Svensson Elisabeth, Lash Timothy L, Resick Patricia A, Hansen Jens Georg, Gradus Jaimie L
Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark.
Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark ; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Clin Epidemiol. 2015 Mar 27;7:235-42. doi: 10.2147/CLEP.S80514. eCollection 2015.
To assess the validity of reaction to severe stress and adjustment disorder diagnoses registered in the Danish Psychiatric Central Research Register (DPCRR), to examine the documentation of stressful and traumatic events in the medical records, and to investigate the occurrence of stress diagnoses among persons not registered in the DPCRR.
Among 101,633 patients diagnosed with International Classification of Diseases, 10th Edition (ICD-10) F43 diagnoses between 1995 and 2011, we selected 50 patients from two hospitals (100 total), comprising one above and one below median age for each diagnosis for five time periods, and reviewed their medical records. We calculated the positive predictive value, comparing registration in the DPCRR with the original medical records, and captured data on stressful life events. Two general practitioners were queried about 50 patients without a stress diagnosis in the DPCRR, regarding whether they had ever received a stress diagnosis.
The positive predictive value was 58% for acute stress reaction, 83% for posttraumatic stress disorder, 94% for adjustment disorder, 71% for other reactions to severe stress, and 68% for reaction to severe stress, unspecified. In 80% of the records, a stressful or traumatic event was noted. Of 100 patients without an F43 diagnosis in the DPCRR, seven had a stress diagnosis.
The DPCRR represents a valid and comprehensive resource for research on reaction to severe stress and adjustment disorders, particularly for posttraumatic stress disorder and adjustment disorder.
评估丹麦精神病学中央研究登记册（DPCRR）中登记的严重应激反应和适应障碍诊断的有效性，检查病历中应激性和创伤性事件的记录，并调查未在DPCRR中登记的人群中应激诊断的发生情况。
在1995年至2011年期间被诊断为国际疾病分类第10版（ICD-10）F43诊断的101,633名患者中，我们从两家医院挑选了50名患者（共100名），在五个时间段内，每种诊断各选取一名年龄高于和低于中位数的患者，并查阅他们的病历。我们计算了阳性预测值，将DPCRR中的登记情况与原始病历进行比较，并收集有关应激性生活事件的数据。询问了两名全科医生，了解DPCRR中50名没有应激诊断的患者是否曾接受过应激诊断。
急性应激反应的阳性预测值为58%，创伤后应激障碍为83%，适应障碍为94%，其他严重应激反应为71%，未特定的严重应激反应为68%。在80%的病历中记录了应激性或创伤性事件。在DPCRR中没有F43诊断的100名患者中，有7名有应激诊断。
DPCRR是研究严重应激反应和适应障碍，特别是创伤后应激障碍和适应障碍的有效且全面的资源。
