RTHD测试器质性精神障碍信度与效度分析及随访研究  

The analysis of reliability and validity of RTHD for organic mental disorders

作　　者：陈忠[1] 孟广彦[2] 杨红梅[2] 高春霓[1] 陈彦方[1] 

机构地区：[1]山东省精神卫生中心,济南250014 [2]济南市精神卫生中心

出　　处：《精神医学杂志》2010年第5期348-350,共3页Journal of Psychiatry

摘　　要：目的用诊断量表-健康与疾病定量测试法-科研版(RTHD-R)现场测试器质性精神障碍和酒精所致精神障碍和躯体疾病(研究组),及躯体疾病共病精神障碍患者(对照组),以及通过随访对RTHD-R进行信度与效度分析。方法采用开放式平行对照设计进行多中心现场测试。首先选取符合CCMD-3诊断标准的器质性精神障碍和酒精所致精神障碍和躯体疾病(42例),及躯体疾病共病精神障碍患者(41例),用RTHD-R评定,再用RTHD软件的逻辑判别系统(RTHD-LVS)进行逻辑诊断,然后在随访第6个月复评一次。结果 2位评定员的首次评定的多轴诊断轴Ⅰ(精神障碍)和轴Ⅲ(躯体疾病和一般医学情况)的评定结果与临床诊断全部一致(Kappa=1)。现场测试的随访复评结果也与临床诊断全部一致(Kappa=1)。同时RTHD-LVS逻辑诊断也得到同样结果。但是轴Ⅱ(人格轴),临床诊断仅有20.5%(17例)诊断人格改变,而评定员和RTHD-LVS均有56.6%(47例)诊断人格改变(χ2=22.89,P<0.001),表明在临床工作中需对轴Ⅱ(人格轴)诊断应予以重视。结论 RTHD-R评定器质性精神障碍、酒精所致精神障碍和躯体疾病,以及躯体疾病共病精神障碍的信度与效度均很高,因此RTHD-R及其诊断软件RTHD-LVS对精神科临床工作和科研有所帮助。Objective To assess and diagnosis patients with organic mental disorders and patients with comorbidity of mental disorders and physical diseases with Rating Test for Health and Diseases （RTHD - R） and its software RTHD -Logical Verdict System （LVS）, and to analysis the reliability and validity of multi -axial diagnosis. Methods A to- tal of 83 patients met with the criteria of CCMD - 3 for organic mental disorders （42 patients） and comorbidity of mental disorders and physical diseases （41 patients） enrolled the parallel controlled and multi -center trial. The patients were assessed with RTHD - R and its software - RTHD - LVS in the baseline and the end of a six - month follow - up. Resuits There were 83 patients in the trial at first, during the follow - up, 1 patient died, 2 patients lost and 80 completed the second rating at the end of follow - up. The results showed that not only there were good reliability between rater A and B, but also validity between raters and clinical diagnosis （golden standard）. However there was low validity of clinical diagnosis in Axis ]I （personality） （X2 = 22.89, P 〈 0.001 ） between the raters and clinical physicians. It was suggested that the Axis II diagnosis often ignored by physicians. The similar results also came from RTHD - LVS. Conclusion The reliability and validity of RTHD testing organic mental disorders are high. It would be also helpful for both clinical work and research.

关 键 词：器质性精神障碍 诊断量表(RTHD) 计算机逻辑诊断 信度 效度 

分 类 号：R749.1[医药卫生—神经病学与精神病学]