DIAGNOSING COMORBIDITY IN SUBSTANCE-ABUSERS - A COMPARISON OF THE TEST-RETEST RELIABILITY OF 2 INTERVIEWS
DIAGNOSING COMORBIDITY IN SUBSTANCE-ABUSERS - A COMPARISON OF THE TEST-RETEST RELIABILITY OF 2 INTERVIEWS
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DOI：
10.3109/00952999509002686
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发表时间：
1995-01-01
影响因子：
2.7
通讯作者：
LARKIN, EJ
中科院分区：
文献类型：
--
作者：
ROSS, HE;SWINSON, R;LARKIN, EJ
本研究考察了两种访谈时间表（计算机和临床医生管理）在诊断治疗药物滥用者终身共病中的测试-重测试可靠性。173名药物滥用者随机分为两组，分别采用计算机诊断访谈表（C-DIS）和DSM-III-R结构化临床访谈表（SCID）。在1 - 2周内，第一组受试者重复C-DIS，第二组受试者由不同的临床医生重新访谈，对初始SCID结果不知情。两种仪器对DSM-III-R精神活性物质使用障碍的kappa范围从。50到。个体疾病89例。然而，在两种仪器上，共病性其他精神障碍的可靠性明显较差，尤其是SCID。C-DIS kappa范围从广泛性焦虑的- 0.05到。单纯恐惧症70分。SCID kappa的范围从。31岁患恐慌症。反社会人格障碍83分。焦虑症作为一个类别，一些恐惧症和反社会人格障碍在两种仪器上都显示出可接受的重测信度水平。对于C-DIS的一些分歧，有一种边界或阈值案例的趋势。临床医生对机体的不同看法导致了恐慌症和重度抑郁症的不同看法。与SCID不同，C-DIS倾向于在初次面谈时诊断出更多的疾病，这可能是其繁琐的探针结构的结果。这两种仪器都不应仅使用一次，以提供药物滥用者共病的可靠终身诊断概况。
This study examines the test-retest reliability of two interview schedules (computer- and clinician-administered) in diagnosing lifetime comorbidity in treated substance abusers. The Computerized Diagnostic Interview Schedule (C-DIS) and the Structured Clinical Interview for DSM-III-R (SCID) were both administered to 173 substance abusers after random assignment to one of two groups. Within 1 to 2 weeks, subjects in the first group repeated the C-DIS and subjects in the second group were reinterviewed by a different clinician, blind to the results of the initial SCID. Both instruments showed good to excellent reliability for DSM-III-R psychoactive substance use disorders with kappas ranging from .50 to .89 for individual disorders. However, the reliability of comorbid other mental disorders was substantially poorer on both instruments, particularly the SCID. C-DIS kappas ranged from -.05 for generalized anxiety to .70 for simple phobia. SCID kappas ranged from .31 for panic disorder to .83 for antisocial personality disorder. Anxiety disorders as a category, some phobic disorders, and antisocial personality disorder showed acceptable levels of test-retest reliability on both instruments. There was a trend for borderline or threshold cases to account for some of the disagreement on the C-DIS. Differences of opinion between clinicians on organicity accounted for some of the disagreements on panic disorder and major depression. The C-DIS, unlike the SCID, tended to diagnose more disorders at initial interview, perhaps a result of its tedious probe structure. Neither instrument should be administered only once to provide a reliable lifetime diagnostic profile of comorbidity in substance abusers.