Skovgaard A M, Isager T, Jørgensen O S
Department of Child Psychiatry, Rigshospitalet, Copenhagen, Denmark.
Acta Psychiatr Scand. 1988 Apr;77(4):469-76. doi: 10.1111/j.1600-0447.1988.tb05153.x.
The study was conducted to compare an experimental multiaxial diagnostic system (MAS) with traditional multicategorical diagnoses in child psychiatric work. Sixteen written case histories were circulated to 21 child psychiatrists, who made diagnoses independently of one another, using two different diagnostic systems. Diagnostic reliability was measured as percentage of interrater agreement. The highest diagnostic reliability was obtained in psychotic disorders, the lowest in personality disorders. The MAS implied improved diagnostic reliability of mental retardation, somatic disorders and developmental disorders. Adjustment reaction (reactio maladaptiva) was the diagnosis most commonly used, but with varying reliability in both systems. The reliability of the socio-economic and psychosocial axes were generally high.
本研究旨在比较一种实验性多轴诊断系统（MAS）与儿童精神病学工作中传统的多分类诊断方法。16份书面病例记录分发给21名儿童精神科医生，他们使用两种不同的诊断系统彼此独立地做出诊断。诊断可靠性以评分者间一致性百分比来衡量。在精神障碍中诊断可靠性最高，在人格障碍中最低。MAS意味着智力发育迟缓、躯体障碍和发育障碍的诊断可靠性有所提高。适应性反应（反应性适应不良）是最常用的诊断，但在两种系统中可靠性各不相同。社会经济和心理社会轴的可靠性总体较高。
