Schneider W, Freyberger H J, Muhs A, Schüssler G
Department of Psychotherapeutic Medicine and Psychosomatics, University of Rostock, Germany.
Psychopathology. 1996;29(5):306-14. doi: 10.1159/000285012.
Selected results from the section psychotherapy/psychosomatics of the ICD-10 research criteria study are discussed. One hundred thirty diagnosticians from 11 psychosomatics centers took part in this section, assessing 16 video-documented patients in case conferences. The results of the study, which were based on 633 diagnostical assessments, demonstrated sufficient chance-corrected interrater reliability coefficients for the majority of the disorders (kappa ranged from 0.22 to 0.99). System-related problems of the ICD-10 approach were identified concerning depressive and psychosomatic disorders. The results are discussed, following some problematical aspects of the concept of comorbidity and multiaxial approaches. Special reference is given to the work group "Operational Psychodynamic Diagnoses' which has produced a multiaxial system covering important psychodynamic variables.
本文讨论了国际疾病分类第10版(ICD - 10)研究标准中关于心理治疗/心身医学部分的选定结果。来自11个心身医学中心的130名诊断医生参与了该部分研究,他们在病例讨论会上对16名有视频记录的患者进行评估。该研究基于633次诊断评估得出的结果表明,大多数疾病的评分者间一致性系数经机遇校正后是足够的(kappa值范围为0.22至0.99)。研究发现ICD - 10方法在抑郁和心身疾病方面存在与系统相关的问题。在讨论结果时,还提及了共病概念和多轴方法的一些问题方面。特别提到了“操作性精神动力学诊断”工作组,该工作组制定了一个涵盖重要精神动力学变量的多轴系统。