The Diagnoses of Schizophrenia, Schizoaffective Disorder, Bipolar Disorder and Unipolar Depression: Interrater Reliability and Congruence between DSM-IV and ICD-10
The Diagnoses of Schizophrenia, Schizoaffective Disorder, Bipolar Disorder and Unipolar Depression: Interrater Reliability and Congruence between DSM-IV and ICD-10
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DOI：
10.1159/000228838
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发表时间：
2009-01-01
期刊：
影响因子：
3.6
通讯作者：
Versiani, Marcio
中科院分区：
文献类型：
--
作者：
Cheniaux, Elie;Landeira-Fernandez, J.;Versiani, Marcio
背景：本研究探讨了DSM-IV和ICD-10对精神分裂症（SCH）、分裂情感障碍（SAD）、双相情感障碍（BPD）和单极抑郁（UPD）诊断的互译信度，以及两种分类系统之间的诊断一致性。抽样和方法：采用复合国际诊断访谈，两名训练有素的精神科医生同时评估100名住院患者并独立评估精神病学诊断。采用Cohen’s kappa系数来估计DSM-IV和ICD-10之间的互译信度和诊断一致性。结果：根据ICD-10标准，SCH的发生率高于DSM-IV标准。考虑到这两种诊断系统，除ICD-10 SAD和DSM-IV UPD外，所有四种疾病分类的互信度系数均大于0.50。仅在SAD方面，DSM-IV与ICD-10的诊断一致性系数低于0.50。BPD与最高程度的判读信度和诊断一致性相关。结论：ICD-10对SCH的诊断标准中缺少排除情感综合征的条目可以解释：ICD-10中SCH的出现频率高于DSM-IV；ICD-10诊断SAD的判读信度不理想，诊断一致性较低。版权所有(C) 2009 S. Karger AG，巴塞尔
Background: The present study investigated the interrater reliability of the diagnoses of schizophrenia (SCH), schizoaffective disorder (SAD), bipolar disorder (BPD) and unipolar depression (UPD) according to both DSM-IV and ICD-10, as well as the diagnostic congruence between the two classificatory systems. Sampling and Methods: Using the Composite International Diagnostic Interview, two trained psychiatrists simultaneously evaluated 100 inpatients and independently assessed the psychiatric diagnoses. The Cohen's kappa coefficient was employed to estimate interrater reliability and diagnostic congruence between DSM-IV and ICD-10. Results: SCH was more frequent according to ICD-10 than DSM-IV criteria. Considering both diagnostic systems, all the four nosological categories, but ICD-10 SAD and DSM-IV UPD, were associated with interrater reliability coefficients above 0.50. The coefficient of the diagnostic congruence between DSM-IV and ICD-10 was inferior to 0.50 only for SAD. BPD was associated with the highest degrees of both interrater reliability and diagnostic congruence. Conclusions: The lack of an item excluding the occurrence of an affective syndrome among ICD-10 diagnostic criteria for SCH can account for: the larger frequency of SCH according to ICD-10 than DSM-IV; the unsatisfactory interrater reliability for the diagnosis of ICD-10 SAD, and the low diagnostic congruence for SAD. Copyright (C) 2009 S. Karger AG, Basel