本文選題：精神病學(xué) + 重性精神障礙　； 參考：《中國全科醫(yī)學(xué)》2014年23期

【摘要】：目的探討《社區(qū)精神障礙診斷與公共安全風(fēng)險評估軟件》診斷功能的信度。方法選擇2010年10月—2012年2月云南省精神病醫(yī)院門診和住院患者以及昆明市豐寧社區(qū)在冊精神病患者200例。通過對當(dāng)事人和知情人進(jìn)行軟件問卷測試,并在3 d內(nèi)由2名精神科醫(yī)生再次復(fù)測,得到精神障礙的診斷、可疑診斷和無診斷3個層次。軟件的信度使用克朗巴赫系數(shù)(Cronbach'sα)分析。結(jié)果在197份有效問卷中,非可疑和無診斷的精神障礙陽性診斷結(jié)果為:重性精神障礙Ⅰ軸診斷,當(dāng)事人版本182例(92.4%),知情人版本190例(96.4%),軟件對當(dāng)事人和知情人版本進(jìn)行綜合診斷為193例(98.0%),2名精神科醫(yī)生診斷為188例(95.4%),差異無統(tǒng)計學(xué)意義(χ2=2.73,P0.05);重性精神障礙Ⅱ軸診斷,當(dāng)事人版本84例(42.6%),知情人版本142例(72.1%),綜合診斷126例(64.0%),2名精神科醫(yī)生診斷117例(59.4%),差異有統(tǒng)計學(xué)意義(χ2=35.28,P0.01)。未能做出診斷但同時也不能排除診斷的可疑診斷,當(dāng)事人版本8例(4.1%),知情人版本7例(3.6%),綜合診斷4例(2.0%),2名精神科醫(yī)生診斷11例(5.6%),差異無統(tǒng)計學(xué)意義(χ2=1.41,P0.05)。在整個問題中,知情人版本偏向于精神障礙為雙相障礙、持續(xù)性妄想障礙和人格障礙,與當(dāng)事人版本和醫(yī)生診斷比較,差異有統(tǒng)計學(xué)意義(P0.05);而當(dāng)事人版本偏向于急性精神障礙和無診斷狀態(tài),與知情人版本和醫(yī)生診斷比較,差異有統(tǒng)計學(xué)意義(P0.05)。當(dāng)事人版本標(biāo)準(zhǔn)化Cronbach'sα=0.849,知情人版本標(biāo)準(zhǔn)化Cronbach'sα=0.835,綜合版本標(biāo)準(zhǔn)化Cronbach'sα=0.887,3 d內(nèi)精神科醫(yī)生根據(jù)同一問題進(jìn)行復(fù)測,進(jìn)行再測信度檢驗總體Cronbach'sα=0.832。Ⅰ軸診斷中的腦器質(zhì)性精神疾病、精神活性物質(zhì)所致精神障礙與Ⅱ軸診斷中的人格障礙呈正相關(guān),心境障礙、精神病性疾病與精神發(fā)育遲滯、人格障礙呈正相關(guān)(P0.05)。結(jié)論《社區(qū)精神障礙診斷與公共安全風(fēng)險評估軟件》對重性精神障礙的診斷功能具有良好的信度,可以作為社區(qū)和家庭使用的輔助診斷工具。
[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 偽. 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 偽 0.849, the insiders standardized Cronbach's 偽 0.835, and the comprehensive version standardized Cronbach's 偽 0.8877.The psychiatrist retested the same problem within 3 days, and tested the overall Cronbach's 偽 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，

本文編號：1917905