目的:本研究旨在根据四种诊断方法评估卡顿紧张的评估者间可靠性和患病率:布什弗朗西斯卡顿紧张评定量表(BFCRS)筛查和完整量表,Braunig的Catatonia评定量表(CRS),ICD10和DSM5。
方法:对于评估者间的可靠性,不同的评估者使用四个量表提供的定义对患者进行评估:BFCRS屏幕和总计,CRS,ICD10和DSM5。Kippendorff\'α用于计算评分者间的可靠性。使用spearman相关性评估不同系统之间的一致性。在三级护理医院的精神病区连续成人入院的临床样本中,使用四个定义研究了卡顿多症的患病率。
结果:发现BFCRSTotal(α=0.779)的评分者间可靠性良好,DSM5和BFCRS筛选为中等(分别为α=0.575和α=0.514),CRS和ICD10为低(分别为α=0.111和α=0.018)。BFCRSTotal和DSM5定义的卡通症具有最高的一致性(rs=0.892p<0.001)。在连续住院的患病率样本中,在BFCRSScreen和ICD10的定义下,患病率最高(10.3%,置信区间[CI]3.9%至16.7%),其次是BFCRS总计和DSM5定义6.9%,CI1.6%至12.2%),而CRS的患病率最低(3.4%,CI0%至7.2%)。
结论:用于确定临床样本中的紧张症的不同方法会产生不同的患病率。
OBJECTIVE: The present study aimed to assess inter-rater reliability and prevalence of catatonia according to four diagnostic methods: Bush Francis Catatonia Rating Scale (BFCRS) both screening and complete scale, Braunig\'s Catatonia Rating Scale (CRS), ICD 10 and
DSM5.
METHODS: For inter-rater reliability, different raters evaluated patients using the definitions provides by the four scales: BFCRS Screen and Total, CRS, ICD10 and
DSM5. Kippendorff\'α was used to compute the inter-rater reliability. Concordance between different systems was assessed using spearman correlation. Prevalence of catatonia was studied using the four definitions in a clinical sample of consecutive adult admissions in a psychiatry ward of a tertiary care hospital.
RESULTS: The inter-rater reliability was found to be good for BFCRS Total (α=0.779), moderate for
DSM5 and BFCRS screen (α=0.575 and α=0.514 respectively) and low for CRS and ICD10 (α=0.111 and α=0.018 respectively). BFCRS Total and
DSM5 definitions of catatonia had highest concordance (rs=0.892 p<0.001). In the prevalence sample of consecutive hospital admissions, the prevalence was found to be highest with the definitions of BFCRS Screen and ICD 10 (10.3%, confidence intervals [CI] 3.9% to 16.7%), followed by BFCRS Total and
DSM5 definitions 6.9%, CI 1.6% to 12.2%) and while CRS yielded the lowest prevalence rate (3.4%, CI 0% to 7.2%).
CONCLUSIONS: Different methods used to determine catatonia in the clinical sample yield different prevalence of this condition.