School of Law, Politics and Sociology, University of Sussex, Brighton, East Sussex, UK.
Curr Opin Psychiatry. 2010 Nov;23(6):546-9. doi: 10.1097/YCO.0b013e32833e040d.
To review recent literature around the controversial diagnosis of personality disorder, and to assess the ethical aspects of its status as a medical disorder.
The diagnostic currency of personality disorder as a psychiatric/medical disorder has a longstanding history of ethical and social challenges through critiques of the medicalization of deviance. More recently controversies by reflexive physicians around the inclusion of the category in the forthcoming revisions of International Classification of Diseases and Diagnostic and Statistical Manual of Mental Disorders classifications reflect the problems of value-laden criteria, with the diagnostic category being severely challenged from within psychiatry as well as from without.
The clinical diagnostic criteria for extremely value-laden psychiatric conditions such as personality disorder need to be analyzed through the lens of values-based medicine, as well as through clinical evidence, as the propensity for political and sociolegal appropriation of the categories can render their clinical and diagnostic value meaningless.
回顾有关人格障碍这一颇具争议性诊断的最新文献，并评估其作为一种医学障碍的伦理方面。
人格障碍作为一种精神/医学障碍的诊断有效性长期以来一直存在伦理和社会挑战，人们批评其将偏差行为医学化。最近，有反思精神科医生对即将进行的《国际疾病分类》和《精神障碍诊断与统计手册》修订版中包含该类别的争议反映了价值 laden 标准的问题，该诊断类别不仅受到精神科内部的严重挑战，也受到外部的挑战。
需要通过基于价值的医学以及临床证据来分析极富价值 laden 的精神科条件（如人格障碍）的临床诊断标准，因为这些类别的政治和社会法律的倾向性可能使它们的临床和诊断价值变得毫无意义。
