Bronisch T, Mombour W
Department of Psychiatry, Clinical Institute, Max Planck Institute, Munich, FRG.
Psychopathology. 1994;27(6):312-20. doi: 10.1159/000284889.
The International Diagnostic Checklists for the assessment of the DSM-III-R and ICD-10 personality disorders (IDCL-P) were compared with a structured interview, the International Personality Disorder Examination (IPDE), using a balanced test-retest design with forty psychiatric inpatients. The results, using pairwise kappa for the calculation of agreement, were as follows: any personality disorder versus no personality disorder 0.52 for DSM-III-R diagnoses and 0.75 for ICD-10 diagnoses. The range for the single personality disorders diagnosed at least five times was from -0.07 to 0.71 for DSM-III-R diagnoses and from 0.38 to 0.68 for ICD-10 diagnoses. Only for DSM-III-R diagnoses do figures exist from three other studies comparing two structured interviews with each other. The results of all four studies suggest that 60% of the variance in personality disorder diagnoses represents variance not attributable to the patients, which is scientifically unacceptable.
使用平衡的重测设计，对40名精神科住院患者，将用于评估《精神疾病诊断与统计手册》第三版修订本（DSM-III-R）和《国际疾病分类》第十版（ICD-10）人格障碍的国际诊断清单（IDCL-P）与一种结构化访谈工具——国际人格障碍检查表（IPDE）进行了比较。采用两两kappa系数计算一致性，结果如下：对于DSM-III-R诊断，有任何人格障碍与无人格障碍的一致性为0.52；对于ICD-10诊断，一致性为0.75。在至少诊断五次的单一人格障碍中，DSM-III-R诊断的范围为-0.07至0.71，ICD-10诊断的范围为0.38至0.68。只有DSM-III-R诊断有另外三项比较两种结构化访谈的研究数据。所有四项研究的结果表明，人格障碍诊断中60%的差异是不可归因于患者的差异，这在科学上是不可接受的。
