Using multiple datasets to examine youth psychiatric diagnosis

使用多个数据集检查青少年精神病学诊断

• 批准号: 8063907
• 负责人: Prudence Winslow Fisher
• 金额: $ 66.09万
• 依托单位: NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-08-01 至 2013-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8063907
• 关键词: 10 year old; Address; Adjustment Disorders; Adolescent; Adolescent Psychiatry; Adopted; Adult; Advisory Committees; Affect; Age; Age of Onset; Algorithms; American Psychiatric Association; Antisocial Personality Disorder; Anxiety; Anxiety Disorders; Archives; Attention deficit hyperactivity disorder; Behavior; Categories; Characteristics; Child; Child Psychiatry; Childhood; Classification; Clinical; Communities; Comorbidity; Conduct Disorder; Consensus; DSM-III; DSM-IV; DSM-V; Data; Data Aggregation; Data Set; Databases; Depressed mood; Development; Diagnosis; Diagnostic; Diagnostic and Statistical Manual; Diagnostic and Statistical Manual of Mental Disorders; Differential Diagnosis; Dimensions; Disease; Disruptive Behavior Disorder; Dysthymic Disorder; Excision; Feeling suicidal; Frequencies; Fright; Future; Generalized Anxiety Disorder; Goals; Health; Health Occupations; Health Professional; Impairment; Individual; International; Interview; Investigation; Knowledge; Life; Link; Literature; Major Depressive Disorder; Manuals; Measures; Mental Depression; Mental Health; Mental disorders; Methodology; Modeling; Modification; Mood Disorders; Moods; National Institute of Mental Health; Natural History; Oppositional Defiant Disorder; Outcome; Panic Disorder; Pattern; Phobic anxiety disorder; Prevalence; Probability Samples; Procedures; Psychiatric Diagnosis; Psychiatrist; Psychologist; Psychometrics; Psychopathology; Qualifier; Research; Research Personnel; Resources; Role; Sampling; Schedule; Severities; Social Functioning; Source; Specific qualifier value; Structure; Symptoms; System; Taxon; Testing; Time; United States National Institutes of Health; Variant; Work; Youth; age related; base; care systems; child well being; comparative; comparison group; cost; depressive symptoms; disease classification; disorder subtype; early onset; experience; follow-up; improved; instrument; longitudinal course; meetings; minor depressive disorder; named group; novel strategies; outcome forecast; prospective; response; stressor; symposium; young adult

DESCRIPTION (provided by applicant): Since the development of DSM-III in 1980, and through its subsequent revisions (DSM-III-R, DSM-IV), DSM criteria have become almost universally accepted as a basis for diagnosis in the mental health professions. Despite this broad acceptance, there is a paucity of empirical data available that support the highly specified diagnostic formations embodied in manual. The impact that adding, removing, or otherwise altering criteria may have on disorder prevalence, natural history, or associated impairment has not been well studied. There is little consensus on the issue of comorbidity and the extent to which this phenomenon represents misplaced diagnostic boundaries, responses to common antecedents, or causal linkages between disorders. Finally, and especially important to child psychiatry, there is relatively little information available about developmental differences in the expression and significance of DSM-defined disorders. The proposed project would compile and analyze a database of diagnostic and symptom data collected by 16 investigations of youth, all of which used a DSM- linked version of the DISC. The total database would have data on approximately 19,000 children and adolescents -- longitudinal data is available on approximately 14,000 of these. The specific analytic aims outlined in the proposal (examining the validity of diagnostic subtypes and specifiers; understanding diagnostic boundaries and comorbidity; justifying diagnostic thresholds; studying the appropriateness of individual symptom criteria; comparing dimensional and categorical definitions) address the most important and pressing diagnostic and classification issues facing the field and will inform the epistemological underpinnings of child and adolescent psychiatric nosology. In a cost-efficient, manner this project will afford a unique opportunity to address many questions that can only be answered with such a large aggregated dataset with well-defined samples assessed with a standardized, comprehensive and transparent methodology. The aggregated data will also represent an invaluable data resource for future research. PUBLIC HEALTH RELEVANCE: The DSM has become the established standard for psychiatric diagnosis but many of the categories and criteria specified in the manual have not been based upon or tested with empirical data. The proposed project will compile and analyze a database of diagnostic and symptom data on approximately 19,000 children and adolescents to address the validity of current and proposed diagnostic categories and criteria. The project will also provide an invaluable data resource for addressing research questions that require large samples assessed with a standardized, comprehensive and transparent methodology.

描述（由申请人提供）：自1980年DSM-III制定以来，通过其随后的修订（DSM-III-R，DSM-IV），DSM标准几乎已被普遍接受为精神卫生专业诊断的基础。尽管这种广泛的接受，有一个经验数据的匮乏，支持高度具体的诊断形成体现在手册中。增加、删除或以其他方式改变标准可能对疾病患病率、自然史或相关损害的影响尚未得到充分研究。关于合并症的问题以及这种现象在多大程度上代表了错位的诊断界限、对共同前因的反应或疾病之间的因果联系，几乎没有共识。最后，对儿童精神病学特别重要的是，关于DSM定义的疾病的表达和意义的发育差异的信息相对较少。拟议的项目将汇编和分析一个数据库的诊断和症状数据收集的16项调查的青年，所有这些都使用了DSM的链接版本的DISC。整个数据库将有大约19 000名儿童和青少年的数据，其中大约14 000人有纵向数据。提案中概述的具体分析目标（检查诊断亚型和说明符的有效性;理解诊断边界和共病;证明诊断阈值;研究个体症状标准的适当性;比较维度和分类定义）解决该领域面临的最重要和最紧迫的诊断和分类问题，并将告知儿童和青少年精神病学的认识论基础疾病分类学该项目将以具有成本效益的方式提供一个独特的机会，解决许多问题，这些问题只能通过使用标准化，全面和透明的方法评估的具有明确定义的样本的大型综合数据集来回答。汇总的数据也将成为未来研究的宝贵数据资源。公共卫生相关性：DSM已成为精神病诊断的既定标准，但手册中规定的许多类别和标准并未基于经验数据或未经经验数据检验。拟议的项目将汇编和分析约19，000名儿童和青少年的诊断和症状数据数据库，以解决当前和拟议的诊断类别和标准的有效性。该项目还将提供宝贵的数据资源，用于解决需要以标准化、全面和透明的方法进行大样本评估的研究问题。