Paykel Eugene S
Department of Psychiatry, University of Cambridge, Cambridge, UK.
Psychopathology. 2002 Mar-Jun;35(2-3):94-9. doi: 10.1159/000065126.
In their sections on mood disorders, both ICD-10 and DSM-IV represent considerable advances on ICD-9 in drawing affective disorders together in one section, distinguishing bipolar disorder from unipolar, including dysthymia and using clear definitions. Problems with ICD-10 include complexity, use of different clinical and research definitions, emphasis on single versus recurrent episodes and the lack of some clinically useful subtypes. DSM-IV is less complex but assigns separate unjustified categories of medical and substance-induced mood disorders, and fails to code its useful qualifiers. Both classifications preserve categories for psychotic depression and melancholia/somatic syndrome, which are better coded in ICD-10. The severity distinctions could usefully be extended to a milder category of minor depression. It is also recommended that the two classifications be brought together, with small differences in definitions ironed out and a single set used both clinically and for research, the simpler DSM-IV organisation, the omission of the categorisations of single versus recurrent and mood disorder due to general medical or substance abuse disorders, and the inclusion of coding for some subtypes such as seasonal and postpartum.
在关于心境障碍的章节中，《国际疾病分类第10版》（ICD - 10）和《精神疾病诊断与统计手册第4版》（DSM - IV）相较于《国际疾病分类第9版》（ICD - 9）都有显著进步，它们将情感障碍归在一个章节，区分双相情感障碍和单相情感障碍，纳入恶劣心境并使用了清晰的定义。ICD - 10存在的问题包括复杂性、使用不同的临床和研究定义、强调单次发作与复发发作以及缺乏一些临床有用的亚型。DSM - IV没那么复杂，但将由医学状况和物质所致心境障碍划分成不合理的单独类别，且未对其有用的限定词进行编码。两种分类都保留了伴有精神病性症状的抑郁症和忧郁症/躯体综合征的类别，而这些在ICD - 10中编码得更好。严重程度的区分可有益地扩展到轻度的轻度抑郁症类别。还建议将这两种分类合并，消除定义上的小差异，形成一套在临床和研究中都适用的分类，采用更简单的DSM - IV架构，省略单次发作与复发发作以及由一般医学状况或物质滥用障碍所致心境障碍的分类，并纳入一些亚型的编码，如季节性和产后的。
