【摘要】 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。更多还原

【Abstract】 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 usefulness of these instruments for the psychological autopsy method were investigated. In addition,the influencing factors of diagnoses obtained through the best- estimate method using the Structured Clinical Interview for DSM- IV Axis Ⅰwere discussed. Methods The subjects of the research were the psychiatric patients of the No. 7 people’s hospital of Dalian and the community persons in the six counties in Liaoning province. Diagnoses by informant’s interview were compared with diagnoses generated 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 informant’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.更多还原