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首页> 外文期刊>Schizophrenia research >Five-year stability of ICD-10 diagnoses among Chinese patients presented with first-episode psychosis in Hong Kong.
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Five-year stability of ICD-10 diagnoses among Chinese patients presented with first-episode psychosis in Hong Kong.

机译：在香港出现首发精神病的中国患者中，ICD-10诊断的五年稳定性。

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BACKGROUND: Diagnostic stability is one measure of predictive validity for psychiatric syndromes. It is an under-studied area in functional psychosis despite its clinical and research implications. We aimed at evaluating the stability of ICD-10 diagnoses in a sample of young people with first-episode psychosis. METHOD: One hundred and sixty-six Hong Kong Chinese enrolled in a regional first-episode psychosis treatment program were studied. Subjects' baseline and final 5-year consensus diagnoses were established via systematic medical records' review to determine diagnostic stability and to identify predictors of diagnostic shift towards schizophrenia spectrum. RESULTS: The overall diagnostic consistency was 80.7%. Bipolar affective disorder and schizophrenia were the most stable diagnostic categories over 5 years with prospective consistency of 100% and 95.8% respectively. The least stable baseline diagnoses were unspecified non-organic psychosis, acute and transient psychotic disorders and delusional disorder. Around one-fifth (19.3%) of subjects had diagnostic revision in 5 years. The predominant pattern of diagnostic shift was towards schizophrenia spectrum disorder. Family history of psychosis and longer duration of untreated psychosis were associated with diagnostic transition towards schizophrenia spectrum. CONCLUSIONS: Schizophrenia and bipolar affective disorder were diagnostically stable and could be reliably classified at intake in a Chinese first-episode psychosis sample using the ICD-10 criteria. Diagnostic instability in the least prevalent categories of functional psychosis highlights the limitations of current taxonomies and calls for ongoing revision of diagnostic criteria. In the absence of biological marker, longitudinal validation across consecutive episodes is necessary for accurate diagnostic ascertainment.
机译：背景：诊断的稳定性是预测精神病综合症有效性的一种方法。尽管具有临床和研究意义，但它仍是功能性精神病研究不足的领域。我们旨在评估首次发作性精神病的年轻人样本中ICD-10诊断的稳定性。方法：研究了纳入地区首发精神病治疗计划的166名香港华人。通过系统的病历审查确定受试者的基线和最终5年共识诊断，以确定诊断稳定性并确定诊断趋向精神分裂症谱系的预测因子。结果：总体诊断一致性为80.7％。双相情感障碍和精神分裂症是五年来最稳定的诊断类别，前瞻性一致性分别为100％和95.8％。基线诊断最不稳定的是未明确的非器官性精神病，急性和短暂性精神病和妄想症。大约五分之一（19.3％）的受试者在5年内进行了诊断修订。诊断转变的主要模式是精神分裂症谱系障碍。精神病的家族史和未接受治疗的精神病的持续时间较长，与向精神分裂症谱系的诊断转变有关。结论：精神分裂症和双相情感障碍在诊断上是稳定的，在使用ICD-10标准的中国首发精神病样本中，摄入时可以可靠地分类。在功能性精神病的最不常见类别中，诊断的不稳定性突出了当前分类法的局限性，并要求不断修订诊断标准。在没有生物标记物的情况下，为了确保准确的诊断确定，必须在连续发作中进行纵向验证。

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