Hine F R, Williams R B
Arch Gen Psychiatry. 1975 Apr;32(4):525-8. doi: 10.1001/archpsyc.1975.01760220137015.
Two problems that interfere with the student's understanding and acceptance of psychiatric knowledge result largely from the use of a categorical model for psychiatric diagnosis. These two problems are: (1) the apparent inapplicability of the standard system of psychiatric diagnosis to real patients; and (2) the apparent irrelevance for general medical practice of psychiatric diagnosis and theory. Both problems may be avoided by presenting psychiatry in the framework of a multidimensional diagnostic schema that used familiar terms but treats them as dimensions with severe, moderate, and mild degrees of impairment rather than as categories of mutually exclusive psychiatric diseases. A teaching program is described in which detailed review of student interviews with psychiatric and especially nonpsychiatric patients is employed to demonstrate the usefulness of multidimensional psychiatric diagnosis.
妨碍学生理解和接受精神科知识的两个问题，很大程度上源于精神科诊断采用的分类模型。这两个问题是：（1）精神科诊断的标准系统明显不适用于真实患者；（2）精神科诊断和理论对一般医疗实践明显缺乏相关性。通过在多维诊断模式的框架内呈现精神病学，可以避免这两个问题。该模式使用熟悉的术语，但将它们视为具有严重、中度和轻度损害程度的维度，而不是相互排斥的精神疾病类别。本文描述了一个教学项目，其中详细回顾了学生对精神科患者尤其是非精神科患者的访谈，以证明多维精神科诊断的实用性。
