简明儿童少年国际神经精神访谈儿童版的信效度
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摘要
目的:评价适用于简明儿童少年国际神经精神访谈(Mini International Neuropsychiatric Interview for children and adolescents,MINI Kid)儿童版的信度和效度。方法:以北京大学第六医院门诊和病房患儿、某小学学生、某寄宿学校初中学生、四川地震后移居日照的儿童青少年共392人为研究对象,同时以学龄儿童情感障碍和精神分裂症问卷(The Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version,K-SADS-PL)为诊断的金标准;由评定者盲法评定,评价MINIKid量表效度、重测信度和内部一致性信度。结果:量表的评定者间一致性Kappa值均在0.80以上,重测信度0.90。以K-SADS-PL为诊断金标准,对MINI Kid儿童版进行效度检验显示,诊断灵敏度分别为注意缺陷多动障碍(32.0%)、对立违抗障碍(30.9%)、品行障碍(78.6%)、儿童情感障碍及情绪问题(66.3%)、抽动障碍(58.5%)、精神病性障碍(93.6%)、创伤后应激障碍(79.2%);诊断特异度分别为注意缺陷多动障碍(95.8%)、对立违抗障碍(94.5%)、品行障碍(94.5%)、儿童情感障碍及情绪问题(66.8%)、抽动障碍(98.8%)、精神病性障碍(98.6%)、创伤后应激障碍(92.7%)。对全部完成儿童版和父母版的319名儿童的两个版本结果进行并联诊断,显示诊断灵敏度分别为注意缺陷多动障碍(86.5%)、对立违抗障碍(83.5%)、品行障碍(92.9%)、儿童情感障碍及情绪问题(73.7%)、抽动障碍(73.6%)、精神病性障碍(97.9%);诊断特异度分别为注意缺陷多动障碍(95.9%)、对立违抗障碍(88.8%)、品行障碍(91.1%)、儿童情感障碍及情绪问题(66.7%)、抽动障碍(98.5%)、精神病性障碍(98.5%)。结论:除儿童情感障碍及情绪问题外,简明儿童少年国际神经精神访谈儿童版单独使用有很高的特异度,但灵敏度偏低,建议与父母版并联使用,以提高灵敏度。
Objective:To evaluate the reliability and validity of the Chinese version of Mini-International Neuropsychiatric Interview for Children and Adolescents,child version(MINI Kid child version).Methods:MINI Kid(child version)was translated into Chinese with the permission of authors.The Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version(K-SADS-PL)was used as the gold standard.The reliability and validity of MINI Kid(child version)was investigated in this study.A total of 392 out-patients and in-patients from Peking University Institute of Mental Health,students from a primary school and a secondary school,and some children suffered from Wenchuan Earthquake were included in the study.MINI Kid(child version)and K-SADS-PL were performed independently with qualified interviewers.Seventeen interviewers for MINI Kid were included in the inter-rater reliability training.Two weeks after the first MINI Kid interview,10 children were evaluated by the second MINI Kid interview to assess the test-retest reliability.Results:The inter-rater reliability was higher than 0.80 and the test-retest reliability was 0.90.Using K-SADS-PL as the gold standard,the validity rest showed that the sensitivity were 32.0% for attention deficit hyperactivity disorder,30.9% for oppositional defiant disorder,78.6% for conduct disorder,66.3% for children affect disorder and emotional problem,58.5% for tic disorder,93.6% for psychotic disorder,and 79.2% for posttraumatic stress disorder,respectively.The specificity were 95.8% for attention deficit hyperactivity disorder,94.5% for oppositional defiant disorder,94.5% for conduct disorder,66.8% for children affect disorder and emotional problem,98.8% for tic disorder,98.6% for psychotic disorder,and 97.2% for posttraumatic stress disorder,respectively.Parallel diagnosis data of parent version and child version of 319 children showed that the sensitivity were 86.5% for attention deficit hyperactivity disorder,83.5% for oppositional defiant disorder,92.9% for conduct disorder,73.7% for children affect disorder and emotional problem,73.6% for tic disorder,and 97.9% for psychotic disorder,respectively;and the specificity were 95.9% for attention deficit hyperactivity disorder,88.8% for oppositional defiant disorder,91.1% for conduct disorder,66.7% for children affect disorder and emotional problem,98.5% for tic disorder,and 98.5% for psychotic disorder,respectively.Conclusion:Except for children affect disorder and emotional problem,the Chinese version of MINI Kid(child version)has good specificity whereas the sensitivity is relatively low.Parallel diagnosis of parent version and child version is recommended.
