Smirnova D A, Petrova N N, Pavlichenko A V, Martynikhin I A, Dorofeikova M V, Eremkin V I, Izmailova O V, Osadshiy Yu Yu, Romanov D V, Ubeikon D A, Fedotov I A, Sheifer M S, Shustov A D, Yashikhina A A, Clark M, Badcock J, Watterreus A, Morgan V, Jablensky A
Centre for Clinical Research in Neuropsychiatry, University of Western Australia, Perth, Avstralia; Samara State Medical University, Samara, Russia.
St. Petersburg State University, St. Peterburg, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2018;118(1):50-60. doi: 10.17116/jnevro20181181150-60.
The Diagnostic Interview for Psychoses (DIP) was developed to enhance the quality of diagnostic assessment of psychotic disorders. The aim of the study was the adaptation of the Russian language version and evaluation of its validity and reliability.
Ninety-eight patients with psychotic disorders (89 video recordings) were assessed by 12 interviewers using the Russian version of DIP at 7 clinical sites (in 6 cities of the Russian Federation). DIP ratings on 32 cases of a randomized case sample were made by 9 interviewers and the inter-rater reliability was compared with the researchers' DIP ratings. Overall pairwise agreement and Cohen's kappa were calculated. Diagnostic validity was evaluated on the basis of comparing the researchers' ratings using the Russian version of DIP with the 'gold standard' ratings of the same 62 clinical cases from the Western Australia Family Study Schizophrenia (WAFSS).
The mean duration of the interview was 47±21 minutes. The Kappa statistic demonstrated a significant or almost perfect level of agreement on the majority of DIP items (84.54%) and a significant agreement for the ICD-10 diagnoses generated by the DIP computer diagnostic algorithm (κ=0.68; 95% CI 0.53,0.93). The level of agreement on the researchers' diagnoses was considerably lower (κ=0.31; 95% CI 0.06,0.56). The agreement on affective and positive psychotic symptoms was significantly higher than agreement on negative symptoms (F(2,44)=20.72, p<0.001, η2=0.485). The diagnostic validity of the Russian language version of DIP was confirmed by 73% (45/62) of the Russian DIP diagnoses matching the original WAFSS diagnoses. Among the mismatched diagnoses were 80 cases with a diagnosis of F20 Schizophrenia in the medical documentation compared to the researchers' F20 diagnoses in only 68 patients and in 62 of the DIP computerized diagnostic outputs. The reported level of subjective difficulties experienced when using the DIP was low to moderate.
The results of the study confirm the validity and reliability of the Russian version of the DIP for evaluating psychotic disorders. DIP can be recommended for use in education and training, clinical practice and research as an important diagnostic resource.
开发精神病诊断访谈(DIP)以提高精神病性障碍诊断评估的质量。本研究的目的是改编俄语版并评估其有效性和可靠性。
12名访谈者在俄罗斯联邦6个城市的7个临床地点,使用俄语版DIP对98例精神病性障碍患者(89份视频记录)进行评估。9名访谈者对随机病例样本中的32例进行DIP评分,并将评分者间信度与研究人员的DIP评分进行比较。计算总体两两一致性和科恩kappa系数。通过将研究人员使用俄语版DIP的评分与西澳大利亚家庭研究精神分裂症(WAFSS)中相同62例临床病例的“金标准”评分进行比较,评估诊断有效性。
访谈的平均时长为47±21分钟。kappa统计量显示,大多数DIP项目(84.54%)的一致性达到显著或几乎完美水平,DIP计算机诊断算法生成的ICD - 10诊断具有显著一致性(κ = 0.68;95% CI 0.53,0.93)。研究人员诊断的一致性水平低得多(κ = 0.31;95% CI 0.06,0.56)。情感性和阳性精神病性症状的一致性显著高于阴性症状(F(2,44)=20.72,p<0.001,η2 = 0.485)。俄语版DIP的诊断有效性通过73%(45/62)的俄语DIP诊断与原始WAFSS诊断匹配得到证实。在不匹配的诊断中,医疗记录中有80例诊断为F20精神分裂症,而研究人员的F20诊断仅68例,DIP计算机化诊断输出中为62例。报告使用DIP时主观困难程度为低到中度。
研究结果证实了俄语版DIP在评估精神病性障碍方面的有效性和可靠性。DIP可作为一种重要的诊断资源,推荐用于教育和培训、临床实践及研究。