Cross validation of a general population survey diagnostic interview: a comparison of CIS-R with SCAN ICD-10 diagnostic categories
Cross validation of a general population survey diagnostic interview: a comparison of CIS-R with SCAN ICD-10 diagnostic categories
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DOI：
10.1017/s0033291799008892
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发表时间：
1999-09-01
影响因子：
6.9
通讯作者：
Vernon, J
中科院分区：
文献类型：
--
作者：
Brugha, TS;Bebbington, PE;Vernon, J
背景结构化诊断访谈与一般人群样本中的临床评估的比较显示出显着的差异。为了验证CIS-R，一个完全结构化的诊断访谈用于全国调查的精神病发病率在英国，它与扫描，一个标准的，半结构化的，临床评估进行了比较。从邮政编码地址文件中随机抽取了1882个莱斯特郡地址，得到了1157个合格的成年人。其中860人完成了CIS-R; 387名成年人在CIS-R上的得分大于或等于8，其中205人完成了SCAN参考考试。仅询问前一周和前一个月的神经症症状。对ICD-10神经症和抑郁障碍、F32至F42以及抑郁症状评分进行一致性评估。社会人口特征与全国调查和1991年人口普查概况非常相似。任何ICD-10神经症性障碍（kappa = 0.25（95% CI，0.1-0.4））和抑郁症（kappa = 0.23（95% CI，0-0.46））的一致性较差。对SCAN参考分类的敏感性也很差。特异性范围为0.8 - 0.9。总抑郁症状的等级相关为0.43（Kendall 'stau B; P < 0.001; N = 205）。高特异性表明，CIS-R和SCAN同意，与一些社区调查的估计数相比，特定疾病的患病率较低。我们发现了大量的病例发现差异。因此，需要重新解释为估计人口中未得到满足的需求而公布的服务利用数据。大规模CIS-R调查数据的价值可以通过合并并行的半结构化临床评估而大大提高。
Background. Comparisons of structured diagnostic interviews with clinical assessments in general population samples show marked discrepancies. In order to validate the CIS-R, a fully structured diagnostic interview used for the National Survey of Psychiatric Morbidity in Great Britain, it was compared with SCAN, a standard, semi-structured, clinical assessment.Methods. A random sample of 1882 Leicestershire addresses from the Postcode Address File yielded 1157 eligible adults. of these 860 completed the CIS-R; 387 adults scores greater than or equal to 8 on the CIS-R and 205 of these completed a SCAN reference examination. Neurotic symptoms, in the previous week and month only, were enquired about. Concordance was estimated for ICD-10 neurotic and depressive disorders, F32 to F42 and for depression symptom score.Results. Sociodemographic characteristics closely resembled National Survey and 1991 census profiles. Concordance was poor for any ICD-10 neurotic disorder (kappa = 0.25 (95% CI, 0.1-0.4)) and for depressive disorder (kappa = 0.23 (95% CI, 0-0.46)). Sensitivity to the SCAN reference classification was also poor. Specificity ranged from 0.8 to 0.9. Rank order correlation for total depression symptoms was 0.43 (Kendall's tau b; P < 0.001; N = 205).Discussion. High specificity indicates that the CIS-R and SCAN agree that prevalence rates for specific disorders are low compared with estimates in some community surveys. We have revealed substantial discrepancies in case finding. Therefore, published data on service utilization designed to estimate unmet need in populations requires re-interpretation. The value of large-scale CIS-R survey data can be enhanced considerably by the incorporation of concurrent semi-structured clinical assessments.