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在《精神疾病诊断与统计手册》第五版中,转换障碍是否应重新归类为分离性障碍?

Should conversion disorder be reclassified as a dissociative disorder in DSM V?

作者信息

Brown Richard J, Cardeña Etzel, Nijenhuis Ellert, Sar Vedat, van der Hart Onno

机构信息

School of Psychological Sciences, Academic Division of Clinical Psychology, University of Manchester, 2nd Floor, Zochonis Building, Brunswick Street, Manchester, M13 9PL, UK.

出版信息

Psychosomatics. 2007 Sep-Oct;48(5):369-78. doi: 10.1176/appi.psy.48.5.369.

Abstract

Pseudoneurological symptoms (i.e., conversion disorder), historically subsumed within the "hysteria" concept alongside phenomena such as psychogenic amnesia and multiple personality disorder, have been classified as somatoform disorders since DSM-III. Since then, there have been repeated calls to reclassify conversion disorder with the dissociative disorders, as in ICD-10. The authors review issues such as the high correlations between pseudoneurological and dissociative symptoms, the high rates of trauma reported for both groups, and the position that these phenomena share underlying processes. Although reintegrating pseudoneurological symptoms with the dissociative disorders is not without complications, there is a strong case for such a reclassification.

摘要

假性神经症状(即转换障碍),在历史上与心因性失忆症和多重人格障碍等现象一同被归入“癔症”概念中,自《精神疾病诊断与统计手册》第三版(DSM-III)起被归类为躯体形式障碍。从那时起,就不断有人呼吁将转换障碍与分离性障碍重新分类,如在《国际疾病分类》第十版(ICD-10)中那样。作者回顾了一些问题,比如假性神经症状与分离性症状之间的高度相关性、两组报告的高创伤发生率,以及这些现象共享潜在过程的观点。尽管将假性神经症状与分离性障碍重新整合并非没有并发症,但有充分理由进行这样的重新分类。

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