Kelly T M, Mann J J
Mental Health Clinical Research Center for the Study of Suicidal Behavior, Western Psychiatric Institute and Clinic, Pittsburgh, PA, USA.
Acta Psychiatr Scand. 1996 Nov;94(5):337-43. doi: 10.1111/j.1600-0447.1996.tb09869.x.
Psychological autopsies are an important research tool in establishing risk factors associated with suicide. We report the results of a validity study comparing psychological autopsy-generated DSM-III-R diagnoses in suicides and non-suicides with chart diagnoses generated by clinicians who had treated the subjects prior to death. The Structured Clinical Interview for DSM-III-R Disorders (SCID-P) and the Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-II) were used to make independent post-mortem diagnoses. Comparison of research diagnoses with clinician ante-mortem diagnoses generated kappa coefficients of 0.85 for Axis I diagnoses and 0.65 for Axis II conditions. These kappa coefficients compare favourably with direct patient interview reliability studies. This provides evidence for the validity of the psychological autopsy as a method of determining psychiatric diagnosis.
心理解剖是确定与自杀相关风险因素的重要研究工具。我们报告了一项效度研究的结果，该研究将心理解剖得出的自杀者和非自杀者的DSM-III-R诊断结果，与在受试者死亡前对其进行治疗的临床医生通过病历得出的诊断结果进行比较。使用《精神障碍诊断与统计手册第三版修订本》（DSM-III-R）障碍的结构化临床访谈（SCID-P）和《精神障碍诊断与统计手册第三版修订本》（DSM-III-R）人格障碍的结构化临床访谈（SCID-II）进行独立的死后诊断。研究诊断结果与临床医生生前诊断结果的比较得出，轴I诊断的kappa系数为0.85，轴II诊断的kappa系数为0.65。这些kappa系数与直接患者访谈可靠性研究相比具有优势。这为心理解剖作为确定精神疾病诊断方法的效度提供了证据。
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