Variability among research diagnostic interview instruments in the application of DSM-IV-TR criteria for pediatric bipolar disorder.
Variability among research diagnostic interview instruments in the application of DSM-IV-TR criteria for pediatric bipolar disorder.
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应用 DSM-IV-TR 标准治疗儿科双相情感障碍时研究诊断访谈工具的变异性。
DOI：
10.1016/j.jaac.2012.03.010
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发表时间：
2012
影响因子：
13.3
通讯作者：
Fisher,PrudenceW
中科院分区：
文献类型：
--
作者：
Galanter,CathrynA;Hundt,StephanieR;Goyal,Parag;Le,Jenna;Fisher,PrudenceW
DSM-IV-TR躁狂发作和双相情感障碍（BD）的标准是为成人制定的，但用于儿童。临床医生和研究人员解释这些标准的方式可能有助于增加对青年的BD诊断。研究访谈的目的是提高诊断的可靠性和有效性，但不同的是，他们如何将DSM-IV-TR标准儿科BD.METHODWe检查DSM-IV-TR标准和描述性文字躁狂发作和躁狂部分六个常用的儿科诊断研究访谈集中在以下方面：DSM-IV-TR的解释、给药建议和评分方法。DSM-IV-TR躁狂发作标准和描述性文本之间存在差异。工具在几个方面有所不同，包括在他们的概念化的情绪标准，是否症状必须代表一个变化，从儿童的通常状态，以及是否B-标准需要共同出现的A-标准。仪器也不同的建议，管理和评分methods.CONCLUSIONSGiven DSM-IV-TR躁狂发作的标准和解释性文字之间的差异，这并不奇怪，有相当大的变化之间的诊断仪器的基础上DSM-IV-TR。这些差异可能导致BD研究中纳入的受试者存在差异，并且研究结果不一致。儿童精神病学领域将受益于更统一的方法来评估症状和确定儿科BD诊断。我们讨论了对未来工具，访谈，评估和DSM-5的修改建议。
OBJECTIVEThe DSM-IV-TR criteria for a manic episode and bipolar disorder (BD) were developed for adults but are used for children. The manner in which clinicians and researchers interpret these criteria may have contributed to the increase in BD diagnoses given to youth. Research interviews are designed to improve diagnostic reliability and validity, but vary in how they incorporate DSM-IV-TR criteria for pediatric BD.METHODWe examined DSM-IV-TR criteria and the descriptive text for a manic episode and the mania sections of six commonly used pediatric diagnostic research interviews focusing on the following: interpretation of DSM-IV-TR, recommendations for administration, and scoring methods.RESULTSThere are differences between the DSM-IV-TR manic episode criteria and descriptive text. Instruments vary in several ways including in their conceptualization of the mood criterion, whether symptoms must represent a change from the child's usual state, and whether B-criteria are required to co-occur with the A-criterion. Instruments also differ on recommendations for administration and scoring methods.CONCLUSIONSGiven the differences between DSM-IV-TR manic episode criteria and explanatory text, it is not surprising that there is considerable variation between diagnostic instruments based on DSM-IV-TR. These differences likely lead to dissimilarities in subjects included in BD research studies and inconsistent findings across studies. The field of child psychiatry would benefit from more uniform methods of assessing symptoms and determining pediatric BD diagnoses. We discuss recommendations for changes to future instruments, interviews, assessment, and the DSM-5.