Diagnosis of comorbid psychiatric disorders in substance users assessed with the Psychiatric Research Interview for Substance and Mental Disorders for DSM-IV
Diagnosis of comorbid psychiatric disorders in substance users assessed with the Psychiatric Research Interview for Substance and Mental Disorders for DSM-IV
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DOI：
10.1176/appi.ajp.163.4.689
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发表时间：
2006-04-01
影响因子：
17.7
通讯作者：
Waxman, R
中科院分区：
文献类型：
--
作者：
Hasin, D;Samet, S;Waxman, R
目的：采用DSM-IV《物质与精神障碍精神病学研究访谈》（PRISM-IV），对DSM-IV所定义的障碍（包括原发障碍和物质诱发障碍）在药物滥用受试者中的可靠性进行检验。方法：来自药物滥用/双重诊断治疗机构和精神卫生治疗机构的药物滥用患者（N=285）参与PRISM-IV的测试和盲测复测访谈，PRISM-IV包括药物滥用者评估的具体指南。结果：原发性和物质性重度抑郁症的Kappas评分范围为0.66 ~ 0.75。精神障碍、饮食障碍、反社会人格障碍和边缘型人格障碍的信度在同一范围内。大多数焦虑症的信度较低。大多数物质依赖障碍的信度为良至优（kappas = 0.65）。连续测量（严重程度、发病年龄）组内相关系数> 0.70，少数例外。原发疾病的可靠性优于药物引起的疾病，尽管不是很大。结论：大多数DSM-IV精神障碍可通过专门设计的程序对药物滥用者进行评估，并具有可接受到极好的可靠性。良好的可靠性提高了显著研究结果的可能性。
Objective: The authors used the Psychiatric Research Interview for Substance and Mental Disorders for DSM-IV ( PRISM-IV) to test the reliability of DSM-IV-defined disorders, including primary and substance-induced disorders, in substance-abusing subjects.Method: Substance-abusing patients ( N=285) from substance abuse/dual-diagnosis treatment settings and mental health treatment settings participated in test and blind retest interviews with the PRISM-IV, which includes specific guidelines for assessment of substance abusers.Results: Kappas for primary and substance-induced major depressive disorder ranged from 0.66 to 0.75. Reliability for psychotic disorders, eating disorders, antisocial personality disorder, and borderline personality disorder was in the same range. Reliability for most anxiety disorders was lower. Reliability was good to excellent ( kappas = 0.65) for most substance dependence disorders. Continuous measures ( severity, age at onset) had intraclass correlation coefficients > 0.70 with few exceptions. Reliability was better for primary than for substance-induced disorders, although not greatly so.Conclusion: Most DSM-IV psychiatric disorders can be assessed in substance-abusing subjects with acceptable to excellent reliability by using specifically designed procedures. Good reliability improves the likelihood of significant study results.