Sachser Cedric, Goldbeck Lutz
Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany.
J Trauma Stress. 2016 Apr;29(2):120-3. doi: 10.1002/jts.22080. Epub 2016 Feb 24.
In 2013, a working group of the World Health Organization (WHO) proposed a reformulation of the posttraumatic stress disorder (PTSD) diagnostic criteria for the upcoming 11(th) edition of the International Classification of Diseases (ICD-11; Maercker, Brewin, Bryant, Cloitre, van Ommeren, et al., 2013). This study investigated the consequences of the proposed ICD-11 PTSD symptom reduction on the prevalence of PTSD in children and adolescents. Prevalence rates of PTSD in a clinical sample of 159 traumatized children and adolescents were compared applying criteria according to the 4(th) edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994), the ICD-10 (WHO, 1992), and the ICD-11. The prevalence rate was 76.1% using DSM-IV, 88.1% using ICD-10, and 61.0% using ICD-11. The use of the criteria proposed for ICD-11 resulted in 27.1% less positive cases compared with ICD-10 and 15.1% less positive cases compared with DSM-IV. Our results showed that in a clinical sample of children and adolescents the prevalence of PTSD was significantly affected by the use of different diagnostic systems. This will constitute a major challenge for research and practice because, depending on the algorithm used, different groups of patients will be included in studies and different groups of individuals will be able to access medical care and therapy.
2013年，世界卫生组织（WHO）的一个工作组针对即将出版的第11版《国际疾病分类》（ICD - 11；梅尔克、布鲁因、布赖恩特、克洛伊特、范·奥默伦等人，2013年）提议重新制定创伤后应激障碍（PTSD）的诊断标准。本研究调查了提议的ICD - 11 PTSD症状减少标准对儿童和青少年PTSD患病率的影响。应用《精神障碍诊断与统计手册》第4版（DSM - IV；美国精神病学协会，1994年）、ICD - 10（WHO，1992年）和ICD - 11的标准，比较了159名受创伤儿童和青少年临床样本中的PTSD患病率。使用DSM - IV时患病率为76.1%，使用ICD - 10时为88.1%，使用ICD - 11时为61.0%。与ICD - 10相比，使用提议的ICD - 11标准导致阳性病例减少27.1%，与DSM - IV相比减少15.1%。我们的结果表明，在儿童和青少年临床样本中，不同诊断系统的使用对PTSD患病率有显著影响。这将对研究和实践构成重大挑战，因为根据所使用的算法，不同的患者群体将被纳入研究，不同的个体群体将能够获得医疗护理和治疗。
