诊断标准对痴呆症患病率的影响 - - 来自瑞典哥德堡的一项基于人口的研究
Hanna Wetterberg1, Jenna Najar2, Therese Rydberg Sterner3
1Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry (HW, JN, TRS, SK, IS), Institute of Neuroscience and Physiology, Sahlgrenska Academy, at the University of Gothenburg, Mölndal, Sweden; Centre for Ageing and Health (AGECAP) at the University of Gothenburg (HW, JN, TRS, SK, IS), Sweden.
概括
不同的痴呆症诊断标准显著影响患病率. 最近的版本,如ICD-11和DSM-5,报告了与旧版本相比,痴呆症的发病率更高.
科学领域:
- 老年学是指老年学的学科.
- 神经学 神经学
- 精神病学是一个精神病学.
背景情况:
- 痴呆症的患病率根据使用的诊断标准有很大差异.
- 准确的痴呆病发病率估计对于公共卫生规划和资源分配至关重要.
- 国际疾病分类 (ICD) 和精神疾病诊断和统计手册 (DSM) 是痴呆症诊断的关键系统.
研究的目的:
- 调查不同诊断标准如何影响痴呆症患病率估计.
- 使用DSM-III-R,DSM-IV,DSM-5,ICD-10和ICD-11标准来比较痴呆症的流行情况.
- 评估DSM和ICD分类系统之间的协调努力.
主要方法:
- 利用了来自瑞典哥德堡 (N=774) 85岁老年人的两个基于人口的横截面研究的数据.
- 进行了全面的健康和神经认知检查.
- 开发了基于DSM-III-R,DSM-IV,DSM-5,ICD-10和ICD-11标准的五个算法,操作了105个变量.
主要成果:
- 国际疾病分类第11版 (ICD-11) 显示,痴呆症患病率最高 (36.4%),其次是DSM-5 (32.9%).
- 较旧的标准,如DSM-III-R (21.4%) 和ICD-10 (20.5%),导致患病率较低.
- 在DSM-5和ICD-11之间观察到很高的一致性 (κ=0.9),表明部分协调.
结论:
- 诊断标准的选择大大影响了痴呆症患病率的估计.
- 最近的诊断标准 (DSM-5,ICD-11) 导致报告的痴呆症患病率更高.
- 虽然DSM和ICD系统之间的协调取得了进展,但差异仍然存在.
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