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中华诊断学电子杂志 ›› 2014, Vol. 02 ›› Issue (02) : 127 -131. doi: 10.3877/cma.j.issn.2095-655X.2014.02.014

所属专题: 文献

临床研究

量子共振检测对精神障碍患者自知力的诊断价值
师建国1,(), 戴尊孝1, 刘飞虎1, 张燕1, 袁晶2, 罗园园1, 崔小花1, 张曼1   
  1. 1. 710061 西安市精神卫生中心精神科
    2. 陕西中医学院
  • 收稿日期:2014-01-28 出版日期:2014-05-26
  • 通信作者: 师建国
  • 基金资助:
    西安市科研计划项目(HM1122)

Further exploration on assessment for patients′ insight with different types of mental disorders by using quantum resonance spectrometer

Jianguo Shi1,(), Zunxiao Dai1, Feihu Liu1, Yan Zhang1, Jing Yuan2, Yuanyuan Luo1, Xiaohua Cui1, Man Zhang1   

  1. 1. Xi′an mental health center, Xi′an 710061, China
  • Received:2014-01-28 Published:2014-05-26
  • Corresponding author: Jianguo Shi
  • About author:
    Corresponding author: Shi Jianguo, Email:
引用本文:

师建国, 戴尊孝, 刘飞虎, 张燕, 袁晶, 罗园园, 崔小花, 张曼. 量子共振检测对精神障碍患者自知力的诊断价值[J/OL]. 中华诊断学电子杂志, 2014, 02(02): 127-131.

Jianguo Shi, Zunxiao Dai, Feihu Liu, Yan Zhang, Jing Yuan, Yuanyuan Luo, Xiaohua Cui, Man Zhang. Further exploration on assessment for patients′ insight with different types of mental disorders by using quantum resonance spectrometer[J/OL]. Chinese Journal of Diagnostics(Electronic Edition), 2014, 02(02): 127-131.

目的

探讨量子共振检测精神障碍患者自知力的可靠性。

方法

采用双盲试验方法,对精神分裂症、心境障碍、分离性障碍患者的自知力,进行量子共振检测仪的检测,并与临床医师的诊断结果进行一致性研究。数据结果采用SPSS 17.0进行统计处理,采用敏感度、特异度、准确度、阳性预测值、阴性预测值、阳性似然比、阴性似然比、Kappa值、Youden指数以及AUC作为诊断性试验的评价指标。

结果

量子共振检测仪检测精神分裂症患者自知力的敏感度为96.2%、特异度为85.7%、准确度为95.0%、阳性预测值为98.1%、阴性预测值为75.0%、阳性似然比为6.727、阴性似然比为0.026、Youden指数为0.758、Kappa值为0.772。检测心境障碍躁狂发作患者自知力的敏感度为94.1%、特异度为93.8%、准确度为94.0%、阳性预测值为97.0%、阴性预测值为88.2%、阳性似然比为15.2、阴性似然比为0.044、Youden指数为0.879、Kappa值为0.864。检测心境障碍抑郁发作患者的敏感度为88.9%、特异度为86.4%、准确度为87.5%、阳性预测值为84.2%、阴性预测值为86.4%、阳性似然比为5.450、阴性似然比为0.128、Youden指数为0.753、Kappa值为0.749。对分离性障碍患者自知力的检测结果中敏感度为89.5%、特异度为92.9%、准确度为90.9%、阳性预测值为94.4%、阴性预测值为86.7%、阳性似然比为12.605、阴性似然比为0.113、Youden指数为0.824、Kappa值为0.816。精神分裂症、心境障碍、躁狂发作、心境障碍、抑郁发作、分离性障碍患者的自知力ROC曲线下面积分别为0.910,0.926,0.876,0.912。

结论

量子共振检测可为精神障碍患者自知力评定提供新的诊断依据。

Objective

To study the reliability of the application of quantum resonance spectrometer(QRS) on the estimation for patients′ insight with different types of mental disorders.

Methods

Double-blind experiment was used to test the insight of patients with schizophrenia, mood (affective) disorders, and dissociative (conversion) disorders with QRS, and compared with clinicians diagnostic results.

Results

The sensitivity was 96.2% by using QRS to test the insight of patients with schizophrenia, the specificity was 85.7%, the accuracy was 95.0%, and the positive predictive value was 98.1%, the negative predictive value was 75.0%, the positive likelihood ratio was 6.727, the negative likelihood ratio was 0.026, the value of Youden index was 0.758, the value of Kappa was 0.772.The sensitivity was 94.1% by testing the insight of patients with manic episode, the specificity was 93.8%, the accuracy was 94.0%, and the positive predictive value was 97.0%, the negative predictive value was 88.2%, the positive likelihood ratio was 15.2, the negative likelihood ratio was 0.044, the value of Youden index was 0.879, the value of Kappa was 0.864.The sensitivity of testing the insight of depressive episode was 88.9%, the specificity was 86.4%, the accuracy was 87.5%, and the positive predictive value was 84.2%, the negative predictive value was 86.4%, the positive likelihood ratio was 5.450, the negative likelihood ratio was 0.128, the value of Youden index was 0.753, the value of Kappa was 0.749.In the result of test the insight of dissociative (conversion) disorders, the sensitivity was 89.5%、the specificity was 92.9%, the accuracy was 90.9%, and the positive predictive value was 94.4%, the negative predictive value was 86.7%.the positive likelihood ratio was 12.605, the negative likelihood ratio was 0.113.the value of Youden index was 0.824, the value of Kappa was 0.816.The insight area under ROC curve of schizophrenia, manic episode, depressive episode, dissociative (conversion) disorders were 0.910, 0.926, 0.876, 0.912, respectively.

Conclusion

QRS can be considered as a new diagnosis tool of estimating patients′ insight.

表1 QRS检测和精神科医师诊断60例精神分裂症患者自知力结果比较(例数)
图1 QRS检测和精神科医师检查精神分裂症患者自知力的ROC曲线
表2 QRS检测与医师精神诊断精神分裂症、心境障碍躁狂发作、心境障碍抑郁发作及分离性障碍患者自知力的结果比较
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