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两种诊断方法的比较。临床国际疾病分类(ICD)诊断与使用诊断访谈表(第2版)的《精神疾病诊断与统计手册》第三版(DSM-III)及研究诊断标准的比较。

A comparison of two diagnostic methods. Clinical ICD diagnoses vs DSM-III and Research Diagnostic Criteria using the Diagnostic Interview Schedule (version 2).

作者信息

Wittchen H U, Semler G, von Zerssen D

出版信息

Arch Gen Psychiatry. 1985 Jul;42(7):677-84. doi: 10.1001/archpsyc.1985.01790300045005.

Abstract

In the context of a seven-year follow-up study, 171 former psychiatric inpatients and 158 subjects from the general population were interviewed twice, first with the German version of the Diagnostic Interview Schedule (DIS) (version 2), and second with a clinical interview using the Arbeitsgemeinschaft für Methodik und Dokumentation in der Psychiatrie (AMDP) checklist to assign a clinical International Classification of Diseases (eighth revision) (ICD-8) diagnosis, independent of the DIS. With the clinicians' ICD-8 diagnosis as a measure of the quality of the DIS, the results indicate a sufficiently high overall specificity and sensitivity of the DIS as a case-finding instrument in a general population survey, and a surprisingly high concordance of most DIS diagnostic classes with comparable ICD diagnoses. Only for panic disorders (possibly due to different symptom and time criteria) and schizophrenia (possibly due to the strict probe system, the dependence on self-reports, and time criteria) was low sensitivity found. Because there is no DIS diagnostic category comparable with ICD-8 unipolar affective psychosis, a meaningful comparison of this ICD category with Research Diagnostic Criteria and DSM-III was not possible.

摘要

在一项为期七年的随访研究中,对171名曾住院治疗的精神疾病患者和158名普通人群进行了两次访谈。第一次使用德文版的诊断访谈表(DIS)(第2版),第二次采用临床访谈,使用精神病学方法与文献工作小组(AMDP)清单来确定临床国际疾病分类(第八版)(ICD - 8)诊断,该诊断独立于DIS。以临床医生的ICD - 8诊断作为衡量DIS质量的标准,结果表明,在普通人群调查中,DIS作为一种病例发现工具,总体特异性和敏感性足够高,并且大多数DIS诊断类别与可比的ICD诊断具有惊人的高一致性。仅在惊恐障碍(可能由于不同的症状和时间标准)和精神分裂症(可能由于严格的探查系统、对自我报告的依赖以及时间标准)方面发现敏感性较低。由于没有与ICD - 8单相情感性精神病可比的DIS诊断类别,因此无法将该ICD类别与研究诊断标准和DSM - III进行有意义的比较。

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