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首页> 美国卫生研究院文献>Schizophrenia Bulletin >SU55. The Reliability of the Total Psychosis Score (TPS) and the Remission and Exacerbation Criteria (REC) for Schizophrenia and Schizoaffective Disorders Using the Standard for Clinicians’ Interview in Psychiatry (SCIP)
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SU55. The Reliability of the Total Psychosis Score (TPS) and the Remission and Exacerbation Criteria (REC) for Schizophrenia and Schizoaffective Disorders Using the Standard for Clinicians’ Interview in Psychiatry (SCIP)

机译：SU55。使用精神病学医师面试标准（SCIP）对精神分裂症和精神分裂症的总体精神病学分数（TPS）和缓解与加重标准（REC）的可靠性

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>Background: The Standard for Clinicians’ Interview in Psychiatry (SCIP) is a new valid and reliable diagnostic interview with dimensional output (1–2). The psychosis module of the SCIP has 18 symptoms and signs representing the core symptoms and signs of schizophrenia (delusions, hallucinations, and disorganized thoughts). The total psychosis score (TPS) is measured by the sum of the hallucinations, delusions, and disorganization dimensions. There is a lack of consensus on how to define the remission, response, and exacerbation of schizophrenia and schizoaffective disorders and there is an urgent need to assess the response to antipsychotic medications using a dimensional model. >Methods: To measure the remission, response, and exacerbation of schizophrenia and schizoaffective disorders, the Remission and Exacerbation Criteria (REC) is defined as the percent change in the total psychosis score (TPS) between a baseline assessment and a subsequent assessment. Compared to the baseline assessment, the REC at a subsequent assessment can be categorized as one of the following 7 categories: (1) Remission (full resolution): 100% decrease in symptoms (TPS = 0), (2) Substantial response: ≥75% decrease in TPS, (3) Good response: 50%–74% decrease in TPS, (4) Partial response: 25%–49% decrease in TPS, (5) Subthreshold response: >0 to <25% decrease in TPS, (6) Unchanged: no change in TPS from the baseline score, and (7) Exacerbation: increase in TPS from baseline score. To study the reliability of the TPS and REC categories, 41 patients from 2 inpatient psychiatric units who had been diagnosed with schizophrenia or schizoaffective disorders (mean age = 36, 49% male, 92% White, 68% with high school education or greater) were interviewed by 2 raters at the same time (inter-rater reliability). Patients were interviewed by 2 raters upon admission and before discharge from the inpatient psychiatric units. Inter-rater reliability of the TPS and kappa for REC were calculated. >Results: Inter-rater reliability for the patients’ total psychosis score (TPS) was good, r = 0.95. Inter-rater reliability for the REC categories of remission, response, and exacerbation using the 25 percentile increments was fair (kappa = 0.56). >Conclusion: The SCIP is the only instrument in the psychiatric literature that has a reliable method of assessing remission, response, and exacerbation in schizophrenia and schizoaffective disorders.
机译：>背景：《临床医生精神病学访谈标准》（SCIP）是一种新的有效可靠的诊断性访谈，具有维度输出（1-2）。 SCIP的精神病模块有18种症状和体征，代表精神分裂症的核心症状和体征（妄想，幻觉和思想混乱）。总的精神病评分（TPS）由幻觉，妄想和无组织维度的总和来衡量。关于如何定义精神分裂症和精神分裂症疾病的缓解，反应和加重尚缺乏共识，并且迫切需要使用三维模型来评估对抗精神病药物的反应。 >方法：为测量精神分裂症和精神分裂症的缓解，缓解和加重，缓解和加重标准（REC）定义为基线评估之间总精神病得分（TPS）的变化百分比以及随后的评估。与基线评估相比，后续评估中的REC可归为以下7种类别之一：（1）缓解（完全缓解）：症状减少100％（TPS = 0），（2）实质性反应：≥ TPS降低75％，（3）良好反应：TPS降低50％–74％，（4）部分反应：TPS降低25％–49％，（5）亚阈值反应：> 0到<25％ TPS，（6）不变：TPS与基线得分相比无变化，（7）恶化：TPS与基线得分相比增加。为了研究TPS和REC类别的可靠性，来自2个住院精神科的41名患者被诊断为精神分裂症或精神分裂症（平均年龄= 36，男性49％，白人92％，高中以上文化程度为68％）同时由2位评估者进行了访谈（评估者之间的可靠性）。入院时和住院精神科出院前，由2位评估者对患者进行了采访。计算了TP的评分者间可靠性和REC的kappa值。 >结果：患者的总精神病评分（TPS）的评分者间信度良好，r = 0.95。使用25％的增量对REC类别的缓解，反应和加重REC类别间的信度是合理的（kappa = 0.56）。 >结论： SCIP是精神病学文献中唯一一种具有评估精神分裂症和精神分裂症患者缓解，缓解和加重病情的可靠方法。

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