Tyrer Peter, Seivewright Helen, Johnson Tony
Department of Psychological Medicine, Imperial College.
J Pers Disord. 2003 Apr;17(2):129-38. doi: 10.1521/pedi.17.2.129.23989.
Although there has been great diagnostic activity within the conditions formally included under the general rubric of neurosis in the last 20 years, there is little evidence that the many new diagnoses (i.e., generalized anxiety disorder, panic disorder, social anxiety disorder, and dysthymic disorder) have helped clinicians and improved the health of those diagnosed. This is largely because of the extensive comorbidity between these disorders negates much of their attempted separation and it is argued that the core of neurosis is a mixed anxiety-depressive disorder, or cothymia, combined with significant personality disorder of any type. The specific association of the anxious-fearful personality cluster (cluster C) and neurosis, called the general neurotic syndrome, is also relevant but appears to have lesser significance as the personality elements are not stable. Data are presented that justify these conclusions from a long-term follow-up study of anxiety and depressive disorders.
尽管在过去20年里，在正式归入神经症总标题下的病症方面有大量的诊断活动，但几乎没有证据表明众多新的诊断（即广泛性焦虑症、惊恐障碍、社交焦虑症和恶劣心境障碍）对临床医生有帮助，也没有改善被诊断者的健康状况。这主要是因为这些病症之间广泛的共病现象否定了它们许多试图区分的努力，有人认为神经症的核心是一种混合性焦虑抑郁障碍，或称为共病心境障碍，再加上任何类型的显著人格障碍。焦虑恐惧人格集群（C类人格）与神经症的特定关联，即一般神经症综合征，也很相关，但由于人格因素不稳定，其重要性似乎较低。文中给出的数据证明了这些结论，这些数据来自一项焦虑症和抑郁症的长期随访研究。