Objective:To evaluate the reliability and validity of the Chinese version of Mini-International Neuropsychiatric Interview for Children and Adolescents,child version(MINI Kid child version).Methods:MINI Kid(child version)was translated into Chinese with the permission of authors.The Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version(K-SADS-PL)was used as the gold standard.The reliability and validity of MINI Kid(child version)was investigated in this study.A total of 392 out-patients and in-patients from Peking University Institute of Mental Health,students from a primary school and a secondary school,and some children suffered from Wenchuan Earthquake were included in the study.MINI Kid(child version)and K-SADS-PL were performed independently with qualified interviewers.Seventeen interviewers for MINI Kid were included in the inter-rater reliability training.Two weeks after the first MINI Kid interview,10 children were evaluated by the second MINI Kid interview to assess the test-retest reliability.Results:The inter-rater reliability was higher than 0.80 and the test-retest reliability was 0.90.Using K-SADS-PL as the gold standard,the validity rest showed that the sensitivity were 32.0% for attention deficit hyperactivity disorder,30.9% for oppositional defiant disorder,78.6% for conduct disorder,66.3% for children affect disorder and emotional problem,58.5% for tic disorder,93.6% for psychotic disorder,and 79.2% for posttraumatic stress disorder,respectively.The specificity were 95.8% for attention deficit hyperactivity disorder,94.5% for oppositional defiant disorder,94.5% for conduct disorder,66.8% for children affect disorder and emotional problem,98.8% for tic disorder,98.6% for psychotic disorder,and 97.2% for posttraumatic stress disorder,respectively.Parallel diagnosis data of parent version and child version of 319 children showed that the sensitivity were 86.5% for attention deficit hyperactivity disorder,83.5% for oppositional defiant disorder,92.9% for conduct disorder,73.7% for children affect disorder and emotional problem,73.6% for tic disorder,and 97.9% for psychotic disorder,respectively;and the specificity were 95.9% for attention deficit hyperactivity disorder,88.8% for oppositional defiant disorder,91.1% for conduct disorder,66.7% for children affect disorder and emotional problem,98.5% for tic disorder,and 98.5% for psychotic disorder,respectively.Conclusion:Except for children affect disorder and emotional problem,the Chinese version of MINI Kid(child version)has good specificity whereas the sensitivity is relatively low.Parallel diagnosis of parent version and child version is recommended.
引文
[1]Kaufman J,Birmaher B,Brent D,et al.Schedule for affectivedisorders and schizophrenia for school-age children-present and li-fetime version(K-SADS-PL):initial reliability and validity da-ta[J].J Am Acad Child Adolesc Psychiatry,1997,36(7):980-988.
[2]First MB,Spitzer RL,Gibbon M,et al.Structured clinical in-terview for DSM-IV-TR axis I disorders.Research version[M].Non-patient ed.(SCID-I/NP).New York:BiometricsResearch,New York State Psychiatric Institute,2001.
[3]Sartorius N,Kaelber CT,Cooper JE,et al.On behalf of allparticipating investigators:Progress toward achieving trial of theclinical guidelines accompanying the WHO Classification of men-tal and behavioral disorders in ICD-10[J].Arch Gen Psychia-try,1993,50:115-124.
[4]Sheehan DV,Lecrubier Y,Sheehan H,et al.The mini-interna-tional neuropsychiatric interview(M.I.N.I.):the develop-ment and validation of a structured diagnostic psychiatric inter-view for DSM-IV and ICD-10[J].J Clin Psychiatry,1998,59(suppl20):22-33.
[5]Spitzer RL,Williams JBW,Gibbon M,et al.The structured cli-nical interview for DSM-III-R,I.History,rational and descrip-tion[J].Arch Gen Psychiatry,1992,49:624-629.
[6]World Health Organization.The composite International Diagnos-tic Interview(CIDI)[M].Authorized Core,Version1.0.Geneva:WHO,1990.
[7]Lecrubier Y,Sheehan DV,Weiller E,et al.The Mini Interna-tional Neuropsychiatric Interview(MINI).A short diagnosticstructured interview:reliability and validity according to the CI-DI[J].Eur Psychiatry,1997,12:224-231.
[8]Sheehan DV,Lecrubier Y,Sheehan H,et al.The validity ofthe Mini International Neuropsychiatric Interview(MINI)ac-cording to the SCID-P and its reliability[J].Eur Psychiatry,1997,12:232-241.
[9]司天梅,舒良,党为民,等.简明国际神经精神访谈中文版的临床信效度[J].中国心理卫生杂志,2009,23(7):493-497.
[10]Sheehan DV,Shytle D,Milo K,et al.Mini international neu-ropsychiatric interview for children and adolescents[M].Eng-lish version5.0.Tampa:University of South Florida College ofMedicine,2006.
