Schneider W, Freyberger H J, Muhs A
Abteilung für Psychotherapie und Psychosomatik, Ruhr-Universität Bochum, Dortmund.
Psychother Psychosom Med Psychol. 1995 Jul;45(7):253-60.
The present paper will discuss some selected results of the ICD-10 Research Criteria Study, section psychotherapy/psychosomatics, which was done between 1990 and 1993 involving 11 centers with 125 diagnosticians. During case conference 610 diagnostical assessments for 16 video-documentated cases were evaluated including an independent polydiagnostic rating (ICD-9, ICD-10, DSM-III-R) and subjective assessments of the diagnostic process. The results of the study could demonstrate sufficient chance-corrected interrater-reliability coefficients (Kappa values 0.69-0.99) for the majority of the disorders. Even on the level of the subjective ratings of the diagnostic process system-related problems of the classificatory approach could be identified concerning depressive and psychosomatic disorders. The results were discussed following some problematical aspects of the concept of comorbidity and multiaxial approaches. Special reference was given to the working group "Operational Psychodynamic Diagnosis (OPD)", which was founded in the Federal Republic of Germany.
本文将讨论国际疾病分类第十版（ICD - 10）研究标准项目中“心理治疗/身心医学”部分的一些选定结果。该项目于1990年至1993年开展，涉及11个中心的125名诊断医师。在病例讨论会上，对16个视频记录病例的610份诊断评估进行了评价，包括独立的多诊断评级（ICD - 9、ICD - 10、DSM - III - R）以及对诊断过程的主观评估。研究结果表明，大多数疾病的评分者间可靠性系数经机会校正后足够高（Kappa值为0.69 - 0.99）。即使在对诊断过程的主观评分层面，也能发现分类方法中与系统相关的问题，涉及抑郁和身心疾病。在讨论结果时，还提及了共病概念和多轴方法的一些问题。特别提到了在德意志联邦共和国成立的“操作性心理动力诊断（OPD）”工作组。
