gold standard, and compare the ICD-10 and DSM IV classifications for PTSD. The CIDI was applied by trained lay interviewers and the SCID by a psychologist. The subjects were selected from a community and an outpatient program. A total of 67 subjects completed both assessments. Kappa coefficients for the ICD-10 and the DSM IV compared to the SCID diagnosis were 0.67 and 0.46 respectively. Validity for the DSM IV diagnosis was: sensitivity (51.5%), specificity (94.1%), positive predictive value (9.5%), negative predictive value (66.7%), misclassification rate (26.9%). The CIDI 2.1 demonstrated low validity coefficients for the diagnosis of PTSD using DSM IV criteria when compared to the SCID. The main source of discordance in this study was found to be the high probability of false-negative cases with regards to distress and impairment as well as to avoidance symptoms.
目的在于研究创伤后应激障碍（PTSD）部分的复合国际诊断访谈（CIDI 2.1）DSM-IV 诊断的准确性，以结构临床访谈（SCID）为金标准，并比较 PTSD 的 ICD-10 和 DSM-IV 分类。CIDI 由经过培训的非专业访谈者进行，SCID 由心理学家进行。研究对象选自社区和门诊计划。共有 67 名受试者完成了这两项评估。ICD-10 和 DSM-IV 与 SCID 诊断的 Kappa 系数分别为 0.67 和 0.46。DSM-IV 诊断的有效性为：敏感性（51.5%），特异性（94.1%），阳性预测值（9.5%），阴性预测值（66.7%），误分类率（26.9%）。与 SCID 相比，CIDI 2.1 用 DSM-IV 标准诊断 PTSD 的有效性系数较低。在这项研究中，产生分歧的主要原因是，在痛苦和损伤以及回避症状方面，假阴性病例的可能性很高。
