Brief diagnostic interviews (SDDS-PC) for multiple mental disorders in primary care. A pilot study.
Brief diagnostic interviews (SDDS-PC) for multiple mental disorders in primary care. A pilot study.
复制标题
针对初级保健中多种精神障碍的简短诊断访谈 (SDDS-PC)。
DOI：
10.1001/archfami.4.3.220
复制
发表时间：
1995
期刊：
影响因子：
--
通讯作者：
C. Hoven
中科院分区：
文献类型：
--
作者：
M. Weissman;M. Olfson;A. Leon;W. Broadhead;T. Gilbert;E. Higgins;J. Barrett;R. Blacklow;M. Keller;C. Hoven
目标
试点测试新的、简短的、结构化的、由医生管理的诊断访谈的可行性和有效性，该访谈针对从患者完成的筛查中识别出的初级保健患者的六种精神障碍。
设计
新诊断访谈与由心理健康专业人员独立管理的《精神疾病诊断和统计手册》修订版第三版 P 版 (SCID-P) 的结构化临床访谈的比较。
设置
罗德岛州的三个家庭诊所和南卡罗来纳州的家庭医学住院医师实习期。
科目
年龄在 18 岁至 70 岁、能够读写英语的连续患者有资格进行筛查； 775 名患者完成了筛查。其中，246 人的至少一种疾病筛查结果呈阳性，并接受了至少一个模块。其中，158 人接受了 SCID-P 面试。
结果
所有 16 名参与的医生都认为诊断访谈很有用。 87% 的人报告说他们诊断出了新的精神问题，93% 的人表示这些模块澄清了可疑的症状。然而，26% 的人认为该程序太耗时，80% 的人认为日常使用需要报销。使用诊断模块检测病例与医生干预和对患者损伤的独立评估相关。经医生访谈诊断为阳性的患者中，超过四分之三 (76.4%) 的 SCID-P 检测结果也呈阳性。患有至少一种疾病（根据 SCID-P）的三分之二（62.7%）的患者被医生访谈归类为患有精神障碍。然而，不同疾病的操作特征各不相同，表明需要在更大的样本中进行修改和测试。
结论
这些简短的医生管理的诊断访谈模块是筛查和诊断系统（初级保健症状驱动诊断系统 [SDDS-PC]，The UpJohn Co，卡拉马祖，密歇根州）的一部分，用于检测初级保健患者的精神障碍。试点结果有助于确定其可行性和有效性。
OBJECTIVE
To pilot test the feasibility and validity of new, brief, structured, physician-administered diagnostic interviews for six mental disorders in primary care patients identified from a patient-completed screen.
DESIGN
Comparison of the new diagnostic interviews with the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition, version P (SCID-P), administered independently by a mental health professional.
SETTING
Three Rhode Island family practices and a South Carolina family medicine residency.
SUBJECTS
Consecutive patients of either sex, aged 18 to 70 years, who were able to read and write English were eligible for screening; 775 patients completed the screen. Of these, 246 screened positive for at least one disorder and received at least one module. Of these, 158 received a SCID-P interview.
RESULTS
The diagnostic interviews were found useful by all 16 participating physicians. Eighty-seven percent reported that they diagnosed a new mental problem, and 93% said that the modules clarified suspected symptoms. However, 26% thought the procedure was too time consuming, and 80% believed that reimbursement would be necessary for routine use. Detection of cases using the diagnostic modules was associated with physician intervention and with independent assessment of patient impairment. Over three quarters of the patients (76.4%) who were classified as positive by the physician interview for any of the diagnoses also tested positive on the SCID-P. Two thirds of the patients (62.7%) with at least one of the disorders (according to SCID-P) were classified by the physician interview as having a mental disorder. However, the operating characteristics varied across specific disorders and indicated a need for revisions and testing in larger samples.
CONCLUSIONS
These brief physician-administered diagnostic interview modules are part of a screening and diagnostic system (Symptom-Driven Diagnostic System for Primary Care [SDDS-PC], The UpJohn Co, Kalamazoo, Mich) to detect mental disorders in primary care patients. The pilot results help establish their feasibility and validity.