心理CT在新兵精神疾病监测过程中的应用_0.docVIP

心理CT在新兵精神疾病监测过程中的应用 作者：甘景梨 高存友 胡兴焕 刘晓辉 杨代德 牛锋 杨春 【关键词】 心理CT；新兵；精神疾病监测；一致性 　　【摘要】 目的 探讨心理CT在新兵精神疾病监测过程中的 应用 价值，为部队顺利开展新兵精神疾病的筛查工作提供可行的客观依据。 方法 应用北京回龙观 医院 开发研制的心理CT对某部4160名新兵进行测查。以《 中国 精神障碍分类与诊断标准》第3版为诊断标准，由专家组通过专访、晤谈、精神检查等方法对新兵进行临床诊断，并将临床诊断与心理CT测查结果进行比较，评价该系统在初步诊断中的应用价值。 结果 心理CT的总检出率为11.46‰，临床诊断的总检出率为7.31‰；两种诊断的总一致率为98.9%（Kappa=0.574，u=46.18）；精神病性障碍一致率为99.6%（Kappa=0.481，u=31.75）；焦虑/抑郁性障碍一致率为99.3%（Kappa=0.371，u=24.33）；正常人判断一致率为99.0%（Kappa=0.489，u=32.12）。经比较差异均有极显著性(P均＜0.01)。 结论 心理CT在新兵精神疾病监测过程中能有效节省时间，是重要的辅助诊断手段。 　　【关键词】 心理CT；新兵；精神疾病监测；一致性 　　 The application of psychological computerized tomography in the survEillance of mental disorders in recruits 　　【Abstract】 Objective To explore the value of psychological computerized tomography (PCT) in the survEIllance of mental disorders and provide workable objective basis for screening of mental disorders in recruits. Methods 4160 recruits were examined with the PCT developed by the Huilongguan hospital of Beijing. Clinical diagnoses for recruits were made by expert group through special visit, interview and mental state examination according to CCMD3,and comparisons of clinical diagnoses and results of the PCT conducted to evaluate the value of the PCT in preliminary diagnosing. Results The total detectable rates were respectively 11.46% of the PCT and 7.31% of clinical diagnosing; the total concordant rate of the 2 diagnosing methods was 98.9%(Kappa=0.574,u=46.18); concordant rate of psychotic disorder was 99.6%(Kappa=0.481,u=31.75); concordant rate of anxiety/depression 99.3% (Kappa=0.371,u=24.33); concordant rate of normal human judgment was 99.0%(Kappa=0.489,u=32.12).Difference all were the most significant( all P0.01). Conclusion The PCT can effectively economize time r in the surveillance of mental disorders for and is an important diagnostic aid. 　　【Keywords】 Psychological CT; recruits; surveillance of mental disorders; uniformity 　　军队属特殊群体，军人需要良好的心理素质和 社会 适应性，但近年的调查显示部队精神疾病的患病率仍然居高不下，这与新兵带病入伍不无关系［1］。每年新兵数量大，而且精神