DeMallie D A, Cottler L B, Compton W M
Washington University School of Medicine, St Louis, MO, USA.
Addiction. 1995 May;90(5):615-25. doi: 10.1046/j.1360-0443.1995.9056153.x.
The present study assesses the stability of the diagnosis of alcoholism among a sample of St Louis, USA Epidemiological Catchment Area Study participants. The Diagnostic Interview Schedule was used at Time 1 and the Composite International Diagnostic Interview--Substance Abuse Module was used at 10-year follow-up. Alcohol abuse and dependence were diagnosed using DSM-III criteria. Kappa values and Yule's statistics for agreement in diagnoses, criterion groups and individual symptoms are reported. Fair to good measurement of agreement was shown for any diagnosis of alcohol abuse or dependence versus no diagnosis. The criterion group for "impairment in social or occupational functioning" showed the highest agreement of the three criterion groups studied. Agreement was lower for individual symptoms of alcoholism. Incident cases accounted for some of the inconsistency in responses over 10 years. Other types of inconsistency found were changing response from yes to no, changing response from no to yes but not meeting the definition of an incident case, and misstating age of onset of symptoms. Mean per cent inconsistency across all symptoms was 11.4%. Further research regarding reasons for inconsistencies is needed.
本研究评估了美国圣路易斯流行病学集水区研究参与者样本中酒精中毒诊断的稳定性。在第一次评估时使用了诊断访谈表，在10年随访时使用了综合国际诊断访谈——药物滥用模块。根据《精神疾病诊断与统计手册》第三版标准诊断酒精滥用和酒精依赖。报告了诊断、标准组和个体症状一致性的kappa值和尤尔统计量。对于任何酒精滥用或依赖诊断与无诊断之间的一致性测量显示为一般到良好。“社会或职业功能受损”标准组在所研究的三个标准组中显示出最高的一致性。酒精中毒个体症状的一致性较低。新发病例导致了10年期间部分反应不一致。发现的其他类型的不一致包括从“是”到“否”的反应变化、从“否”到“是”但不符合新发病例定义的反应变化以及症状发病年龄的错误陈述。所有症状的平均不一致百分比为11.4%。需要对不一致的原因进行进一步研究。
