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诊断重度抑郁症XI:对《精神疾病诊断与统计手册》第四版症状背后结构的计量学调查

Diagnosing major depressive disorder XI: a taxometric investigation of the structure underlying DSM-IV symptoms.

作者信息

Ruscio John, Zimmerman Mark, McGlinchey Joseph B, Chelminski Iwona, Young Diane

机构信息

Psychology Department, The College of New Jersey, Ewing New Jersey 08628, and Department of Psychiatry and Human Behavior, Rhode Island Hospital, Providence, Rhode Island, USA.

出版信息

J Nerv Ment Dis. 2007 Jan;195(1):10-9. doi: 10.1097/01.nmd.0000252025.12014.c4.

Abstract

Psychopathologists have long debated the latent structure of mental disorders, and a number of researchers have suggested that depression may be best characterized as a continuous, rather than categorical, phenomenon. Nonetheless, attention has been drawn to limitations permeating existing research and the need for studies using more appropriate statistical methods developed expressly to tease apart taxonic (categorical) and dimensional (continuous) structural models. The present study examined the structure underlying the DSM-IV symptoms of major depressive disorder in a large outpatient sample rigorously assessed using semistructured clinical interviews. The results of a series of taxometric procedures and consistency tests supported a taxonic structural model, consistent with the only previous taxometric study of DSM-IV symptoms in an adult outpatient sample. In addition to the need for further replication and clarification, these results have implications for the assessment and diagnosis of major depressive disorder. Suggestions for several additional avenues of research are discussed.

摘要

长期以来,精神病理学家一直在争论精神障碍的潜在结构,一些研究人员认为,抑郁症或许最好被描述为一种连续的而非分类的现象。尽管如此,人们已注意到现有研究存在的局限性,以及开展研究以使用更合适的统计方法的必要性,这些方法是专门为区分分类(类别)和维度(连续)结构模型而开发的。本研究在一个大型门诊样本中,使用半结构化临床访谈进行了严格评估,以检验重度抑郁症的DSM-IV症状背后的结构。一系列分类测量程序和一致性检验的结果支持了一种分类结构模型,这与之前唯一一项针对成人门诊样本中DSM-IV症状的分类测量研究结果一致。除了需要进一步重复验证和阐明之外,这些结果对重度抑郁症的评估和诊断也具有启示意义。文中还讨论了其他几个研究途径的建议。

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