Oe Misari, Ito Masaya, Takebayashi Yoshitake, Katayanagi Akiko, Horikoshi Masaru
Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Japan.
National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, Tokyo, Japan.
Eur J Psychotraumatol. 2020 May 19;11(1):1753938. doi: 10.1080/20008198.2020.1753938. eCollection 2020.
: The diagnostic criteria for posttraumatic stress disorder (PTSD) differ between DSM-5 and ICD-11, which may affect the estimation of prevalence. : To investigate the concordance of ICD-11 and DSM-5, as compared to ICD-10 and DSM-IV, regarding PTSD caseness among Japanese people who had experienced different potentially traumatic events. In addition, we estimated the comorbidity with major depressive disorder and generalized anxiety disorder according to these four diagnostic manuals. : A web-based survey ( = 6,180) was conducted from November 2016 to March 2017. Participants completed the PTSD Checklist for DSM-5, and other standardized measures of PTSD, depression, and anxiety. : The prevalence of PTSD caseness according to ICD-11 was significantly lower as compared to DSM-IV, DSM-5, and ICD-10. Cohen's kappa between DSM-5 and ICD-11 was 0.79, indicating substantial agreement. Comorbidity with depression was significantly higher in unique DSM-5 cases than in unique ICD-11 cases. Unique DSM-5 PTSD cases were significantly stronger functionally impaired than unique ICD-11 PTSD cases. : Although requiring fewer items, the ICD-11 showed substantial agreement with DSM-5 regarding PTSD caseness. The lower comorbidity rates in unique cases may support the concept of the ICD-11 which intends to reduce comorbidity by identifying the core elements of PTSD.
创伤后应激障碍(PTSD)的诊断标准在《精神疾病诊断与统计手册》第五版(DSM - 5)和《国际疾病分类》第11版(ICD - 11)中有所不同,这可能会影响患病率的估计。为了调查ICD - 11与DSM - 5相比,与ICD - 10和DSM - Ⅳ相比,在经历不同潜在创伤事件的日本人中PTSD病例的一致性。此外,我们根据这四本诊断手册估计了与重度抑郁症和广泛性焦虑症的共病情况。2016年11月至2017年3月进行了一项基于网络的调查(n = 6180)。参与者完成了DSM - 5的PTSD检查表以及其他PTSD、抑郁和焦虑的标准化测量。与DSM - Ⅳ、DSM - 5和ICD - 10相比,根据ICD - 11诊断的PTSD病例患病率显著更低。DSM - 5和ICD - 11之间的科恩kappa系数为0.79,表明一致性较高。在仅符合DSM - 5标准的病例中,与抑郁症的共病率显著高于仅符合ICD - 11标准的病例。仅符合DSM - 5标准的PTSD病例在功能损害方面比仅符合ICD - 11标准的PTSD病例显著更严重。尽管所需项目较少,但ICD - 11在PTSD病例方面与DSM - 5显示出较高的一致性。仅符合单一标准病例中较低的共病率可能支持ICD - 11通过识别PTSD核心要素来降低共病率的概念。