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从《精神疾病诊断与统计手册》第三版到第四版,强迫症诊断标准的流行率及严重程度的变化

The changing prevalence and severity of obsessive-compulsive disorder criteria from DSM-III to DSM-IV.

作者信息

Crino Rocco, Slade Tim, Andrews Gavin

机构信息

Clinical Research Unit for Anxiety and Depression, St. Vincent's Hospital, 299 Forbes St., Darlinghurst, N.S.W., 2010, Australia.

出版信息

Am J Psychiatry. 2005 May;162(5):876-82. doi: 10.1176/appi.ajp.162.5.876.

Abstract

OBJECTIVE

Relative to other mental disorders, the prevalence of obsessive-compulsive disorder (OCD) in the general population is not well established. Some epidemiological surveys have determined the prevalence of DSM-III OCD, but this is one of the first reports, to the authors' knowledge, of DSM-IV OCD's prevalence.

METHOD

Data from the Australian National Survey of Mental Health and Well-Being, a nationally representative epidemiological survey of mental disorders, were analyzed. The prevalence and associated characteristics of DSM-IV OCD were identified, and then the data were rescored for DSM-III OCD. Cases defined by each system were compared.

RESULTS

The 12-month prevalence of DSM-IV OCD was 0.6%, considerably less than found in surveys employing DSM-III diagnostic criteria. DSM-IV OCD showed significantly higher levels of comorbidity, disability, health service use, and treatment received.

CONCLUSIONS

Changes in the reported prevalence and severity of OCD between DSM-III and DSM-IV cases are most likely a function of the differences in diagnostic criteria between DSM-III and DSM-IV.

摘要

目的

相对于其他精神障碍,强迫症(OCD)在普通人群中的患病率尚未得到充分明确。一些流行病学调查已确定了DSM-III强迫症的患病率,但据作者所知,这是关于DSM-IV强迫症患病率的首批报告之一。

方法

对澳大利亚全国心理健康与幸福调查的数据进行了分析,该调查是一项具有全国代表性的精神障碍流行病学调查。确定了DSM-IV强迫症的患病率及相关特征,然后对数据重新进行评分以得出DSM-III强迫症的情况。对每个系统所定义的病例进行了比较。

结果

DSM-IV强迫症的12个月患病率为0.6%,显著低于采用DSM-III诊断标准的调查结果。DSM-IV强迫症显示出更高的共病率、残疾率、医疗服务利用率和接受治疗率。

结论

DSM-III和DSM-IV病例中报告的强迫症患病率和严重程度的变化很可能是DSM-III和DSM-IV诊断标准差异的结果。

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