Erfurth A, Arolt V
Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Münster.
Nervenarzt. 2003 Jan;74(1):55-70; quiz 70-1. doi: 10.1007/s00115-003-1473-x.
On the basis of epidemiology, neurobiology and clinical observation, the classification of bipolar disorders has shown considerable development and expansion in recent years. In particular, the recognition of mixed states, the introduction of bipolar II disorders, increasing awareness of the diagnosis of hypomania, as well as the interest in cyclothymic disorders and temperament have led to a shift in diagnostic attitudes in the USA, as well as in European countries. In this article, the possible clinical and scientific benefits of such tendencies are discussed, as are the risks of broadening bipolar disorders beyond DSM-IV. Also demonstrated is how several "modern" concepts of bipolarity have deep roots in the history of German psychiatry; a mixity scale based on Kraepelin's classification of affective mixed states is presented.
基于流行病学、神经生物学和临床观察，近年来双相情感障碍的分类有了显著的发展和扩充。特别是，对混合状态的认识、双相II型障碍的引入、对轻躁狂诊断意识的提高，以及对环性心境障碍和气质的关注，已导致美国以及欧洲国家在诊断态度上的转变。本文讨论了这些趋势可能带来的临床和科学益处，以及将双相情感障碍的范围扩展到超出《精神疾病诊断与统计手册》第四版（DSM-IV）所带来的风险。同时还展示了几种“现代”双相情感障碍概念如何在德国精神病学历史中有着深厚的根源；并提出了一种基于克雷佩林情感混合状态分类的混合量表。
