【摘要】 目的探讨健康问题与疾病定量测试法逻辑判别系统(RTHD-LVS)对偏执型和未定型精神分裂症的多轴诊断及其效度。方法运用RTHD对临床符合中国精神障碍分类与诊断标准第三版(CCMD-3)诊断为精神分裂症偏执型和未定型的患者106例进行半定式评估,然后运用RTHD-LVS科研版和临床版对这些病例进行再诊断。以临床诊断作为金标准,比较两种版本诊断与临床诊断的符合率及两种版本诊断的一致性。结果①轴l诊断:RTHD-LVS科研版轴l诊断与临床诊断符合者99例(93.4%),RTHD-LVS临床版轴l诊断与临床诊断符合者100例(94.3%)。RTHD-LVS两种版本对于偏执型和未定型精神分裂症的诊断一致性均较好(Kappa值分别为0.83和0.92)。②其他轴:本组患者中内向人格特征突出73例(68.8%)。病前1年内有肯定的精神刺激作为诱因者20例(18.9%)。最重社会功能损害稍差或更差者106例(100.0%),目前功能稍差或更差者81例(76.4%)。目前评为无效或恶化者40例(37.7%)。结论RTHD-LVS对精神分裂症患者作了全面的定性与定量评估,结果表明两种版本轴1精神障碍的诊断对精神分裂症诊断效度高,且两种版本之间的一致性好。更多还原

【Abstract】 Objective To validate the rating test for health and disease and its logical verdict system (RTHD-LVS) as a diagnostic instrument for assessing the patients with schizophrenia. Methods A total of 106 patients who met CCMD-3 criteria of paranoid or undifferentiated schizophrenia were assessed by using RTHD, and then were rediagnosed by RTHD-LVS. The logical diagnoses of research version(RV) and clinical version(CV) were compared. Results The number of patients had the RV axis I diagnosis of schizophrenia was 99(93.4%), and the number of patients had the CV axis I diagnosis of schizophrenia was 100(94.3%). As to paranoid schizophrenia, Kappa for the RV axis I diagnosis and that of CV was 0.83. As to undifferentiated schizophrenia, KAPPA for RV and CV was 0.92. RTHD-LVS also assessed other axes, the results showed: Seventy three (68.8%) patients were introverted. Twenty (18.9%) had experienced important negative life events in the prior year. Eighty one(76.4%) had grossly inadequate current functioning and 106(100%) had poor or grossly at the time of their worst episode, Forty (37.7%) had experienced no effects or deteriorated. Conclusions RTHD-LVS is a valid and reliable tool to evaluate the patients with schizophrenia. The logical diagnoses of both versions were greatly consistent with the clinical diagnoses.更多还原