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使用维度而不是类别是否可以消除与亚阈值障碍相关的问题?

Would the use of dimensions instead of categories remove problems related to subthreshold disorders?

机构信息

Institute of Psychiatry, Ain Shams University, Cairo 3 Shawarby Street, Kasr El Nil, Cairo, Egypt.

出版信息

Eur Arch Psychiatry Clin Neurosci. 2009 Nov;259 Suppl 2:S129-33. doi: 10.1007/s00406-009-0052-y.

Abstract

Scientific progress fostered in DSM and ICD over the past quarter of century has significantly increased awareness of the limitation of categorical definitions of mental illness. Disorders highly merge into another with no natural boundary in between. The addition of continuous, "dimensional" measures into the various diagnostic domains might help resolve some of the critical taxonomic issues currently facing the field of mental health. It was overtly recognized that both categorical and dimensional approaches to diagnosis are important both for clinical work and for research, and that the ideal taxonomy would offer both. Within each diagnostic entity, there are multiple options for creating a dimensional scale based on a categorical definition. The ICD 10 and DSM IV have no place for subthreshold disorders except in atypical, not otherwise specified or to marginalize its existence with subsequent suffering and impairment of the patients. The chapter will discuss how the subthreshold affective, psychotic, anxiety, cognitive and substance abuse and other psychiatric disorders contribute to psychiatric morbidity and impairment. The chapter discusses the impairment and suffering of patients with subthreshold various psychiatric disorders and how its inclusion in a dimensional approach may result in ameliorating the suffering of that group as their current status may initiate some ethical considerations for their management.

摘要

在过去四分之一个世纪中,DSM 和 ICD 所推动的科学进步显著提高了人们对精神疾病分类定义局限性的认识。各种障碍高度融合,彼此之间没有自然的界限。在各种诊断领域中加入连续的“维度”测量可能有助于解决心理健康领域当前面临的一些关键分类问题。人们明确认识到,分类和维度诊断方法对于临床工作和研究都很重要,理想的分类法将两者都包括在内。在每个诊断实体中,都有多种基于分类定义创建维度量表的选择。ICD-10 和 DSM-IV 除了在非典型、未另作说明或边缘化的情况下,没有为阈下障碍提供位置,以使其存在,并随后导致患者遭受痛苦和受损。这一章将讨论阈下情感、精神病、焦虑、认知和物质滥用及其他精神障碍如何导致精神疾病发病率和受损。这一章还讨论了阈下各种精神障碍患者的受损和痛苦,以及将其纳入维度方法可能会如何减轻该群体的痛苦,因为他们的现状可能会引发一些关于他们管理的伦理考虑。

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