The Effect of Draft DSM-V Criteria on Posttraumatic Stress Disorder Prevalence
The Effect of Draft DSM-V Criteria on Posttraumatic Stress Disorder Prevalence
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DOI：
10.1002/da.22012
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发表时间：
2012-12-01
影响因子：
7.4
通讯作者：
Beckham, Jean C.
中科院分区：
文献类型：
--
作者：
Calhoun, Patrick S.;Hertzberg, Jeffrey S.;Beckham, Jean C.
背景本研究旨在检查DSM-V创伤后应激障碍（PTSD）标准与DSM-IV分类规则的一致性，并检查DSM-V PTSD标准对患病率的影响。方法样本（N = 185）包括在美国东南部的学术医疗中心和VA医疗中心进行的创伤和健康研究的参与者。根据结构化临床访谈的结果计算DSM-IV和拟议的DSM-V分类之间的患病率和一致性。计算每种可能的方法定义DSM-V PTSD的患病率和诊断效率指数，包括敏感性、特异性、曲线下面积（AUC）和Kappa。结果95%的样本报告的事件符合DSM-IV PTSD标准A1和A2，但只有89%的样本报告的创伤符合DSM-V标准A。检查DSM-IV和DSM-V算法之间一致性的结果表明，几种算法的AUC高于0.90。与要求聚类D和E中的三个症状相比，聚类D和E中的两个症状的要求提供了与DSM-IV的强一致性（AUC = 0.93; Kappa = 0.86）以及灵敏度和特异性之间的更大平衡。结论尽管DSM-V的PTSD诊断标准有几个显著的变化，但几个可能的分类规则与DSM-IV具有良好的一致性。DSM-V决策规则对患病率的影响程度将在很大程度上受到DSM-IV PTSD基础比率的影响。抑郁和焦虑29：1032-1042，2012. 2012年出版。本条目属于美国政府作品，在美国属于公有领域。
Background This study was designed to examine the concordance of proposed DSM-V posttraumatic stress disorder (PTSD) criteria with DSM-IV classification rules and examine the impact of the proposed DSM-V PTSD criteria on prevalence. Method The sample (N = 185) included participants who were recruited for studies focused on trauma and health conducted at an academic medical center and VA medical center in the southeastern United States. The prevalence and concordance between DSM-IV and the proposed DSM-V classifications were calculated based on results from structured clinical interviews. Prevalence rates and diagnostic efficiency indices including sensitivity, specificity, area under the curve (AUC), and Kappa were calculated for each of the possible ways to define DSM-V PTSD. Results Ninety-five percent of the sample reported an event that met both DSM-IV PTSD Criterion A1 and A2, but only 89% reported a trauma that met Criterion A on DSM-V. Results examining concordance between DSM-IV and DSM-V algorithms indicated that several of the algorithms had AUCs above 0.90. The requirement of two symptoms from both Clusters D and E provided strong concordance to DSM-IV (AUC = 0.93; Kappa = 0.86) and a greater balance between sensitivity and specificity than requiring three symptoms in both Clusters D and E. Conclusions Despite several significant changes to the diagnostic criteria for PTSD for DSM-V, several possible classification rules provided good concordance with DSM-IV. The magnitude of the impact of DSM-V decision rules on prevalence will be largely affected by the DSM-IV PTSD base rate in the population of interest. Depression and Anxiety 29: 1032-1042, 2012. Published 2012. This article is a U.S. Government work and is in the public domain in the USA.