Kranzler H R, Kadden R M, Burleson J A, Babor T F, Apter A, Rounsaville B J
Department of Psychiatry, University of Connecticut School of Medicine, Farmington, USA.
Compr Psychiatry. 1995 Jul-Aug;36(4):278-88. doi: 10.1016/s0010-440x(95)90073-x.
Although structured diagnostic interviews are increasingly being used in substance abuse treatment settings, there has been limited systematic evaluation of their ability to enhance reliability and validity of psychiatric diagnoses. The present report provides data on the concurrent, discriminant, and predictive validity of current substance use disorders and common comorbid diagnoses in a sample of 100 substance abuse patients. Diagnoses formulated primarily by master's-level clinicians in the usual course of their duties were compared with diagnoses formulated by research technicians using a semistructured interview. Results indicated that the validity of clinician diagnoses was good for substance use disorders, moderate for personality disorders, and poor for anxiety disorders and major depression. Greater validity was observed for substance abuse diagnoses formulated by research technicians using the semistructured interview. Based on these findings, we conclude that psychiatric diagnosis in substance abuse patients may be improved by adding elements of structured interviews to the clinician's usual assessment.
尽管结构化诊断访谈在药物滥用治疗环境中越来越多地被使用，但对其提高精神疾病诊断可靠性和有效性的能力进行的系统评估却很有限。本报告提供了100名药物滥用患者样本中当前药物使用障碍和常见共病诊断的同时效度、区分效度和预测效度的数据。将主要由硕士水平的临床医生在日常工作中做出的诊断与研究技术人员使用半结构化访谈做出的诊断进行了比较。结果表明，临床医生对药物使用障碍的诊断效度良好，对人格障碍的诊断效度中等，对焦虑障碍和重度抑郁症的诊断效度较差。使用半结构化访谈的研究技术人员做出的药物滥用诊断的效度更高。基于这些发现，我们得出结论，通过在临床医生的常规评估中增加结构化访谈的元素，可以改善药物滥用患者的精神疾病诊断。
