Impaired but undiagnosed
Impaired but undiagnosed
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DOI：
10.1097/00004583-199902000-00011
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发表时间：
1999-02-01
影响因子：
13.3
通讯作者：
Erkanli, A
中科院分区：
文献类型：
--
作者：
Angold, A;Costello, EJ;Erkanli, A
目的：调查不符合DSM-III-R标准的29种明确定义障碍中的任何一种的社会心理障碍患者的患病率和结果，并建议对非其他特定（NOS）诊断和V代码的操作定义。方法：在大烟山研究的第一波中，对1015名年龄在9岁、11岁和13岁的青少年进行了两阶段的一般人群抽样。一年后使用儿童和青少年精神病学评估对他们进行了再次访谈。结果：手足关系问题的加权患病率为1.4%。亲子关系问题占3.6%，关系问题NOS占0.6%。症状性障碍的总体发生率为9.4%。通过各种“病例测量”，那些有症状性障碍的人被证明比那些既没有诊断也没有障碍的人更不安，和那些有诊断但没有障碍的人一样不安。结论：儿童和青少年不符合DSM-III-R任何明确定义的障碍标准，但有与社会心理障碍相关的症状应被视为患有精神障碍。建议研究人员对DSM分类学中包含的许多NOS诊断采用该定义，并在其研究诊断算法中实施该定义。
Objective: To investigate the prevalence and outcomes of individuals with psychosocial impairment not meeting DSM-III-R criteria for any of 29 well-defined disorders and to suggest operational definitions for not otherwise specified (NOS) diagnoses and V codes. Method: Two-stage general population sampling resulted in 1,015 youths aged 9, 11, and 13 years being interviewed in the first wave of the Great Smoky Mountains Study. They were reinterviewed 1 year later using the Child and Adolescent Psychiatric Assessment. Results: The weighted prevalence of sibling relational problems was found to be 1.4%. That of parent-child relational problems was 3.6% and that of relational problems NOS was 0.6%. The overall rate of symptomatic impairment was 9.4%. Across a variety of "caseness measures," those with symptomatic impairment proved to be more disturbed than those without either a diagnosis or impairment, and as disturbed as those with a diagnosis but without impairment. Conclusion: Children and adolescents who do not meet DSM-III-R criteria for any well-defined disorder but who have symptoms associated with psychosocial impairment should be regarded as suffering from a psychiatric disorder. It is suggested that researchers adopt this definition for the many NOS diagnoses included in the DSM nosology and implement it in their research diagnostic algorithms.