《精神疾病诊断与统计手册》第四版（DSM-IV）与《国际疾病分类》第十版——诊断标准修订版（ICD-10-DCR）中人格障碍的诊断一致性。

Diagnostic agreement between the DSM-IV and ICD-10-DCR personality disorders.

作者信息

Starcevic V, Bogojevic G, Kelin K

机构信息

Institute of Mental Health, Belgrade, Yugoslavia.

出版信息

Psychopathology. 1997;30(6):328-34. doi: 10.1159/000285078.

DOI:10.1159/000285078

PMID:9444702

Abstract

The SCID-II Personality Questionnaire, modified for DSM-IV and ICD-10 Diagnostic Criteria for Research (ICD-10-DCR), was administered to 58 consecutive patients with agoraphobia with panic disorder in order to screen for personality disorders (PDs) and assess diagnostic agreement between DSM-IV and ICD-10-DCR. The diagnostic agreement, as expressed by kappa values, was 0.78 for the presence of any personality disorder (PD), but it ranged from 0.51 for schizoid PD to 0.83 for dependent PD. There was a tendency for ICD-10-DCR to overdiagnose PDs, except for borderline and dependent PDs. The sources of disagreement can be traced to differences in the conceptualization of some PDs and differences in diagnostic criteria and diagnostic thresholds; these are further examined in an effort to improve diagnostic criteria and attain greater compatibility between the two diagnostic systems.

摘要

对58例连续性广场恐怖症伴惊恐障碍患者施行了根据《精神疾病诊断与统计手册》第四版（DSM-IV）及《国际疾病分类》第十版研究用诊断标准（ICD-10-DCR）修改的分裂样人格障碍-II型人格问卷，以筛查人格障碍（PDs）并评估DSM-IV与ICD-10-DCR之间的诊断一致性。以kappa值表示的诊断一致性，对于任何人格障碍（PD）的存在为0.78，但范围从分裂样PD的0.51到依赖型PD的0.83。除边缘型和依赖型PD外，ICD-10-DCR有过度诊断PDs的倾向。分歧的根源可追溯到某些PDs概念化的差异以及诊断标准和诊断阈值的差异；对这些进行了进一步研究，以努力改进诊断标准并使两种诊断系统之间具有更高的兼容性。