Olfson M, Leon A C, Broadhead W E, Weissman M M, Barrett J E, Blacklow R S, Gilbert T T, Higgins E S
College of Physicians and Surgeons of Columbia University and New York State Psychiatric Institute, New York 10032, USA.
Psychopharmacol Bull. 1995;31(2):415-20.
The Symptom Driven Diagnostic System for Primary Care (SDDS-PC) is a new computerized clinical procedure to assist primary care physicians in diagnosing mental disorders during the course of routine practice. It has three components: (1) a 5-minute patient-administered 16-item screening questionnaire, (2) six 5-minute physician-administered diagnostic interview modules based on DSM-III-R criteria, and (3) a longitudinal tracking form. The SDDS-PC covers five disorders (major depression, panic disorder, alcohol abuse or dependence, generalized anxiety disorder, and obsessive compulsive disorder) as well as suicidal ideation. Patients who screen positive for a disorder receive the corresponding diagnostic interview module. Patients who meet mental disorder criteria on the diagnostic interview module are then followed with the longitudinal tracking form. Minor or subsyndromal conditions are also addressed at the physician's discretion. This article describes the development of SDDS-PC and summarizes results from two studies which involved comparisons between the SDDS-PC and independently administered full-length structured diagnostic interviews.
基层医疗症状驱动诊断系统(SDDS-PC)是一种新型计算机化临床程序,旨在协助基层医疗医生在日常诊疗过程中诊断精神障碍。它有三个组成部分:(1)一份由患者自行填写的5分钟16项筛查问卷,(2)六个基于《精神疾病诊断与统计手册》第三版修订版(DSM-III-R)标准、由医生进行的5分钟诊断访谈模块,以及(3)一份纵向跟踪表。SDDS-PC涵盖五种疾病(重度抑郁症、惊恐障碍、酒精滥用或依赖、广泛性焦虑障碍和强迫症)以及自杀意念。筛查出某种疾病呈阳性的患者会接受相应的诊断访谈模块。在诊断访谈模块中符合精神障碍标准的患者随后会使用纵向跟踪表进行跟踪。轻微或亚综合征情况也由医生自行决定处理。本文描述了SDDS-PC的开发过程,并总结了两项研究的结果,这两项研究涉及SDDS-PC与独立进行的完整结构化诊断访谈之间的比较。