CAJ | 학술논문

目的：探讨心理解剖临床定式访谈(SCID)诊断准确性的影响因素。方法研究对象为大连市第七人民医院的就诊的209例患者和大连地区的144名社区人群。由经过统一培训的，并获得 NIMH 访谈员资格认证的研究人员对研究对象和信息人分别进行SCID访谈。结果①心理解剖SCID诊断的一致性较好：kappa值从抑郁障碍的0.696到精神分裂症的0.930；灵敏度从焦虑障碍的55.10%到精神分裂症的88.57%；特异度从抑郁障碍的95.70%到酒精使用障碍的100%。②不同类别的信息人心理解剖 SCID诊断的一致率差异有统计学意义(P<0.05)，其中一级亲属心理解剖 SCID诊断一致率最高(P<0.05)。农村信息人心理解剖 SCID诊断一致率高于城市，与患者同住高于不与患者同住，差异有统计学意义(P<0.05)。信息人学历越高，心理解剖 SCID 诊断一致率越高，差异有统计学意义(P<0.05)。结论心理解剖 SCID 诊断具有较好的灵敏度和特异度，与患者本人 SCID 诊断一致性良好。心理解剖 SCID诊断精神疾病时尽可能选取一级亲属(父母或配偶)以及高学历者为信息提供者。
목적：탐토심리해부림상정식방담(SCID)진단준학성적영향인소。방법연구대상위대련시제칠인민의원적취진적209례환자화대련지구적144명사구인군。유경과통일배훈적，병획득 NIMH 방담원자격인증적연구인원대연구대상화신식인분별진행SCID방담。결과①심리해부SCID진단적일치성교호：kappa치종억욱장애적0.696도정신분렬증적0.930；령민도종초필장애적55.10%도정신분렬증적88.57%；특이도종억욱장애적95.70%도주정사용장애적100%。②불동유별적신식인심리해부 SCID진단적일치솔차이유통계학의의(P<0.05)，기중일급친속심리해부 SCID진단일치솔최고(P<0.05)。농촌신식인심리해부 SCID진단일치솔고우성시，여환자동주고우불여환자동주，차이유통계학의의(P<0.05)。신식인학력월고，심리해부 SCID 진단일치솔월고，차이유통계학의의(P<0.05)。결론심리해부 SCID 진단구유교호적령민도화특이도，여환자본인 SCID 진단일치성량호。심리해부 SCID진단정신질병시진가능선취일급친속(부모혹배우)이급고학력자위신식제공자。
Objective The sensitivity and specificity of using psychological autopsies to diagnose a psychiatric disorder are a critical issue.Therefore,the sensitivity and specificity of the Structured Clinical Interview for DSM-IV AxisⅠand the useful-ness of these instruments for the psychological autopsy method were investigated.In addition,the influencing factors of diag-noses obtained through the best- estimate method using the Structured Clinical Interview for DSM-IV Axis Ⅰwere dis-cussed.Methods The subj ects of the research were the psychiatric patients of the No.7 people's hospital of Dalian and the com-munity persons in the six counties in Liaoning province.Diagnoses by informant's interview were compared with diagnoses gen-erated by a personal interview.Results The kappa coefficients of agreement by personal and informant's interview were from 0. 696 for anxiety disorder to 0.930 for schizophrenia;The specificity of most diagnoses obtained through the best-estimate method using the Structured Clinical Interview for DSM-IV AxisⅠwas higher than 88%,yet the sensitivity was lower than the specificity.The influencing factors of diagnoses obtained through the best-estimate method using the Structured Clinical Interview for DSM-IV AxisⅠwere category and education of the informants.Conclusion The sensitivity and specificity of using psychological autopsies to diagnose a psychiatric disorder were fair to excellent.The influencing factors of diagnoses by inform-ant's interview were category and education of the informants.The Structured Clinical Interview for DSM-IV Axis Ⅰcan be recommended as a tool for the psychological autopsy research.