瑞典国家患者登记处人格障碍诊断的有效性。

Validity of the personality disorder diagnosis in the Swedish National Patient Register.

机构信息

Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden.

出版信息

Acta Psychiatr Scand. 2020 May;141(5):432-438. doi: 10.1111/acps.13166. Epub 2020 Mar 20.

DOI:10.1111/acps.13166

PMID:32092153

Abstract

AIMS

The Swedish National Patient Register (NPR) is an exceptional source of information in clinical epidemiological research. The register is, however, not validated for the diagnosis of personality disorder (PD). We therefore assessed its validity in this patient group, and the group with emotionally unstable PD (EUPD)/borderline personality disorder (BPD).

METHODS

Records from 100 random adult patients (aged 15-65 years) diagnosed with any PD in the NPR between 1987 and 2015 were analysed using a protocol based on general diagnostic criteria for PD, as well as specific criteria for EUPD/BPD in both ICD and DSM classification systems.

RESULTS

Of the 100 patients, 27 had been given a diagnosis of EUPD, 23 another specific PD and 50 an unspecified PD. Using ICD criteria, 88 of 95 evaluable patients could be confirmed to have a PD, that is an agreement rate of 93%. Using DSM criteria, the agreement was lower (77 patients or 81%). Of 26 evaluable patients with a diagnosis of EUPD/BPD, the diagnosis was confirmed in all cases when using the ICD criteria, but in only 20 when using the DSM criteria.

CONCLUSIONS

The NPR is a valid source of data for the diagnosis of PD per se and also of EUPD in women.

摘要

目的

瑞典全国患者登记处（NPR）是临床流行病学研究中一种极好的信息来源。然而，该登记处并未针对人格障碍（PD）的诊断进行验证。因此，我们在此患者群体以及情绪不稳定 PD（EUPD）/边缘型人格障碍（BPD）群体中评估了其有效性。

方法

根据 PD 的一般诊断标准以及 ICD 和 DSM 分类系统中 EUPD/BPD 的特定标准，分析了在 1987 年至 2015 年期间在 NPR 中被诊断为任何 PD 的 100 名随机成年患者（年龄 15-65 岁）的记录。

结果

在 100 名患者中，27 名被诊断为 EUPD，23 名被诊断为另一种特定 PD，50 名被诊断为未特指 PD。使用 ICD 标准，95 名可评估患者中有 88 名可以被确认患有 PD，即一致性率为 93%。使用 DSM 标准，一致性较低（77 名患者或 81%）。在 26 名可评估的 EUPD/BPD 患者中，使用 ICD 标准可在所有情况下确认诊断，但使用 DSM 标准仅可在 20 名患者中确认诊断。