The Composite International Diagnostic Interview (CIDI-Auto): problems and remedies for diagnosing panic disorder and social phobia
The Composite International Diagnostic Interview (CIDI-Auto): problems and remedies for diagnosing panic disorder and social phobia
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DOI：
10.1002/mpr.154
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发表时间：
2003-01-01
影响因子：
3.1
通讯作者：
Stein, MB
中科院分区：
文献类型：
--
作者：
Means-Christensen, A;Sherbourne, CD;Stein, MB
在最近一项关于初级保健中惊恐障碍治疗的研究中，综合国际诊断访谈(CIDI-Auto)被用来提供精神诊断。然而，在数据收集期间和之后，人们发现CIDI似乎将相当数量的人归入或未能归入诊断类别，其方式与调查人员的临床经验相冲突。恐慌症模块中问题的措辞，加上缺乏结构化的后续调查，导致明显的恐慌症假阴性。此外，符合惊恐障碍或社交恐惧症标准的患者没有收到基于可能与临床实践不一致的诊断，有时也不符合DSM-IV的设计。在这项研究中，对访谈进行了修改，包括对惊恐障碍模块进行了额外的调查，并修改了用于分配或排除恐慌症和社交恐惧症诊断的决策规则。这些变化导致更多的患者被纳入惊恐障碍和社交恐惧症诊断类别，我们认为CIDI-Auto的这些变化提高了这一工具的临床有效性。我们没有检查未修改或修改的CIDI的假阳性率，但这是一个重要的问题，需要在未来的研究中进行评估。
In a recent study of treatment for panic disorder in primary care, the Composite International Diagnostic Interview (CIDI-Auto) was used to provide psychiatric diagnoses. However, during and after data collection, it was discovered that the CIDI appeared to place, or fail to place, a substantial number of people into diagnostic categories in ways that conflicted with the investigators' clinical experience. The wording of questions in the panic module, coupled with a lack of structured follow-up probes, resulted in apparent false negatives for panic disorder. Moreover, patients who would otherwise meet criteria for panic disorder or social phobia did not receive a diagnosis based on rides that may he discordant with clinical practice and, at times, the design of the DSM-IV.For this study, changes were made to the interview, including additional probes for the panic disorder module and modification of the decision rules used to assign or rule out diagnoses of panic disorder and social phobia. The changes resulted in greater inclusion of patients in the panic disorder and social phobia diagnostic categories and we argue that these changes to the CIDI-Auto increase the clinical validity of this instrument. We did not examine the false positive rate for the unmodified or modified CIDI, but this is an important issue that needs to he evaluated in future research.