의료보험 . 보호 자료에 표기된 정신과 진단의 진단 정확도 -경기도 연천지역 자료에서 -

• 영문명: Diagnostic Accuracy of the Mental Disorders Entered in the Medical Security Records
• 발행기관: 대한신경정신의학회
• 저자명: 황성헤 홍진표 조맹제
• 간행물 정보: 『신경정신의학』제35권 제6호, 1307~1318쪽, 전체 12쪽
• 주제분류: 의약학 > 정신과학
• 파일형태: PDF
• 발행일자: 1996.11.30

영문 초록

Objective ： To evaluate the diagnostic accuracy of the psychiatric diagnoses described in medical security records. Method : Using medical security records in Yonchon in 1993, 346 patients with psychiatric diagnoses(ICD-9 290-319) were sampled for the study. 13 trained interviewers visited the patients home and interviewed with semistructured interview schedule made by the authors. 13 interviewers consisted of public health doctors, social worker, nurses, psychiatric residents and psychiatrist. On each interview data of the sample patients, consensus diagnoses were made by the authors according to ICD-9 and DSM- IH -R criteria. Result ： Sensitivity, specificity and kappa value o f Schizophrenic psychoses(ICD-9 295) were 0.77, 0.97 and 0.77，respectively. Those of Affective psychoses(ICD-9 296) were 0.28，0.94 and 0.27，respectively. Those of Neurotic disorders(ICD-9 300) were 0.78，0.73 and 0.40, respectively. Those of Alcohol dependence syndrome(ICD-9 303) were 0.46, 0.99 and 0.57， respectively. Those o f Special symptoms and syndromes not elsewhere classified(ICD-9 307) were 0.47，0.94 and 0.39，respectively. Overall kappa value was 0.46. Conclusion ： Overall Kappa value was moderately acceptable. But the diagnostic accuracy of Affective psychoses was very low. It may be due to low recognition rate of depression by primary care physicians, and the obscurity of ICD-9 classification for mood disorders. Psychiatric education for primary care physicians and using self-report questionnaire for screening test will be needed to improve the diagnostic accuracy.

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결 과

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참고문헌

키워드

Medical security Psychiatric diagnosis Diagnostic accuracy Diagnostic reliability