Diagnostic reliability of bipolar II disorder
Diagnostic reliability of bipolar II disorder
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DOI：
10.1001/archpsyc.59.8.736
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发表时间：
2002-08-01
影响因子：
--
通讯作者：
DePaulo, JR
中科院分区：
文献类型：
--
作者：
Simpson, SG;McMahon, FJ;DePaulo, JR
背景资料：虽然重性抑郁症和躁狂症的诊断可靠性已经得到很好的建立，但轻躁狂和双相II（BPII）障碍的诊断可靠性还没有建立。这仍然是临床医生的一个重要问题，特别是对那些进行遗传研究的BP障碍，因为双相I型（BPI）和BPII疾病往往集群在同一个家庭。我们已经评估了我们对BP障碍、复发性单相情感障碍及其组成性发作的诊断可靠性方法：采用访谈法和最佳估计诊断法，对37名BPI患者（包括15名BP患者）进行了情感障碍和精神分裂症共评量表的终身版访谈;（2）情感障碍和精神分裂症的重测时间表--对26名受试者（包括13名BP障碍者）的终身版访谈;（3）在BPI障碍的遗传连锁研究中由2名非访谈精神科医生对524名受试者的最佳估计诊断。诊断的基础上选定的一组功能障碍的研究诊断标准，除了复发性抑郁症以及轻躁狂症的诊断BPII disorders.Results：在共同评定的访谈，我们观察到完全一致的诊断抑郁症，躁狂症，轻躁狂发作的采访者之间。在重测访谈中，躁狂、轻躁狂和重性抑郁发作的科恩K系数分别为0.83、0.72和1.0。在最佳估计水平下，BPI、BPII和复发性单相障碍的Cohen K系数分别为0.99、0.99和0.98。结论：由有经验的精神科医生进行访谈和最佳估计诊断，可以获得较好的BPII评定者间信度。
Background: Although the diagnostic reliability of major depression and mania has been well established, that of hypomania and bipolar II (BPII) disorder has not. This remains an important issue for clinicians, especially for those undertaking genetic studies of BP disorder since bipolar I (BPI) and BPII disorders often cluster in the same families. We have assessed our diagnostic reliability of BP disorders, recurrent unipolar disorder, and their constituent episodes (major depression, mania, and hypomania) using interview and best-estimate diagnostic procedures used in a genetic study of families with BPI disorder.Methods: Reliability was assessed for (1) co-rated Schedule for Affective Disorders and Schizophrenia-Lifetime version interviews of 37 subjects including 15 with BP disorders; (2) test-retest Schedule for Affective Disorders and Schizophrenia-Lifetime version interviews of 26 subjects including 13 with BP disorders; and (3) best-estimate diagnoses made by 2 noninterviewing psychiatrists on 524 subjects in a genetic linkage study of BPI disorder. Diagnoses were based on Research Diagnostic Criteria for a Selected Group of Functional Disorders, except that recurrent major depression as well as hypomania was required for a diagnosis of BPII disorder.Results: On co-rated interviews, we observed complete agreement between interviewers for diagnosing major depressive, manic, and hypomanic episodes. For test-retest interviews, the Cohen K coefficients were 0.83 for manic, 0.72 for hypomanic, and 1.0 for major depressive episodes. At the best-estimate level, the Cohen K coefficients were 0.99 for BPI, 0.99 for BPII, and 0.98 for recurrent unipolar disorder.Conclusion: Good interrater reliability for BPII can be achieved when the interviews and best-estimate diagnoses are done by experienced psychiatrists.