DSM-IV پژوهشي درباره توافق دستياران روانپزشكي در زمينه تشخيص گذاري اختلالات محور بر اساس

A STUDY ON THE AGREEMENT OF PSYCHIATRIC RESIDENTS IN DIAGNOSTING DSM-IV AXIS I

Background & Aim : DSM-IV as a system for classification of psychiatric disorders, presently is used extensively by psychiatrics. Although reliability of this system is being discussed in many studies; in majority of cases, assessment is carried out by structured or semistructured diagnostic inter-views, which are generally incompatible with usual clinical work. Hence, this study was carried out to investigate agreement among psychiatric residents about diagnosing DSM-IV axis I by an unstructured interview. Materials & Methods : The study was a cross - sectional research. One hundred and seventeen psychiatric patients were interviewed in daily morning reports in Razi psychiatric hospital in Tabriz. The patients were evaluated by each residents separately and diagnosis on axis (I) were made. Collected data were analysed regarding agreement rate among residents by use of ICC (Intraclass Correlation Coefficient); also for assessment of effects of other variables upon these diagnoses, analysis of variance was done. Results : Agreement rate among residents in diagnosing axis (I) was good to excellent (ICC: 0.71). Resident and patients personal characteristics were not significantly important in explaining diagnoses. Also, with the exception of "patient perception", mental status assessments were not significantly important in this regard. Diagnoses in axes (III) and (IV) were important in explaining some part of final diagnostic process in axis (I). Discussion : It seems that when same information about patients are available for researchers, psychiatric disorders can be diagnosed with a good reliability even without using structured interview.