O'Boyle M, Self D
Dept. of Psychiatry and Behavioral Sciences, University of Texas Medical Branch, Galveston 77550-2777.
Psychiatry Res. 1990 Apr;32(1):85-92. doi: 10.1016/0165-1781(90)90138-u.
The study examined agreement between personality disorder diagnoses obtained using two structured interviews and the effect of depression on the diagnoses obtained. Twenty subjects were interviewed while depressed, using the Personality Disorder Examination and the Structured Clinical Interview for DSM-III-R Personality Disorder; both interviews are designed to yield DSM-III-R personality disorder diagnoses. Eighteen subjects were reinterviewed later, 17 after recovery. Diagnostic agreement between the two instruments for any disorder was fair (kappa = 0.38). Kappas for the personality disorder clusters ranged from 0.08 to 0.83. Kappas for individual personality disorders ranged from 0.18 for paranoid disorder to 0.62 for borderline disorder. While the depressive state did not consistently affect categorical diagnoses, dimensional scores tended to be higher when patients were depressed. A dimensional profile, in which scores on each disorder are generated for subjects, may be more reliable than categorical diagnoses derived from the same instrument.
该研究考察了使用两种结构化访谈得出的人格障碍诊断之间的一致性，以及抑郁对所获诊断结果的影响。对20名处于抑郁状态的受试者进行了访谈，采用的是《人格障碍检查》和《DSM-III-R人格障碍结构化临床访谈》；这两种访谈都旨在得出DSM-III-R人格障碍诊断结果。18名受试者随后接受了再次访谈，17名在康复后接受了访谈。两种工具对任何一种障碍的诊断一致性一般（kappa系数=0.38）。人格障碍类别的kappa系数范围为0.08至0.83。个体人格障碍的kappa系数范围从偏执型障碍的0.18到边缘型障碍的0.62。虽然抑郁状态并未始终如一地影响类别诊断，但患者处于抑郁状态时，维度分数往往更高。为受试者生成每种障碍分数的维度概况可能比源自同一工具的类别诊断更可靠。
