CAJ | 학술논문

目的:初步制订"病理性上网"的诊断标准,为全国测查及完善该标准提供依据.方法:检索文献中常用的与"病理性上网"有关的 "诊断标准"或筛选标准,据此建立"病理性上网"的诊断标准条目库及初步诊断标准.测查中,由每两名具有高级职称的精神科医生(共8名)组成一组,根据"病理性上网"操作性定义,以本文制定的初步诊断标准为检查提纲,交替对79名因上网问题住院的受试者及其家属进行访谈,独立评定并作出诊断.另外,方便选取某高中一年级2个班的全体男生,共44人,由评定者单独访谈、评定.两名评定者均作出诊断时方可确诊,否则排除诊断.结果:123名受试者中"病理性上网"者为54名.两名专家的诊断一致性Kappa=0.812(P<0.001).条目库中12条症状有2条评定者间一致性差,4条对诊断贡献小.在保留的6个条目中,4条以上阳性时,诊断的灵敏度为78.9%,特异度为95.3%.严重程度标准偏严格.确定诊断者的病程90.7%为3个月以上,77.7%为6个月以上.结论:修订后的初步诊断标准包括6项症状标准,3项严重程度标准,1项病程标准,以及排除标准.本标准评定者间一致性高、可操作性强,可作为下一步制定"病理性上网"操作性诊断标准的基础.
목적:초보제정"병이성상망"적진단표준,위전국측사급완선해표준제공의거.방법:검색문헌중상용적여"병이성상망"유관적 "진단표준"혹사선표준,거차건립"병이성상망"적진단표준조목고급초보진단표준.측사중,유매량명구유고급직칭적정신과의생(공8명)조성일조,근거"병이성상망"조작성정의,이본문제정적초보진단표준위검사제강,교체대79명인상망문제주원적수시자급기가속진행방담,독립평정병작출진단.령외,방편선취모고중일년급2개반적전체남생,공44인,유평정자단독방담、평정.량명평정자균작출진단시방가학진,부칙배제진단.결과:123명수시자중"병이성상망"자위54명.량명전가적진단일치성Kappa=0.812(P<0.001).조목고중12조증상유2조평정자간일치성차,4조대진단공헌소.재보류적6개조목중,4조이상양성시,진단적령민도위78.9%,특이도위95.3%.엄중정도표준편엄격.학정진단자적병정90.7%위3개월이상,77.7%위6개월이상.결론:수정후적초보진단표준포괄6항증상표준,3항엄중정도표준,1항병정표준,이급배제표준.본표준평정자간일치성고、가조작성강,가작위하일보제정"병이성상망"조작성진단표준적기출.
Objective:To establish a preliminary diagnostic criteria of pathological internet use for field test in China.Methods:Through searching common "pathological internet use" diagnostic criteria or screen criteria in literature,a diagnostic criteria items pool and a preliminary diagnostic criteria of "pathological internet use" were established .According to the diagnostic criteria,each 2 senior professional psychiatrists in turn interviewed 79 patients and their parents,and then made diagnosis respectively. In addiction,44 high school students were each evaluated by one psychiatrist.The definite diagnosis was made when 2 evaluators make the same diagnosis for one patient.Result:In 123 patients,54 were pathological internet use.For diagnosis,the value of kappa for inter-rater reliability was 0.812( P<0.001).In the 12 criteria items,2 for poor inter-rater reliability and 4 for little contribution to diagnosis were eliminated.In the reserved 6 items,if 4 items(or more)were positive,the diagnostic sensitivity was 78.9% and specificity was 95.3%.Functional impairment criteria were made strictly.In the patients who were made the definite diagnosis,90.7% had duration of illness above 3 months,and 77.7% above 6 months.Conclusion:The preliminary diagnostic criteria of pathological internet use after revised includes 6 symptom criteria,3 functional impairment criteria,duration of illness and exclusive criteria.The criteria proposed is with high consistency on evaluations made by psychiatric raters,and with operational convenience.The criteria,after further revised,may fit the clinical application.