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[基于OPD-KJ的综合诊断对儿童和青少年精神科患者有哪些优势?]

[What are the advantages of a comprehensive diagnostic based on OPD-KJ in child and adolescent psychiatric patients?].

作者信息

Seiffge-Krenke Inge, Fliedl Rainer, Katzenschläger Petra

机构信息

Psychologisches Institut der Universität Mainz.

出版信息

Z Kinder Jugendpsychiatr Psychother. 2013 Mar;41(2):121-31; quiz 131-2. doi: 10.1024/1422-4917/a000219.

Abstract

OBJECTIVE

This paper presents the advantages of making comprehensive diagnoses with OPD-KJ in a child and adolescent psychiatric sample.

METHOD

In addition to the MAS and the ICD-10 diagnoses, three axes of the OPD-KJ, the conflict and structural axis as well the axis of treatment conditions, were assessed, in 61 inpatient child and adolescent psychiatric patients in Austria.

RESULTS

There are significant gender differences in the importance of internalized, developmentally inhibitive conflicts. However, the structural level was low to moderate in all patients. Structural capacities such as dealing with negative emotions, self and object differentiation, and contact could be maintained only with substantial help from outside. Older patients were more motivated to obtain treatment and show more insight. Of importance were also links between the conflict axis and the treatment conditions. Patients who have been classified as control vs. submissive showed less treatment motivation, reduced motivation to change, and more gains than did patients with other conflicts.

CONCLUSION

The study shows that, beyond the axis of treatment conditions, a comprehensive OPD-KJ diagnosis that gathered information from the assessment of the conflict and structural axis as well can provide useful information for treatment planning.

摘要

目的

本文阐述了在儿童和青少年精神科样本中使用OPD-KJ进行综合诊断的优势。

方法

除了MAS和ICD-10诊断外,对奥地利61名住院儿童和青少年精神科患者评估了OPD-KJ的三个轴,即冲突与结构轴以及治疗条件轴。

结果

内化的、发育抑制性冲突的重要性存在显著的性别差异。然而,所有患者的结构水平均为低到中等。诸如处理负面情绪、自我与客体分化以及接触等结构能力只有在外部大量帮助下才能维持。年龄较大的患者更有动力接受治疗且洞察力更强。冲突轴与治疗条件之间的联系也很重要。被归类为控制型与顺从型的患者与其他冲突类型的患者相比,治疗动机更低,改变动机减弱,且获益更多。

结论

研究表明,除治疗条件轴外,从冲突和结构轴评估中收集信息的全面OPD-KJ诊断也可为治疗计划提供有用信息。

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