Hasin D S, Grant B F
Columbia University, New York.
J Psychiatr Res. 1987;21(3):301-11. doi: 10.1016/0022-3956(87)90032-x.
The DIS and the SADS-L diagnostic procedures occupy an important position in psychiatric research. We compared these procedures for assessing depressive disorders in patients with substance abuse problems. The two instruments agreed poorly, and the SADS-L produced a considerably higher proportion of cases than the DIS. A number of factors were examined to determine their influence on the agreement obtained for Major Depression. These factors included (1) recency of the disorder, (2) the primary/secondary distinction, (3) clinical experience of the DIS interviewers, (4) numerous subject characteristics and (5) the DIS procedure for differentiating organic from non-organic affective symptomatology, which relies on subjects' attributions of the cause of symptoms. The first four factors did not influence agreement. However, removal of the influence of the fifth factor did increase agreement between the instruments appreciably. Validation evidence favored the SADS-L, although not definitively. Implications of the findings are discussed.
DIS和SADS-L诊断程序在精神病学研究中占据重要地位。我们比较了这些用于评估有药物滥用问题患者的抑郁症的程序。这两种工具的一致性较差，且SADS-L得出的病例比例比DIS高得多。我们研究了一些因素，以确定它们对重度抑郁症诊断一致性的影响。这些因素包括：（1）疾病的近期性；（2）原发性/继发性区分；（3）DIS访谈者的临床经验；（4）众多的受试者特征；以及（5）DIS区分器质性与非器质性情感症状的程序，该程序依赖于受试者对症状原因的归因。前四个因素不影响一致性。然而，消除第五个因素的影响确实显著提高了两种工具之间的一致性。验证证据支持SADS-L，尽管并不确凿。我们讨论了研究结果的意义。
