Rey J M, Plapp J M, Stewart G W
Rivendell Adolescent Unit, Royal Prince Alfred Hospital, Concord, NSW, Australia.
J Child Psychol Psychiatry. 1989 Nov;30(6):879-88. doi: 10.1111/j.1469-7610.1989.tb00289.x.
The authors report a reliability study of the DSM-III diagnostic system in a series of 393 adolescent referrals diagnosed by two clinicians over a period of 3 years. Overall reliability (kappa) was 0.59. However, most of the frequently used diagnoses had reliabilities of 0.7 or higher. Dysthymic, Adjustment, Overanxious and Avoidant Disorders showed poor diagnostic agreement (kappa below 0.4). The patterns of agreement across this and other studies suggest that diagnostic criteria for Affective, Anxiety and Adjustment Disorders are in need of further improvement.
作者报告了一项对《精神疾病诊断与统计手册》第三版（DSM-III）诊断系统的信度研究，该研究涉及393名青少年转诊患者，由两名临床医生在3年时间内进行诊断。总体信度（kappa值）为0.59。然而，大多数常用诊断的信度为0.7或更高。恶劣心境障碍、适应性障碍、过度焦虑障碍和回避型障碍的诊断一致性较差（kappa值低于0.4）。本研究及其他研究的一致性模式表明，情感障碍、焦虑障碍和适应性障碍的诊断标准需要进一步改进。
