Department of Public Health, Nagoya City University Graduate School of Medicine, Nagoya, Japan; Department of Child and Adolescent Psychiatry, Kamibayashi Memorial Hospital, Ichinomiya, Japan.
Department of Child and Adolescent Psychiatry, Kamibayashi Memorial Hospital, Ichinomiya, Japan.
Compr Psychiatry. 2020 Jan;96:152148. doi: 10.1016/j.comppsych.2019.152148. Epub 2019 Nov 13.
The Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime version (K-SADS-PL) is a widely used semi-structured diagnostic interview in child and adolescent psychiatry. However, given the extensive use of the K-SADS-PL in clinical practice and research and its adaptation for use in many languages and cultures, validation studies of the instrument are scarce. This study was designed to examine the inter-rater reliability, criterion validity and construct validity of the updated instrument, the K-SADS-PL for DSM-5, in Japanese outpatients totaling 95 children and adolescents.
We translated and adapted the updated instrument into Japanese using a standard forward-backward translation procedure. Two of nine experienced clinicians independently made diagnoses using the interview for each patient in a conjoint session. Discrepancies in diagnosis between two clinicians were resolved by consensus, and the consensus diagnosis was compared with a "best-estimate" diagnosis made by five experienced clinicians using all available data sources for patients who were blinded to the diagnosis using the K-SADS-PL for DSM-5. The "best-estimate" diagnosis of ASD was also based on the Diagnostic Interview for Social and Communication Disorders.
The inter-rater reliability was very good, as shown by κ ≥ 0.8 for all disorders examined: autism spectrum disorder (ASD), attention-deficit hyperactivity disorder, tic disorders, selective mutism, enuresis and encopresis. The criterion validity was good, as shown by κ ≥ 0.6 for all disorders examined, except for ASD (κ = 0.59). This study also revealed good construct validity of the instrument by confirming the expected associations with each scale from the Social Responsiveness Scale-2nd edition and the Strengths and Difficulties Questionnaire.
These results suggest that the K-SADS-PL for DSM-5 generates valid diagnoses in child and adolescent psychiatry.
用于儿童和青少年精神病学的情感障碍和精神分裂症定式检查修订版（K-SADS-PL）是一种广泛使用的半结构化诊断访谈。然而，鉴于 K-SADS-PL 在临床实践和研究中的广泛应用，以及它在许多语言和文化中的适应性，该工具的验证研究很少。本研究旨在检验日本门诊 95 名儿童和青少年患者使用的经过更新的 K-SADS-PL for DSM-5 的评估者间信度、标准效度和构念效度。
我们使用标准的正向翻译和反向翻译程序将更新后的仪器翻译成日语。九位经验丰富的临床医生中的两位在联合会议上独立使用访谈对每位患者进行诊断。两位临床医生之间的诊断差异通过共识解决，共识诊断与五位经验丰富的临床医生使用所有患者的可用数据来源做出的“最佳估计”诊断进行比较，患者对使用 K-SADS-PL for DSM-5 的诊断是盲态的。ASD 的“最佳估计”诊断也基于《社交和沟通障碍诊断访谈》。
所有检查的疾病的评估者间信度均非常好，κ≥0.8，包括自闭症谱系障碍（ASD）、注意缺陷多动障碍、抽动障碍、选择性缄默症、遗尿症和遗粪症。除了 ASD（κ=0.59），所有检查的疾病的标准效度都很好，κ≥0.6。本研究还通过确认与第二版社交反应量表和困难强度问卷的每个量表的预期关联，证明了该工具具有良好的构念效度。
这些结果表明，K-SADS-PL for DSM-5 可以在儿童和青少年精神病学中产生有效的诊断。
