简明儿童少年国际神经精神访谈(父母版)的信效度

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简明儿童少年国际神经精神访谈(父母版)的信效度【摘要】目的:评价简明儿童少年国际神经精神访谈(Mini International Neurops ychiatric Interview for children and adolescents,MINI Kid)(父母版)的信度和效度。

方法:以北京大学第六医院门诊和病房患儿、九一小学学生、海淀寄宿学校初中学生共369人为研究对象,由评定者盲法评定,同时以学龄儿童情感障碍和精神分裂症问卷(The Sc hedule for Affective Disorders and Schizophrenia for School-Age Children-Presen t and Lifetime Version,K-SADS-PL)量表为诊断金标准,评价量表效度。

测定量表的重测信度和内部一致性信度。

结果:量表的评定者间一致性Kappa 值均在0.80以上,重测信度0.90。

以K-SADS-PL为诊断金标准,对MINI Kid父母版进行效度检验显示,诊断灵敏度分别为注意缺陷多动障碍(80.9%)、对立违抗障碍(78.0%)、品行障碍(75.0%)、儿童情感障碍及情绪问题(65.8%)、抽动障碍(66.0%)、精神病性障碍(91.5%)、广泛发育障碍(74.0%);诊断特异度分别为注意缺陷多动障碍(97.0%)、对立违抗障碍(91.1%)、品行障碍(94.2%)、儿童情感障碍及情绪问题(77.8%)、抽动障碍(99.2%)、精神病性障碍(99.6%)、广泛发育障碍(100.0%)。

结论:简明儿童少年国际神经精神访谈父母版具有较好的信度和效度,适用于儿童精神障碍的流行病学研究。

【关键词】中文版;简明儿童少年国际神经精神访谈;信度;效度;诊断试验中图分类号:R749.94 文献标识码:A 文章编号:1000-6729(2010)012-0921-05doi:10.3969/j.issn.1000-6729.2010.12.009Reliability and validity of Chinese version of the Mini International NeuropsychiatricInterview for Children and Adolescents(Parent Version)LIU Yu-Xin,LIU Jin,WANG Yu-FengPeking University Institute of Mental Health,Key Laboratory of Ministr y of Health(Peking University),Beijing 100191,ChinaCorresponding author,WANG Yu-Feng,E-mail:wangyf@【Abstract】Objective:To evaluate the reliability and validity of the C hinese version of Mini-International Neuropsychiatric Interview for Children an d Adolescents,parent version(MINI Kid parent version).Methods:MINI Kid(parent v ersion)was translated into Chinese with the permission of authors.The Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and L ifetime Version(K-SADS-PL)was used as the gold standard.The reliability and val idity of MINI Kid(parent version)was investigated in this study.A total of 369 subjects,including out-patients and in-patients from Peking University Institut e of Mental Health and students from a primary school and a secondary school we re included in this study.MINI Kid(parent version)and K-SADS-PL were performed independently with qualified interviewers.Seventeen interviewers for MINI Kid w ere included in the inter-rater reliability training.Two weeks after the first MINI Kid interview,10 parents were evaluated by the second MINI Kid interview t o assess the test-retest reliability.Results:The interrater reliability was hig her than 0.80,and the test-retest reliability was ing K-SADS-PL as the g old standard,the validity rest showed that the sensitivity were 80.9% for atten tion deficit hyperactivity disorder,78.0% for oppositional defiant disorder,75. 0% for conduct disorder,65.8% for children affect disorder and emotional problem,66.0% fortic disorder,91.5% for psychotic disorder,74.0% for pervasive develo pmental disorder,respectively.The specificity were 97.0% for attention deficit hyperactivity disorder,91.1% for oppositional defiant disorder,94.2% for conduc t disorder,77.8% for children affect disorder and emotional problem,99.2% for t ic disorder,99.6% for psychotic disorder,100.0% for pervasive developmental dis order,respectively.Conclusion:The results suggest that the Chinese version of M INI Kid(parent version)has satisfied reliability and validity and is suitable f or epidemiological study.【Key Words】 Chinese version;Mini International Neuropsychiatric Inter view for children and adolescents(MINI Kid);reliability;validity;diagnostic tes t根据国内外儿童心理健康状况的研究进展,各类儿童精神障碍已经成为危害儿童和少年身心健康的重要因素。

我国儿童少年的精神障碍已经引起全社会的广泛关注。

了解儿童精神障碍的患病率、分布特征和影响因素,可以为制订公共卫生政策、提供医疗和干预服务提供科学依据。

简明国际神经精神访谈(Mini International Neuropsychiatric Interview,MI NI)是为《精神障碍诊断与统计手册》(Diagnostic and Statistical Manual of Mental Disorders,4th edition,DSM-IV)[1]和《国际精神障碍统计分类手册》(Internationa l Classification of Disease,10th version,ICD-10)[2]中精神疾病的诊断而设计的一个简短定式诊断交谈问卷,由美国及欧洲的精神病学家和临床医师联合制定,适用于多中心临床试验和流行病学研究进行简短并准确的定式精神检查,在非研究性医疗机构中也可作为跟踪患者医疗结局的第一个步骤[3]。

简明儿童少年国际神经精神访谈(Mini Internati onal Neuropsychiatric Interview for children and adolescents,MINI Kid)源自MINI问卷,增加了DSM-IV 和ICD-10中与儿童相关的诊断,适用于6~16岁的儿童和少年,目前最新的英文版本是5.0版[4],包括直接询问儿童和少年的问卷与询问父母的问卷。

鉴于国内缺乏适用于流行病学研究和临床多中心研究的标准化诊断工具,在得到MINI工具作者授权后,本文引进和翻译该量表,并对其父母版的信度和效度进行初步测试,以期为儿童精神障碍的流行病学调查及临床多中心研究提供实用、可靠的标准化工具。

1 对象和方法1.1对象样本来源于2007年4月-2008年9月北京大学第六医院儿童门诊及儿童病房就诊患儿、海淀区九一小学学生、海淀区寄宿学校初中学生,共369名。

其中男孩270名,女孩99名,年龄6~17岁,平均年龄(11.2±2.9)岁。

所有受试者均自愿参加本研究,并获得了家长的口头同意。

1.2工具1.2.1 MINI Kid父母版由本文作者对英文5.0版量表[4]进行翻译,请有经验的英文编辑修改,并邀请中英文俱佳的加拿大籍精神科医师进行回译,针对回译中发现的问题反复修订后最终定稿。

引进之初对7名具有初中以上受教育程度的家长进行试测,发现家长均能理解该问卷的内容并接受问卷调查,在我国文化背景下运用具有可接受性。