An empirically derived approach to the classification and diagnosis of mood disorders.
An empirically derived approach to the classification and diagnosis of mood disorders.
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一种根据经验得出的情绪障碍分类和诊断方法。
DOI：
10.1002/j.2051-5545.2012.tb00127.x
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发表时间：
2012
期刊：
影响因子：
--
通讯作者：
DeFife,JaredA
中科院分区：
文献类型：
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作者：
Westen,Drew;Malone,JohannaC;DeFife,JaredA
本文介绍了一个系统，用于诊断情绪障碍，是经验得出的，并设计其在日常实践中的临床效用。一个随机的全国样本的精神科医生和临床心理学家描述了一个随机选择的当前的病人与测量设计的临床经验丰富的线人，情绪障碍诊断问卷（MDDQ），并完成了额外的研究表格。我们对MDDQ应用因子分析，以识别患者样本中自然发生的诊断分组。该分析产生了三种临床上不同的心境障碍维度或谱，与连续版本的DSM和ICD中包含的主要心境障碍（重度抑郁、心境恶劣和躁狂）一致，沿着自杀风险指数。诊断标准严格根据经验确定。使用诊断效率统计学的初始数据支持DSM-IV诊断中维度的准确性;回归分析支持MDDQ量表的判别效度;相关性分析显示与心境障碍家族史和功能结局相关的连贯模式，支持差异性。也许最重要的是，MDDQ诊断量表在预测适应功能和精神病史方面的有效性高于DSM-IV诊断。经验得出的综合征可以用于诊断情绪综合征维度没有复杂的诊断算法，或可以组合成诊断原型，消除了需要不断扩大的类别的情绪障碍，是临床上笨拙。
This article describes a system for diagnosing mood disorders that is empirically derived and designed for its clinical utility in everyday practice. A ran-dom national sample of psychiatrists and clinical psychologists described a randomly selected current patient with a measure designed for clinically ex-perienced informants, the Mood Disorder Diagnostic Questionnaire (MDDQ), and completed additional research forms. We applied factor analysis to the MDDQ to identify naturally occurring diagnostic groupings within the patient sample. The analysis yielded three clinically distinct mood disorder dimen-sions or spectra, consistent with the major mood disturbances included in the DSM and ICD over successive editions (major depression, dysthymia, and mania), along with a suicide risk index. Diagnostic criteria were determined strictly empirically. Initial data using diagnostic efficiency statistics sup-ported the accuracy of the dimensions in discriminating DSM-IV diagnoses; regression analyses supported the discriminant validity of the MDDQ scales; and correlational analysis demonstrated coherent patterns of association with family history of mood disorders and functional outcomes, supporting va-lidity. Perhaps most importantly, the MDDQ diagnostic scales demonstrated incremental validity in predicting adaptive functioning and psychiatric his-tory over and above DSM-IV diagnosis. The empirically derived syndromes can be used to diagnose mood syndromes dimensionally without complex di-agnostic algorithms or can be combined into diagnostic prototypes that eliminate the need for ever-expanding categories of mood disorders that are clini-cally unwieldy.