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《精神疾病诊断与统计手册》第四版(DSM-IV)和《国际疾病分类》第十版(ICD-10)中厌食症和贪食症的结构化访谈:更新(第三版)修订本

Structured Interview for Anorexic and Bulimic disorders for DSM-IV and ICD-10: updated (third) revision.

作者信息

Fichter M M, Herpertz S, Quadflieg N, Herpertz-Dahlmann B

机构信息

Klinik Roseneck, Hospital for Behavioral Medicine, Prien Germany.

出版信息

Int J Eat Disord. 1998 Nov;24(3):227-49. doi: 10.1002/(sici)1098-108x(199811)24:3<227::aid-eat1>3.0.co;2-o.

Abstract

OBJECTIVES

Earlier versions of the Structured Interview for Anorexic and Bulimic Disorders (SIAB) were modified in order to include new research findings and to update the expert rating interview to the diagnostic criteria of DSM-IV and ICD-10. The semistandardized interview was developed for reliable and valid assessment of the specific as well as the general psychopathology of eating disorders.

METHOD

Data from SIAB-EX interviews (current and past/lifetime symptom expression) were available from three samples: (a) 330 eating-disordered patients assessed at the start of treatment, (b) 148 former eating-disordered patients with anorexia nervosa (AN) or bulimia nervosa (BN) assessed at follow-up, and (c) 111 community controls. Sixty-one of the 87 items of the SIAB-EX with a 5-point scale were factor analyzed.

RESULTS

Principal components analyses with varimax rotation produced the following six components of the SIAB-EX (lifetime): (I) Body Image and Slimness Ideal; (II) General Psychopathology; (III) Sexuality and Social Integration; (IV) Bulimic Symptoms; (V) Measures to Counteract Weight Gain, Fasting, and Substance Abuse; and (VI) Atypical Binges. The factor solution for the current symptom expression was very similar to that based on lifetime symptom expression. Average item and factor scores are given for six groups of eating-disordered patients and controls. High interrater reliability was established for both current and the past symptom expression. Cronbach's alpha coefficients indicated good internal consistency for five of the six components of the SIAB-EX. DSM-IV and ICD-10 diagnoses for eating disorders can be derived directly or by using a computer algorithm from the SIAB-EX. A detailed 90-page manual facilitates the training of interviewers.

CONCLUSION

The 87-item SIAB-EX was originally developed for detailed assessment of eating disorders cross-sectionally and longitudinally. The updated version which allows for diagnosis according to DSM-IV and ICD-10 is described here.

摘要

目的

对神经性厌食症和贪食症结构化访谈(SIAB)的早期版本进行修改,以纳入新的研究结果,并将专家评分访谈更新至符合《精神疾病诊断与统计手册》第四版(DSM-IV)和《国际疾病分类》第十版(ICD-10)的诊断标准。开发这种半标准化访谈是为了可靠且有效地评估饮食失调的特定及一般精神病理学表现。

方法

SIAB-EX访谈(当前及过去/终生症状表现)的数据来自三个样本:(a)330名在治疗开始时接受评估的饮食失调患者;(b)148名在随访时接受评估的曾患神经性厌食症(AN)或神经性贪食症(BN)的既往饮食失调患者;以及(c)111名社区对照者。对SIAB-EX的87个采用5级量表评分的项目中的61项进行了因子分析。

结果

采用方差最大化旋转的主成分分析得出了SIAB-EX(终生)的以下六个成分:(I)身体意象与理想苗条程度;(II)一般精神病理学表现;(III)性与社会融合;(IV)贪食症状;(V)防止体重增加、禁食及物质滥用的措施;以及(VI)非典型暴食。当前症状表现的因子解与基于终生症状表现的因子解非常相似。给出了六组饮食失调患者及对照者的平均项目得分和因子得分。当前及过去症状表现均建立了较高的评分者间信度。克朗巴哈系数表明SIAB-EX六个成分中的五个具有良好的内部一致性。饮食失调的DSM-IV和ICD-10诊断可直接从SIAB-EX得出,或通过计算机算法得出。一本90页的详细手册便于对访谈者进行培训。

结论

87项的SIAB-EX最初是为横断面和纵向详细评估饮食失调而开发的。本文描述了允许根据DSM-IV和ICD-10进行诊断的更新版本。

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