使用四种不同工具评估紧张症：评分者间信度及住院临床人群中的患病率。

Assessing catatonia using four different instruments: Inter-rater reliability and prevalence in inpatient clinical population.

作者信息

Sarkar Siddharth, Sakey Sreekanth, Mathan Kaliaperumal, Bharadwaj Balaji, Kattimani Shivanand, Rajkumar Ravi P

机构信息

Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India; Department of Psychiatry and National Drug Dependence Treatment Centre, All India Institute of Medical Sciences (AIIMS), New Delhi, India.

Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.

出版信息

Asian J Psychiatr. 2016 Oct;23:27-31. doi: 10.1016/j.ajp.2016.07.003. Epub 2016 Jul 11.

DOI:10.1016/j.ajp.2016.07.003

PMID:27969074

Abstract

BACKGROUND AND AIMS

The present study aimed to assess inter-rater reliability and prevalence of catatonia according to four diagnostic methods: Bush Francis Catatonia Rating Scale (BFCRS) both screening and complete scale, Braunig's Catatonia Rating Scale (CRS), ICD 10 and DSM5.

METHODS

For inter-rater reliability, different raters evaluated patients using the definitions provides by the four scales: BFCRS Screen and Total, CRS, ICD10 and DSM5. Kippendorff'α was used to compute the inter-rater reliability. Concordance between different systems was assessed using spearman correlation. Prevalence of catatonia was studied using the four definitions in a clinical sample of consecutive adult admissions in a psychiatry ward of a tertiary care hospital.

RESULTS

The inter-rater reliability was found to be good for BFCRS Total (α=0.779), moderate for DSM5 and BFCRS screen (α=0.575 and α=0.514 respectively) and low for CRS and ICD10 (α=0.111 and α=0.018 respectively). BFCRS Total and DSM5 definitions of catatonia had highest concordance (r=0.892 p<0.001). In the prevalence sample of consecutive hospital admissions, the prevalence was found to be highest with the definitions of BFCRS Screen and ICD 10 (10.3%, confidence intervals [CI] 3.9% to 16.7%), followed by BFCRS Total and DSM5 definitions 6.9%, CI 1.6% to 12.2%) and while CRS yielded the lowest prevalence rate (3.4%, CI 0% to 7.2%).

CONCLUSION

Different methods used to determine catatonia in the clinical sample yield different prevalence of this condition.

摘要

背景与目的

本研究旨在根据四种诊断方法评估评定者间信度及紧张症的患病率，这四种诊断方法分别为：布什-弗朗西斯紧张症评定量表（BFCRS）的筛查量表及完整量表、布劳尼希紧张症评定量表（CRS）、国际疾病分类第10版（ICD 10）和精神疾病诊断与统计手册第5版（DSM5）。

方法

为评估评定者间信度，不同评定者依据四种量表给出的定义对患者进行评估：BFCRS筛查量表及总量表、CRS、ICD10和DSM5。使用基彭多夫α系数计算评定者间信度。采用斯皮尔曼相关性评估不同系统之间的一致性。在一家三级护理医院精神科病房连续收治的成年患者临床样本中，使用这四种定义研究紧张症的患病率。

结果

发现评定者间信度对于BFCRS总量表良好（α=0.779），对于DSM5和BFCRS筛查量表中等（分别为α=0.575和α=0.514），对于CRS和ICD10较低（分别为α=0.111和α=0.018）。紧张症的BFCRS总量表定义与DSM5定义一致性最高（r=0.892，p<0.001）。在连续入院患者的患病率样本中，BFCRS筛查量表和ICD 10定义的患病率最高（10.3%，置信区间[CI] 3.9%至16.