[11]Schwab-Stone ME,Shaffer D,Dulcan MK et al,Criterion va-lidity of the NIMH Diagnostic Interview Schedule for Children,Version2.3(DISC-2.3)[J].J Am Acad Child Adolesc Psy-chiatry,1996,35:878-888.
[12]Sheehan DV,Sheehan KH,Shytle RD,et al.Reliability andvalidity of the Mini International Neuropsychiatric Interview forChildren and Adolescents(MINI-KID)[J].J Clin Psychia-try,2010,71(3):313-326.
[13]Judd LL,Kessler RC,Paulus MP,et al.Comorbidity as a fun-damental feature of generalized anxiety disorders:results fromthe National Comorbidity Study(NCS)[J].Acta PsychiatrScand,1998,98(Suppl393):6-11.
[14]胡赤怡,胡纪泽,段卫东,等.复合性国际诊断访谈表的效度研究[J].中国神经精神疾病杂志,2008,34(7):385-389.
[15]Fisher PW,Shaffer D,Piacentini JC,et al.Sensitivity of theDiagnostic Interview Schedule for Children.2nd Ed(DISC-2.1)for specific diagnoses of children and adolescents[J].J AmAcad Child Adolesc Psychiatry,1993,32:666-673.
[2]First MB,Spitzer RL,Gibbon M,et al.Structured clinical in-terview for DSM-IV-TR axis I disorders.Research version[M].Non-patient ed.(SCID-I/NP).New York:BiometricsResearch,New York State Psychiatric Institute,2001.
[3]Sartorius N,Kaelber CT,Cooper JE,et al.On behalf of allparticipating investigators:Progress toward achieving trial of theclinical guidelines accompanying the WHO Classification of men-tal and behavioral disorders in ICD-10[J].Arch Gen Psychia-try,1993,50:115-124.
[4]Sheehan DV,Lecrubier Y,Sheehan H,et al.The mini-interna-tional neuropsychiatric interview(M.I.N.I.):the develop-ment and validation of a structured diagnostic psychiatric inter-view for DSM-IV and ICD-10[J].J Clin Psychiatry,1998,59(suppl20):22-33.
[5]Spitzer RL,Williams JBW,Gibbon M,et al.The structured cli-nical interview for DSM-III-R,I.History,rational and descrip-tion[J].Arch Gen Psychiatry,1992,49:624-629.
[6]World Health Organization.The composite International Diagnos-tic Interview(CIDI)[M].Authorized Core,Version1.0.Geneva:WHO,1990.
[7]Lecrubier Y,Sheehan DV,Weiller E,et al.The Mini Interna-tional Neuropsychiatric Interview(MINI).A short diagnosticstructured interview:reliability and validity according to the CI-DI[J].Eur Psychiatry,1997,12:224-231.
[8]Sheehan DV,Lecrubier Y,Sheehan H,et al.The validity ofthe Mini International Neuropsychiatric Interview(MINI)ac-cording to the SCID-P and its reliability[J].Eur Psychiatry,1997,12:232-241.
[9]司天梅,舒良,党为民,等.简明国际神经精神访谈中文版的临床信效度[J].中国心理卫生杂志,2009,23(7):493-497.
[10]Sheehan DV,Shytle D,Milo K,et al.Mini international neu-ropsychiatric interview for children and adolescents[M].Eng-lish version5.0.Tampa:University of South Florida College ofMedicine,2006.
[11]Schwab-Stone ME,Shaffer D,Dulcan MK et al,Criterion va-lidity of the NIMH Diagnostic Interview Schedule for Children,Version2.3(DISC-2.3)[J].J Am Acad Child Adolesc Psy-chiatry,1996,35:878-888.
[12]Sheehan DV,Sheehan KH,Shytle RD,et al.Reliability andvalidity of the Mini International Neuropsychiatric Interview forChildren and Adolescents(MINI-KID)[J].J Clin Psychia-try,2010,71(3):313-326.
[13]Judd LL,Kessler RC,Paulus MP,et al.Comorbidity as a fun-damental feature of generalized anxiety disorders:results fromthe National Comorbidity Study(NCS)[J].Acta PsychiatrScand,1998,98(Suppl393):6-11.
[14]胡赤怡,胡纪泽,段卫东,等.复合性国际诊断访谈表的效度研究[J].中国神经精神疾病杂志,2008,34(7):385-389.
[15]Fisher PW,Shaffer D,Piacentini JC,et al.Sensitivity of theDiagnostic Interview Schedule for Children.2nd Ed(DISC-2.1)for specific diagnoses of children and adolescents[J].J AmAcad Child Adolesc Psychiatry,1993,32:666-673.
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