Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, Mexico.
Universidad Nacional Autónoma de México, Ciudad de México, Mexico.
J Psychiatr Res. 2018 Jun;101:28-33. doi: 10.1016/j.jpsychires.2018.02.029. Epub 2018 Mar 1.
Changes to the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5) incorporate the inclusion or modification of six disorders: Autism Spectrum Disorder, Social Anxiety Disorder, Intermittent Explosive Disorder, Disruptive Mood Dysregulation Disorder, Avoidant/Restrictive Food Intake Disorder and Binge Eating Disorder. The objectives of this study were to assess the construct validity and parent-child agreement of these six disorders in the Spanish language Schedule for Affective Disorders and Schizophrenia for School Age Children Present and Lifetime Version (K-SADS-PL-5) in a clinical population of children and adolescents from Latin America. The Spanish version of the K-SADS-PL was modified to integrate changes made to the DSM-5. Clinicians received training in the K-SADS-PL-5 and 90% agreement between raters was obtained. A total of 80 patients were recruited in four different countries in Latin America. All items from each of the six disorders were included in a factor analysis. Parent-child agreement was calculated for every item of the six disorders, including the effect of sex and age. The factor analysis revealed 6 factors separately grouping the items defining each of the new or modified disorders, with Eigenvalues greater than 2. Very good parent-child agreements (r>0.8) were found for the large majority of the items (93%), even when considering the sex or age of the patient. This independent grouping of disorders suggests that the manner in which the disorders were included into the K-SADS-PL-5 reflects robustly the DSM-5 constructs and displayed a significant inter-informant reliability. These findings support the use of K-SADS-PL-5 as a clinical and research tool to evaluate these new or modified diagnoses.
《精神障碍诊断与统计手册》第五版(DSM-5)的修订纳入或修改了六种疾病:自闭症谱系障碍、社交焦虑障碍、间歇性爆发性障碍、心境恶劣障碍、回避/限制型食物摄入障碍和暴食障碍。本研究的目的是评估这些疾病在西班牙语版《儿童青少年情绪障碍和精神分裂症现患和终生定式访谈检查(K-SADS-PL-5)》中的结构效度和父母-孩子一致性,该研究纳入了拉丁美洲的临床儿童和青少年人群。对 K-SADS-PL 进行了西班牙语版本的修改,以纳入 DSM-5 的修订内容。临床医生接受了 K-SADS-PL-5 的培训,实现了 90%的评估者间一致性。共在拉丁美洲的四个国家招募了 80 名患者。每个疾病的所有项目都被纳入因子分析。对六种疾病的每一项均进行了父母-孩子一致性评估,包括性别和年龄的影响。因子分析结果显示,6 个因子可分别对每个新疾病或修改疾病的定义项目进行分组,特征值均大于 2。对于大多数项目(93%),包括考虑患者的性别或年龄时,均发现了很好的父母-孩子一致性(r>0.8)。这些疾病的独立分组表明,这些疾病被纳入 K-SADS-PL-5 的方式很好地反映了 DSM-5 的概念结构,显示出显著的信息提供者间可靠性。这些发现支持使用 K-SADS-PL-5 作为评估这些新诊断或修改诊断的临床和研究工具。