Sauer H, Richter P, Schröder J, Sass H
Department of Psychiatry, University of Heidelberg, Federal Republic of Germany.
Eur Arch Psychiatry Clin Neurosci. 1992;242(1):34-8. doi: 10.1007/BF02190340.
In the DSM-III and DSM-III-R the affective or mood category has been widened and mood-incongruent psychotic affective illness (MICPAI) included. The present study was undertaken to determine whether this broad mood category is still homogeneous. Personality factors were used as parameters. Minnesota Multiphasic Personality Inventory findings of 54 patients with MICPAI were compared with those of 21 probands with a DSM-III typical affective disorder and with those of 15 DSM-III schizophrenics. It was shown that MICPAI differed significantly from typical affective disorder, but not from schizophrenia, in particular regarding the subscales "schizophrenia" and "psychopathic deviate". When MICPAI was subdivided into the depressed and manic type, the depressed type was found to be more closely related to schizophrenia (with respect to the subscales "paranoia" and "schizophrenia"), whereas the manic type hardly differed from affective disorder. Whether this result is due to diagnostic inaccuracies is discussed. Our finding that MICPAI differs from typical affective disorder with respect to personality is in accordance with heredity and outcome studies demonstrating that MICPAI is associated with a higher risk for schizophrenia in first-degree relatives and with worse outcomes when compared with typical affective disorder. It can thus be concluded that the decision to include MICPAI in the affective or mood category of the DSM-III or DSM-III-R has rendered this category more heterogeneous.
在《精神疾病诊断与统计手册》第三版（DSM - III）和第三版修订本（DSM - III - R）中，情感或情绪类别已扩大，纳入了情绪不协调性精神病性情感障碍（MICPAI）。本研究旨在确定这一宽泛的情绪类别是否仍然具有同质性。人格因素被用作参数。将54例MICPAI患者的明尼苏达多相人格调查表结果与21例符合DSM - III典型情感障碍的先证者以及15例DSM - III精神分裂症患者的结果进行比较。结果显示，MICPAI与典型情感障碍有显著差异，但与精神分裂症无显著差异，特别是在“精神分裂症”和“精神病态偏差”分量表方面。当将MICPAI细分为抑郁型和躁狂型时，发现抑郁型与精神分裂症的关系更为密切（在“偏执狂”和“精神分裂症”分量表方面），而躁狂型与情感障碍几乎没有差异。讨论了这一结果是否归因于诊断不准确。我们发现MICPAI在人格方面与典型情感障碍不同，这与遗传和预后研究结果一致，这些研究表明MICPAI在一级亲属中患精神分裂症的风险更高，与典型情感障碍相比预后更差。因此可以得出结论，将MICPAI纳入DSM - III或DSM - III - R的情感或情绪类别这一决定使该类别变得更加异质。
