National Comorbidity Survey Replication Adolescent Supplement (NCS-A): III. Concordance of DSM-IV/CIDI Diagnoses With Clinical Reassessments
National Comorbidity Survey Replication Adolescent Supplement (NCS-A): III. Concordance of DSM-IV/CIDI Diagnoses With Clinical Reassessments
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DOI：
10.1097/chi.0b013e31819a1cbc
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发表时间：
2009-04-01
影响因子：
13.3
通讯作者：
Merikangas, Kathleen R.
中科院分区：
文献类型：
--
作者：
Kessler, Ronald C.;Avenevoli, Shelli;Merikangas, Kathleen R.
目的：报告基于美国国家合并症调查复制青少年补充补充材料 (NCS-A) 中完全结构化的非专业人士管理的世界卫生组织综合国际诊断访谈 (CIDI) 3.0 版的终生 DSM-IV 诊断的临床重新评估研究的结果。方法：以学龄儿童情感障碍和精神分裂症表 (K-SADS) 作为金标准，对 347 名 NCS-A 受访者的概率子样本进行盲法临床重新评估访谈。对 DSM-IV/CIDI 病例进行过采样，并对临床重新评估样本进行加权以针对这种过采样进行调整。结果：CIDI 和 K-SADS 患病率估计之间存在良好的总体一致性，尽管 CIDI 估计值明显高于 K-SADS 对特定恐惧症 (51.2%) 和对立违抗性障碍 (38.7%) 的估计值。相比之下，CIDI 中任何疾病的估计患病率仅略高于 K-SADS (8.3%)。大多数诊断都发现个人层面的 CIDI 与 K-SADS 具有很强的一致性。受试者工作特征曲线下面积（不受患病率影响的分类准确性的衡量标准）对于任何焦虑障碍为 0.88，对于任何情绪障碍为 0.89，对于任何破坏性行为障碍为 0.84，对于任何物质障碍为 0.94，对于任何障碍为 0.87。尽管酒精依赖和 I 型双相情感障碍和 I 型双相情感障碍的接受者操作特征曲线下面积低得令人无法接受，但这些问题分别通过与酒精滥用和 I 型双相情感障碍的汇总得到了解决。 Logistic 回归分析证明，考虑 CIDI 症状水平数据可显着改善对某些 K-SADS 诊断的预测。结论：这些结果证明，NCS-A 基于 CIDI 做出的诊断与盲法临床诊断总体上具有良好的一致性。 J. Am.阿卡德。儿童青少年。精神病学，2009；48(4)：386-399。
Objective: To report results of the clinical reappraisal study of lifetime DSM-IV diagnoses based on the fully structured lay-administered World Health Organization Composite International Diagnostic Interview (CIDI) Version 3.0 in the U.S. National Comorbidity Survey Replication Adolescent Supplement (NCS-A). Method: Blinded clinical reappraisal interviews with a probability subsample of 347 NCS-A respondents were administered using the Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS) as the gold standard. The DSM-IV/CIDI cases were oversampled, and the clinical reappraisal sample was weighted to adjust for this oversampling. Results: Good aggregate consistency was found between CIDI and K-SADS prevalence estimates, although CIDI estimates were meaningfully higher than K-SADS estimates for specific phobia (51.2%) and oppositional defiant disorder (38.7%). Estimated prevalence of any disorder, in comparison, was only slightly higher in the CIDI than K-SADS (8.3%). Strong individual-level CIDI versus K-SADS concordance was found for most diagnoses. Area under the receiver operating characteristic curve, a measure of classification accuracy not influenced by prevalence, was 0.88 for any anxiety disorder, 0.89 for any mood disorder, 0.84 for any disruptive behavior disorder, 0.94 for any substance disorder, and 0.87 for any disorder. Although area under the receiver operating characteristic curve was unacceptably low for alcohol dependence and bipolar I and II disorders, these problems were resolved by aggregation with alcohol abuse and bipolar I disorder, respectively. Logistic regression analysis documented that consideration of CIDI symptom-level data significantly improved prediction of some K-SADS diagnoses. Conclusions: These results document that the diagnoses made in the NCS-A based on the CIDI have generally good concordance with blinded clinical diagnoses. J. Am. Acad. Child Adolesc. Psychiatry, 2009;48(4):386-399.