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评估 DSM-5 结构性临床访谈 (SCID) 在我国综合医院门诊躯体症状障碍中的应用。

Assessment of the structured clinical interview (SCID) for DSM-5 for somatic symptom disorder in general hospital outpatient clinics in China.

机构信息

Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.

Department of Psychosomatic Medicine and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg im Breisgau, Germany.

出版信息

BMC Psychiatry. 2021 Mar 10;21(1):144. doi: 10.1186/s12888-021-03126-0.

Abstract

BACKGROUND

It is still unknown whether the "Somatic symptom disorders (SSD) and related disorders" module of the Structured Clinical Interview for DSM-5, research version (SCID-5-RV), is valid in China. This study aimed to assess the SCID-5-RV for SSD in general hospital outpatient clinics in China.

METHODS

This multicentre cross-sectional study was conducted in the outpatient clinics of nine tertiary hospitals in Beijing, Jincheng, Shanghai, Wuhan, and Chengdu between May 2016 and March 2017. The "SSD and related disorders" module of the SCID-5-RV was translated, reversed-translated, revised, and used by trained clinical researchers to make a diagnosis of SSD. Several standardized questionnaires measuring somatic symptom severity, emotional distress, and quality of life were compared with the SCID-5-RV.

RESULTS

A total of 699 patients were recruited, and 236 were diagnosed with SSD. Of these patients, 46 had mild SSD, 78 had moderate SSD, 100 had severe SSD, and 12 were excluded due to incomplete data. The SCID-5-RV for SSD was highly correlated with somatic symptom severity, emotional distress, and quality of life (all P < 0.001) and could distinguish nonsevere forms of SSD from severe ones.

CONCLUSIONS

This study suggests that SCID-5-RV for SSD can distinguish SSD from non-SSD patients and severe cases from nonsevere cases. It has good discriminative validity and reflects the DSM-5 diagnostic approach that emphasizes excessive emotional, thinking, and behavioural responses related to symptoms.

摘要

背景

DSM-5 研究版结构临床访谈(SCID-5-RV)的“躯体症状障碍(SSD)及相关障碍”模块在中国是否有效仍不清楚。本研究旨在评估该模块在中国综合医院门诊中 SSD 的适用性。

方法

本多中心横断面研究于 2016 年 5 月至 2017 年 3 月在北京、晋城、上海、武汉和成都的 9 家三级医院的门诊进行。经过翻译、回译、修订,由经过培训的临床研究人员使用 SCID-5-RV 的“躯体症状障碍及相关障碍”模块进行 SSD 诊断。与 SCID-5-RV 比较的还有几种测量躯体症状严重程度、情绪困扰和生活质量的标准化问卷。

结果

共纳入 699 例患者,其中 236 例诊断为 SSD。这些患者中,46 例为轻度 SSD,78 例为中度 SSD,100 例为重度 SSD,12 例因数据不完整被排除。SCID-5-RV 对 SSD 的诊断与躯体症状严重程度、情绪困扰和生活质量高度相关(均 P<0.001),并能区分非重度和重度 SSD。

结论

本研究表明,SCID-5-RV 对 SSD 具有良好的鉴别效度,能区分 SSD 与非 SSD 患者,以及重度与非重度患者。它具有良好的区分效度,反映了 DSM-5 强调与症状相关的过度情绪、思维和行为反应的诊断方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d74/7944631/86d1b4534001/12888_2021_3126_Fig1_HTML.jpg

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