ISSN:0254-4962    

DOI:10.1159/000285003

出版商:S. Karger AG    

年代:1996

数据来源: Karger

ISSN:0254-4962    

DOI:10.1159/000285004

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

The design of the international multicentric field trial on ICD-10, chapter V (F) ‘Mental and Behavioural Disorders (including disorders of psychological development): Diagnostic Criteria for Research’ including some modifications for the study in German-speaking countries is described. The different stages of the study, the assessment instruments, and the database are presented.

ISSN:0254-4962    

DOI:10.1159/000285005

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

The results of the ICD-10 Diagnostic Criteria for Research (DCR) field trial in German-speaking countries concerning section F0 (organic mental disorders) are reported. On the comparatively small data basis of the study, acceptance and interrater-reliability cannot be estimated satisfactorily. Despite this general problem, it can be said that section F0 of ICD-10 DCR maintains a high degree of continuity with respect to ICD-10. Some categories caused diagnostic disturbances and needed further specification, especially the criteria regarding the temporal relationship between the onset of an organic disorder and the psychiatric symptomatology. The recently published definite DCR seem to avoid most of the problems of the earlier version used in this study.

ISSN:0254-4962    

DOI:10.1159/000285006

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

The results of the ICD-10 Diagnostic Criteria for Research (DCR) field trial in German-speaking countries concerning section F1 (mental and behavioural disorders due to use of psychoactive substances) show a comparatively sufficient level of acceptance. The subjective assessment of the diagnostic process and the chance-corrected interrater reliability (kappa = 0.70) are below average but quite acceptable, which is possibly due to the study design as well as the high comorbidity of disorders in this field. However, interrater reliability based on the strictly defined operationalized criteria of the DCR improved markedly compared to earlier ICD-10 field trials in German-speaking countries.

ISSN:0254-4962    

DOI:10.1159/000285007

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

The results of the ICD-10 field trial of the Diagnostic Criteria for Research in German-speaking countries concerning section F2, ‘Schizophrenia, schizotypal and delusional disorders’, are presented. From a total of 39 cases (written case reports and video tapes) 5 met the criteria for schizophrenia (F20) with 201 ratings. The majority of clinicians rated the ease of diagnosis, confidence of diagnosis, and goodness of fit positive. The reliability of the 2-character diagnoses was excellent (F2; kappa = 0.88), as was the case for the category schizophrenia (F20; kappa = 0.89) and was higher than in the comparable study concerning the Clinical Diagnostic Guidelines.

ISSN:0254-4962    

DOI:10.1159/000285008

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

The present study reports results of the ICD-10 research criteria trial concerning the diagnosis of affective disorders (section F3). On the basis of written case reports and videotapes a total of 451 clinicians from 34 centres in German-speaking countries prepared 2,228 diagnostic ratings on 39 different psychiatric patients. Three of the 39 cases met the diagnostic criteria for affective disorders, and 248 of the diagnostic assessments referred to these cases. The majority of clinicians rated the reliability, the ease and the suitability of the diagnostic criteria positively. The reliability of the affective disorders was extremely good, with a kappa of 0.93 in the range of 2-character diagnoses. The reliability of the 3-character categories was much smaller: Kappa values for depressive episode (F31) and recurrent depressive disorder (F33) were 0.68 and 0.54, respectively. The lowest concordance had a kappa value of 0.22 and was found in the case report of dysthymia (F34.1). Therefore a more precise definition of the diagnostic criteria for dysthymia would be desirable.

ISSN:0254-4962    

DOI:10.1159/000285009

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

The concept of neurotic and psychosomatic disorders in ICD-10, chapter V (F), follows the principle of descriptive diagnosis; therefore the classical approaches with special regard to psychoanalytic terminology were abandoned. These changes were subject of a multicentric field trial in German speaking countries evaluating practicability, acceptability, feasibility, reliability and aspects of validity of the ICD-10 Diagnostic Criteria for Research: Involving 34 psychiatric, child-psychiatric and psychosomatic centres 17 video-documented cases with ICD-10 diagnoses from sections F4 and F5 were assessed independently in case conferences. On the basis of 1,116 ratings, acceptability and practicability were rated as comparatively sufficient. For 3-character diagnostic categories, the chance-corrected interrater reliability coefficients (kappa) showed a range from 0.62 to 0.95. The concordance with the independently assessed expert consensus diagnosis for the different cases showed a range between 87 and 100 %.

ISSN:0254-4962    

DOI:10.1159/000285010

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

Results of the ICD-10 Diagnostic Criteria for Research (DCR) field trial in German-speaking countries revealed a high level of interrater reliability (kappa = 0.79) for disorders of adult personality and behaviour (section F6) with marked differences between specific diagnoses: borderline personality = 0.76, transsexualism = 0.98, factitious disorder = 0.33. Compared with the results of the field trial concerning the Clinical Guidelines for section F6 of ICD-10, the application of the more precise and restrictive DRC led to an improvement of general kappa values of 0.15.

ISSN:0254-4962    

DOI:10.1159/000285011

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

Selected results from the section psychotherapy/psychosomatics of the ICD-10 research criteria study are discussed. One hundred thirty diagnosticians from 11 psychosomatics centers took part in this section, assessing 16 video-documented patients in case conferences. The results of the study, which were based on 633 diagnostical assessments, demonstrated sufficient chance-corrected interrater reliability coefficients for the majority of the disorders (kappa ranged from 0.22 to 0.99). System-related problems of the ICD-10 approach were identified concerning depressive and psychosomatic disorders. The results are discussed, following some problematical aspects of the concept of comorbidity and multiaxial approaches. Special reference is given to the work group Operational Psychodynamic Diagnoses’ which has produced a multiaxial system covering important psychodynamic variables.

ISSN:0254-4962    

DOI:10.1159/000285012

出版商:S. Karger AG    

年代:1996

数据来源: Karger