Helzer J E, Spitznagel E L, McEvoy L
Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110.
Arch Gen Psychiatry. 1987 Dec;44(12):1069-77. doi: 10.1001/archpsyc.1987.01800240045007.
A clinical reexamination by psychiatrists is a useful comparison for exploring lay Diagnostic Interview Schedule-derived psychiatric diagnoses in general population surveys, but as a validity standard psychiatric reexamination is less than ideal. There are many potential sources of disagreement that have nothing to do with the validity of either the lay or the psychiatrist examination. Another approach to comparing lay and psychiatrist diagnoses is to examine their relative predictive power. We describe such a comparison using outcome variables derived from the one-year follow-up examination of Epidemiologic Catchment Area respondents done at the St. Louis site. We examine several outcome variables across nine diagnostic categories. Within the limits of the available data, lay and psychiatrist diagnoses appear to be essentially equal in terms of the number of outcomes better predicted and few of the differences in predictive power approach statistical significance. We discuss the implications of these findings for the analysis of lay interviewer Diagnostic Interview Schedule-derived diagnoses.
在一般人群调查中，精神科医生进行的临床复查是探索基于外行版诊断访谈表得出的精神疾病诊断的有益对照，但作为一种效度标准，精神科复查并不理想。存在许多可能导致分歧的来源，这与外行或精神科医生检查的效度均无关。比较外行和精神科医生诊断的另一种方法是检验它们的相对预测能力。我们使用从圣路易斯地区对流行病学集水区受访者进行的一年随访检查中得出的结果变量来描述这样一种比较。我们在九个诊断类别中检验了几个结果变量。在现有数据的范围内，就更好预测的结果数量而言，外行和精神科医生的诊断似乎基本相当，并且预测能力的差异很少接近统计学显著性。我们讨论了这些发现对分析基于外行访谈者诊断访谈表得出的诊断的意义。
