DSM-5诊断标准在西班牙儿童和青少年样本中的敏感性和特异性

IF 5.2 3区 医学 Q1 PSYCHIATRY
Ana Blázquez Hinojosa , Luisa Lázaro Garcia , Olga Puig Navarro , Eva Varela Bondelle , Rosa Calvo Escalona
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引用次数: 3

摘要

关于自闭症谱系障碍(ASD)的DSM-5标准存在争议。鉴于已报道的混合结果,我们的主要目的是确定DSM-5在儿童和青少年西班牙样本中的敏感性和特异性。作为次要目标,我们评估了DSM-IV-TR在DSM-5中的诊断稳定性,以及诊断为ASD或社会(实用)沟通障碍(SPCD)的儿童之间的临床差异。方法本研究于2017年开展,回顾我院所评估患者的病历。来自ASD症状的家长报告测量项目(自闭症诊断访谈-修订版)与DSM-5标准相匹配,并用于评估DSM-5标准和现行DSM-IV标准与临床诊断相比的敏感性和特异性。结果dsm -5的敏感性在0.69 ~ 1.00之间,女性较高。按年龄划分,DSM-5和DSM-IV-TR标准的敏感性相似。在智商的情况下,DSM-5标准对“低功能”类别的人的敏感度较低。DSM-5特异性范围为0.64 ~ 0.73,而所有表型亚组的DSM-5特异性相似。在稳定性方面,83.3%的自闭症病例保留了使用DSM-5标准诊断的ASD。关于ASD和SPCD之间的差异,我们发现ASD患者比SPCD患者接受更多的药物治疗。结论需要进一步的研究来证实我们的结果。研究集中在SPCD表型将是必要的,以确定与ASD的结果差异和最有效的诊断和治疗工具。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Sensibilidad y especificidad de los criterios diagnósticos DSM-5 en el trastorno del espectro autista en una muestra de niños y adolescentes españoles

Background

Controversy exists regarding the DSM-5 criteria for autism spectrum disorders (ASD). Given the mixed results that have been reported, our main aim was to determine DSM-5 sensitivity and specificity in a child and adolescent Spanish sample. As secondary goals, we assessed the diagnostic stability of DSM-IV-TR in DSM-5, and clinical differences between children diagnosed with an ASD or a social (pragmatic) communication disorder (SPCD).

Methods

This study was carried out in 2017, reviewing the medical records of patients evaluated in our service. Items from a parent report measure of ASD symptoms (Autism Diagnostic Interview-Revised) were matched to DSM-5 criteria and used to assess the sensitivity and specificity of the DSM-5 criteria and current DSM-IV criteria when compared with clinical diagnoses.

Results

DSM-5 sensitivity ranged from 0.69 to 1.00, and was higher in females. By age, the DSM-5 and DSM-IV-TR criteria showed similar sensitivity. In the case of intellectual quotient, DSM-5 criteria sensitivity was lower for those in the “low-functioning” category. DSM-5 specificity ranged from 0.64 to 0.73, while DSM-5 specificity was similar for all phenotypic subgroups. With respect to stability, 83.3% of autism disorder cases retained a diagnosis of ASD using the DSM-5 criteria. With regard to differences between ASD and SPCD, we found that patients diagnosed with ASD received more pharmacological treatment than those diagnosed with SPCD.

Conclusions

Further research is required to confirm our results. Studies focusing on the SPCD phenotype will be necessary to determine outcome differences with ASD and the most effective diagnostic and therapeutic tools.

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来源期刊
自引率
3.30%
发文量
58
期刊介绍: The Spanish Journal of Psychiatry and Mental Health (SJPMH), incorporated into ISSN 1888-9891, is the official scientific publication of the Spanish Society of Psychiatry and Mental Health. The journal focuses on studying mental illnesses, their pathological processes, and their psychosocial consequences, and aims to disseminate scientific advances in all areas related to mental health and illness. SJPMH accepts unpublished works on psychiatry and mental health, including their medical and social implications. The journal provides space for research in the biological, clinical, and psychosocial fields. Manuscripts undergo peer-review by external reviewers before being accepted for publication. SJPMH is indexed in Index Medicus/Medline, IBECS, Social Sciences Citation Index Journal Citation Reports/Social Sciences Edition, and Current Contents/Social and Behavioral Sciences.
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