The Bipolar Affective Disorder Dimension Scale (BADDS)--a dimensional scale for rating lifetime psychopathology in bipolar spectrum disorders.
The Bipolar Affective Disorder Dimension Scale (BADDS)--a dimensional scale for rating lifetime psychopathology in bipolar spectrum disorders.
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DOI：
10.1186/1471-244x-4-19
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发表时间：
2004-07-05
期刊：
影响因子：
4.4
通讯作者：
Jones L
中科院分区：
文献类型：
--
作者：
Craddock N;Jones I;Kirov G;Jones L
目前的操作诊断系统对双相谱系障碍的终身诊断分类有很大的局限性。问题包括：（1）难以操作化精神病理学的不同发作的整合，（2）等级导致信息的丢失，（3）诊断类别之间的边界通常是任意的，（4）类别之间的边界通常需要主观解释的主要元素，（5）可用的诊断类别相对无助于区分严重性，（6）“未另行说明（NOS）”类别是高度异质性的，（7）亚临床病例在当前的诊断类别中没有被有效地容纳。在越来越多的证据表明存在比现有分类所承认的更广泛的双极谱的背景下，后一种限制尤其相关。我们已经开发了一个数字评级系统，双相情感障碍维度量表，BADDS，可以作为一个辅助传统的最佳估计终身诊断程序。量表定义由（a）DSMIV和ICD 10中认可的心境综合征的当前概念，（B）关于发作严重程度的文献，以及（c）我们自己的临床经验提供信息。我们进行了一个迭代过程，在这个过程中，我们最初同意了量表的定义，在多组病例上试用它们，并进行了修改，以提高实用性和可靠性。BADDS有四个维度，每个维度在0 - 100量表上被评为整数，测量终身精神病理学的四个关键领域：躁狂（M），抑郁（D），精神病（P）和不协调（I）。根据我们的经验，它易于学习，使用简单，具有出色的评分者间可靠性，并保留了根据DSMIV和ICD 10进行诊断所需的关键信息。使用BADDS作为常规分类诊断的辅助手段提供了对终生精神病理学的更丰富的描述，其（a）可以适应亚临床特征，（B）在单个常规诊断类别内区分个体之间的疾病严重程度，以及（c）证明了被分类为不同疾病类别但其疾病都接近疾病类别的个体的疾病经历之间的相似性。两个类别之间的界限。BADDS可能是有用的研究人员和临床医生有兴趣的描述和分类的个人与疾病躺在双相频谱的终身精神病理学。
Current operational diagnostic systems have substantial limitations for lifetime diagnostic classification of bipolar spectrum disorders. Issues include: (1) It is difficult to operationalize the integration of diverse episodes of psychopathology, (2) Hierarchies lead to loss of information, (3) Boundaries between diagnostic categories are often arbitrary, (4) Boundaries between categories usually require a major element of subjective interpretation, (5) Available diagnostic categories are relatively unhelpful in distinguishing severity, (6) "Not Otherwise Specified (NOS)" categories are highly heterogeneous, (7) Subclinical cases are not accommodated usefully within the current diagnostic categories. This latter limitation is particularly pertinent in the context of the increasing evidence for the existence of a broader bipolar spectrum than has been acknowledged within existing classifications. We have developed a numerical rating system, the Bipolar Affective Disorder Dimension Scale, BADDS, that can be used as an adjunct to conventional best-estimate lifetime diagnostic procedures. The scale definitions were informed by (a) the current concepts of mood syndrome recognized within DSMIV and ICD10, (b) the literature regarding severity of episodes, and (c) our own clinical experience. We undertook an iterative process in which we initially agreed scale definitions, piloted their use on sets of cases and made modifications to improve utility and reliability. BADDS has four dimensions, each rated as an integer on a 0 – 100 scale, that measure four key domains of lifetime psychopathology: Mania (M), Depression (D), Psychosis (P) and Incongruence (I). In our experience it is easy to learn, straightforward to use, has excellent inter-rater reliability and retains the key information required to make diagnoses according to DSMIV and ICD10. Use of BADDS as an adjunct to conventional categorical diagnosis provides a richer description of lifetime psychopathology that (a) can accommodate sub-clinical features, (b) discriminate between illness severity amongst individuals within a single conventional diagnostic category, and (c) demonstrate the similarity between the illness experience of individuals who have been classified into different disease categories but whose illnesses both fall near the boundaries between the two categories. BADDS may be useful for researchers and clinicians who are interested in description and classification of lifetime psychopathology of individuals with disorders lying on the bipolar spectrum.