Paykel Eugene S
University of Cambridge, Department of Psychiatry, Cambridge, UK.
Dialogues Clin Neurosci. 2008;10(3):279-89. doi: 10.31887/DCNS.2008.10.3/espaykel.
This paper reviews concepts of depression, including history and classification. The original broad concept of melancholia included all forms of quiet insanity. The term depression began to appear in the nineteenth century, as did the modern concept of affective disorders, with the core disturbance now viewed as one of mood. The 1980s saw the introduction of defined criteria into official diagnostic schemes. The modern separation into unipolar and bipolar disorder was introduced following empirical research by Angst and Perris in the 1960s. The partially overlapping distinctions between psychotic and neurotic depression, and between endogenous and reactive depression, started to generate debate in the 1920s, with considerable multivariate research in the 1960s. The symptom element in endogenous depression currently survives in melancholia or somatic syndrome. Life stress is common in various depressive pictures. Dysthymia, a valuable diagnosis, represents a form of what was regarded earlier as neurotic depression. Other subtypes are also discussed.
本文回顾了抑郁症的相关概念，包括其历史和分类。忧郁症最初的广义概念涵盖了所有形式的隐匿性精神病。“抑郁症”这一术语在19世纪开始出现，情感障碍的现代概念也是如此，如今核心障碍被视为情绪方面的一种。20世纪80年代，明确的标准被引入官方诊断方案。现代将抑郁症分为单相和双相障碍是在20世纪60年代安格斯特和佩里斯进行实证研究之后提出的。精神病性抑郁和神经症性抑郁之间，以及内源性抑郁和反应性抑郁之间部分重叠的区别在20世纪20年代开始引发争论，在20世纪60年代有大量的多变量研究。内源性抑郁中的症状要素目前在忧郁症或躯体综合征中仍然存在。生活压力在各种抑郁情况中都很常见。恶劣心境是一种有价值的诊断，代表了一种早期被视为神经症性抑郁的形式。本文还讨论了其他亚型。
