CCMD-3与DSM-Ⅳ儿童孤独症两种诊断标准的比较

目的：比较中国精神疾病分类方案与诊断标准第三版（CCMD-3）与美国精神障碍诊断和统计手册第四版（DSM-Ⅳ）儿童孤独症诊断的一致性，探讨CCMD-3儿童孤独症诊断中存在的问题，确定诊断标准中各症状条目的出现频率。方法：运用CCMD-3和DSM-Ⅳ儿童孤独症诊断标准对连续首次就诊的255名可疑发育障碍儿童进行诊断。结果：两种诊断系统儿童孤独症、不典型孤独症、非孤独症诊断的总体一致率为96．08％；诊断差异主要来自于儿童孤独症和不典型孤独症的诊断不一致；个别症状在孤独症儿童中出现频率较低。结论：CCMD-3和DSM-Ⅳ儿童孤独症诊断标准具有较好的诊断一致性；为进一步提高诊断一致性，对CCMD-3中个别症状条目予以调整有所必要。

A Comparative Study of Diagnostic Criteria of CCMD - 3 and DSM - Ⅳ on Childhood Autism

Objective: Comparing the diagnostic criteria of CCMD-3 and DSM-IV on childhood autism, finding problems in the diagnosis of childhood Autism with CCMD-3 and ascertaining the emerging frequency of symptoms in both criteria.Methods:255 children with suspected developmental disorder were diagnosed with criteria of CCMD-3 and DSM-IV on childhood autism. Results:The total accordance of diagnosis of both criteria on childhood autism, atypical autism and non-autism was 96.08%, the discrepancy mainly came from the diagnostic difference of both criteria on childhood autism and atypical childhood autism. The emerging frequency of some symptoms in both criteria was low.Conclusions:The accordance of diagnosis of both criteria on childhood autism was well. Minority of items in criteria of CCMD-3 on autism should be revised in order to improve the diagnostic accordance with DSM-IV.