精神障碍流行病学调查中RTHD-R信效度及实用性研究

目的:通过精神障碍流行病学调查中RTHD与SCID效度和信度比较,检验RTHD的可理解性、可操作性和可接受性。方法:在精神障碍流行病学调查中,对650例受试对象进行RTHD和SCID的平行交叉检验,首先,分别做出RTHD和SCID的DSM-IV诊断,比较RTHD与SCID两个诊断量表的信度;然后以精神科专家的临床诊断为金标准,分别检验RTHD与SCID的评定员诊断效度、同时也检验RTHD的计算机逻辑诊断与专家诊断的效度,以及比较RTHD与SCID评定的病种和受检者合作程度。结果:RTHD与SCID两个诊断量表的信度:评定员之间诊断一致率96.2%;Kappa=0.888;RTHD与SCID诊断一致率96.4%;Kappa=0.851;RTHD与SCID两个诊断量表的效度:RTHD与精神科专家的临床诊断一致率99.3%;Kappa=0.970;RTHD组平均用时31.2±17.8分钟,SCID组平均用时42.5±19.5分钟,P<0.05。结论:RTHD具有良好的信度和效度,实用性好,值得在流行病学调查中推广应用。

Evaluation of the reliability and validity of RTHD-R in mental-disorders epidemic research

Objective To test the understandability,practicality,and acceptability of RTHD-R,by comparing the reliability and validity of RTHD and SCID in mental-disorders epidemic research.Methods The parallel-crossover design was used to test RTHD and SCID in 600 respondents,and DSM-Ⅳ was used for diagnosing.Reliability of two scales was also evaluated.Taking professional clinical diagnosis as golden criteria,the estimators’ diagnostic validity of RTHD and SCID were tested;the validity of programming logical diagnosis and professional diagnosis for RTHD were tested;the cooperativeness of the tester and kind of disease in RTHD and SCID were compared.Results As for reliability of RTHD and SCID,the diagnostic consistency rate among estimators was 96.2%,KAPPA being0.888.The diagnostic consistency rate of RTHD and SCID was 96.4%,KAPPA being 0.851.RTHD team averagely used 31.2±17.8 min to finish the scale,while SCID team used 42.5±19.5 min(P<0.05).Conclusion RTHD has desirable reliability and validity,and is worthwhile to be widely used in epidemic surveys.