Baghai Thomas C, Eser Daniela, Möller Hans-Jürgen
Dept of Psychiatry, Ludwig-Maximilians-University Munich, Germany.
Dialogues Clin Neurosci. 2008;10(3):309-20. doi: 10.31887/DCNS.2008.10.3/tcbaghai.
Core symptoms of depression are a combination of psychological and somatic symptoms, often combined with psychomotor and cognitive disturbances. Diagnostic classification of depression including the concepts of melancholic, endogenous, or severe depression describe severely depressed patients suffering from most of the core symptoms, together with clinical characteristics of a cyclic unipolar or bipolar course, lower placebo response rates, higher response rates to electroconvulsive therapy, to antidepressant treatments with dually or mixed modes of action, or to lithium augmentation. Higher rates of hypothalamic-pituitary-adrenal axis hyperactivity and specific electroencephalographic patterns have also been shown in this patient group. Summarizing the symptomatology of depression in these patients, a broad overlap between the abovementioned subgroups can be suggested. Because the positive diagnosis of those core symptoms of depression may include clinical consequences, it would be of use to integrate all the mentioned concepts in the upcoming new versions of the diagnostic systems DSM-V and ICD-11.
抑郁症的核心症状是心理症状和躯体症状的组合，常伴有精神运动和认知障碍。抑郁症的诊断分类包括 melancholic、内源性或重度抑郁症等概念，描述了患有大多数核心症状的重度抑郁患者，以及循环性单相或双相病程的临床特征、较低的安慰剂反应率、对电休克治疗、对具有双重或混合作用模式的抗抑郁治疗或对锂盐增效治疗的较高反应率。该患者群体还显示出较高的下丘脑 - 垂体 - 肾上腺轴功能亢进率和特定的脑电图模式。总结这些患者的抑郁症症状学，可以看出上述亚组之间存在广泛重叠。由于抑郁症那些核心症状的阳性诊断可能会带来临床后果，因此在即将推出的新版诊断系统 DSM - V 和 ICD - 11 中整合所有上述概念将会有用。
