易激惹情绪与《精神障碍诊断与统计手册》。
Irritable mood and the Diagnostic and Statistical Manual of Mental Disorders.
机构信息
Departments of Psychiatry and Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland USA.
出版信息
Child Adolesc Psychiatry Ment Health. 2009 Oct 24;3(1):35. doi: 10.1186/1753-2000-3-35.
BACKGROUND
The terms 'irritable mood' and 'irritability' have been applied to describe and define a variety of different categories in the Diagnostic and Statistical Manual of Mental Disorders (DSM). More precise diagnostic terms and concepts are needed.
METHODS
A concise critical historical review of DSM categories characterized by irritability, anger, and aggression is presented followed by recommendations.
RESULTS
This analysis describes the broad ranging and imprecise use of the term irritability since the first DSM in 1952. A more age-appropriate and functional realignment of psychiatric categories linked to dysfunctional anger is suggested. Among other recommendations, this realignment would remove irritability as a problematic definer in the present DSM mood categories: expand oppositional defiant disorder to include adults; link the callous unemotional subtype of conduct disorder in adolescents to antisocial personality disorder; move intermittent explosive disorder to an appropriate category: and expand the term 'mood' to apply also to dysfunctional anger and anxiety.
CONCLUSION
The non-specific term 'irritability' commonly used in the DSM has had an adverse effect on diagnostic specificity and thereby on treatment. Dysfunctional anger is a major mood disorder which merits a more prominent and better defined representation in psychiatric nomenclature.
背景
在《精神障碍诊断与统计手册》（DSM）中，术语“烦躁情绪”和“易激惹”被用于描述和定义各种不同的类别。需要更精确的诊断术语和概念。
方法
本文对DSM 中以烦躁、愤怒和攻击为特征的类别进行了简明扼要的批判性历史回顾，并提出了建议。
结果
自 1952 年第一版 DSM 以来，该分析描述了“易激惹”一词广泛而不精确的使用。建议对与功能失调性愤怒相关的精神科类别进行更符合年龄和功能的重新调整。除其他建议外，这种重新调整将消除烦躁作为目前 DSM 情绪类别中存在问题的定义者：将对立违抗性障碍扩大到包括成年人；将青少年中冷酷无情的品行障碍亚型与反社会人格障碍联系起来；将间歇性爆发障碍转移到适当的类别；并将“情绪”一词扩展到也适用于功能失调性愤怒和焦虑。
结论
DSM 中常用的非特异性术语“易激惹”对诊断特异性产生了不利影响，从而对治疗产生了不利影响。功能失调性愤怒是一种主要的情绪障碍，值得在精神科命名法中更突出和更好地定义。
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