Department of Neuroscience, Psychiatry, Uppsala University Hospital, Uppsala, Sweden.
J Psychiatr Ment Health Nurs. 2013 Nov;20(9):768-75. doi: 10.1111/jpm.12009. Epub 2013 Apr 29.
The aim of this study was to further explore the properties of axis IV in the Diagnostic and statistical manual of mental disorders, 4th edition (DSM-IV). In a naturalistic cross-sectional design, a group (n = 163) of young (18-25 years old) Swedish psychiatric outpatients was assessed according to DSM-IV. Psychosocial and environmental problems/axis IV were evaluated through structured interviewing by a social worker and by self-assessment on a questionnaire. Reliability between professional assessment and self-assessment of axis IV was examined. Concurrent validity of axis IV was also examined. Reliability between professional and self-assessed axis IV was fair to almost perfect, 0.31-0.83, according to prevalence and bias-adjusted kappa. Categories of psychosocial stress and environmental problems were related to the presence of axis I disorders, co-morbidity, personality disorders and decreasing Global Assessment of Functioning (GAF) values. The revised axis IV according to DSM-IV seems to have concurrent validity, but is still hampered by limited reliability.
本研究旨在进一步探讨《精神障碍诊断与统计手册》第 4 版（DSM-IV）中轴 IV 的特性。在自然的横断研究设计中，对一组（n=163）年轻（18-25 岁）的瑞典精神科门诊患者进行评估，评估依据为 DSM-IV。通过社会工作者的结构化访谈和患者在问卷上的自我评估来评估社会心理和环境问题/轴 IV。检验了专业评估与自我评估轴 IV 的可靠性。同时也检验了轴 IV 的相关性。根据流行度和偏倚校正的 kappa，专业评估和自我评估轴 IV 的可靠性为 0.31-0.83，属于一般到极好。社会心理压力和环境问题的类别与轴 I 障碍的存在、共病、人格障碍和整体功能评估（GAF）值下降有关。根据 DSM-IV 修订的轴 IV 似乎具有相关性，但仍受到可靠性有限的困扰。
