社区重性精神障碍诊断软件信度研究

发布时间：2018-05-21 05:20

  本文选题：精神病学 + 重性精神障碍　； 参考：《中国全科医学》2014年23期

【摘要】：目的探讨《社区精神障碍诊断与公共安全风险评估软件》诊断功能的信度。方法选择2010年10月—2012年2月云南省精神病医院门诊和住院患者以及昆明市丰宁社区在册精神病患者200例。通过对当事人和知情人进行软件问卷测试,并在3 d内由2名精神科医生再次复测,得到精神障碍的诊断、可疑诊断和无诊断3个层次。软件的信度使用克朗巴赫系数(Cronbach'sα)分析。结果在197份有效问卷中,非可疑和无诊断的精神障碍阳性诊断结果为:重性精神障碍Ⅰ轴诊断,当事人版本182例(92.4%),知情人版本190例(96.4%),软件对当事人和知情人版本进行综合诊断为193例(98.0%),2名精神科医生诊断为188例(95.4%),差异无统计学意义(χ2=2.73,P0.05);重性精神障碍Ⅱ轴诊断,当事人版本84例(42.6%),知情人版本142例(72.1%),综合诊断126例(64.0%),2名精神科医生诊断117例(59.4%),差异有统计学意义(χ2=35.28,P0.01)。未能做出诊断但同时也不能排除诊断的可疑诊断,当事人版本8例(4.1%),知情人版本7例(3.6%),综合诊断4例(2.0%),2名精神科医生诊断11例(5.6%),差异无统计学意义(χ2=1.41,P0.05)。在整个问题中,知情人版本偏向于精神障碍为双相障碍、持续性妄想障碍和人格障碍,与当事人版本和医生诊断比较,差异有统计学意义(P0.05);而当事人版本偏向于急性精神障碍和无诊断状态,与知情人版本和医生诊断比较,差异有统计学意义(P0.05)。当事人版本标准化Cronbach'sα=0.849,知情人版本标准化Cronbach'sα=0.835,综合版本标准化Cronbach'sα=0.887,3 d内精神科医生根据同一问题进行复测,进行再测信度检验总体Cronbach'sα=0.832。Ⅰ轴诊断中的脑器质性精神疾病、精神活性物质所致精神障碍与Ⅱ轴诊断中的人格障碍呈正相关,心境障碍、精神病性疾病与精神发育迟滞、人格障碍呈正相关(P0.05)。结论《社区精神障碍诊断与公共安全风险评估软件》对重性精神障碍的诊断功能具有良好的信度,可以作为社区和家庭使用的辅助诊断工具。
[Abstract]:Objective to explore the reliability of diagnostic function of community psychiatric disorders and public safety risk assessment software. Methods 200 outpatients and inpatients in Yunnan Psychiatric Hospital from October 2010 to February 2012 and 200 registered mental patients in Fengning Community of Kunming City were selected. The patients and informants were tested by software questionnaire, and were re-tested by two psychiatrists within 3 days. The diagnosis of mental disorders, suspicious diagnosis and no diagnosis were obtained. The reliability of the software was analyzed with Cronbach's coefficient Cronbach's 伪. Results among 197 valid questionnaires, the positive diagnosis results of non-suspicious and undiagnosed mental disorders were as follows: major mental disorders I axis diagnosis. 182 cases were involved in the patient version and 190 cases in the insider version. The software made a comprehensive diagnosis of the litigants and the insiders version: 193 cases were diagnosed as 98.0%, 188 cases were diagnosed by two psychiatrists, the difference was not statistically significant (蠂 2 / 2.73 / P 0.05; diagnosis of the second axis of severe mental disorders, 蠂 ~ 2 / 2.73 / P 0.05). The patient version was 84 cases with 42.6 cases, the insiders version 142 cases with 72.1 cases, the comprehensive diagnosis of 126 cases with 64.0 cases and 2 psychiatrists with 59.4 cases with significant difference (蠂 2 = 35.28 P 0.01). The patient version of 8 cases was 4.1m, the insiders version of 7 cases was 3.6T, the comprehensive diagnosis of 4 cases was 2.020 / 2 and 2 psychiatrists diagnosed 11 cases with 5.6T, the difference was not statistically significant (蠂 ~ 2 / 1.41) (P = 0.05), but the diagnosis of suspicious diagnosis could not be ruled out at the same time (蠂 ~ 2 / 1.41) (蠂 ~ (2) 1 / 1) / P ~ (0.05) (P < 0.05). Throughout the problem, the insiders' version favours bipolar disorder, persistent delusional disorder and personality disorder, compared with the patient's version and the doctor's diagnosis. The difference was statistically significant (P 0.05), but the patient version was inclined to acute mental disorder and no diagnostic status, compared with the insiders version and the doctor's diagnosis, the difference was statistically significant (P 0.05). The party concerned standardized Cronbach's 伪 0.849, the insiders standardized Cronbach's 伪 0.835, and the comprehensive version standardized Cronbach's 伪 0.8877.The psychiatrist retested the same problem within 3 days, and tested the overall Cronbach's 伪 0.832.I axis diagnosis of brain organic mental diseases. The mental disorders caused by psychoactive substances were positively correlated with the personality disorders in the diagnosis of axis 鈪，

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