Thomas A B
Emeritus Professor of Psychiatry, Vanderbilt University, Toronto, Ontario, Canada.
Dialogues Clin Neurosci. 2001 Dec;3(4):257-63. doi: 10.31887/DCNS.2001.3.4/abthomas.
The term psychosis was first introduced in the mid-19th century for the separation of psychiatric disorders from neurological disorders within the neuroses. The concept of psychosis has become gradually restricted from a generic term for psychiatric disorders to one of the major classes of mental illness, which was assumed to be the result of a disease process, and, more recently, to a symptom present in many psychiatric disorders. In the course of this development, the díagnostic criteria for psychosis shifted from the severity of the clinical manifestations and the degree of impairment in social functioning to the presence of one or more symptoms in a set of psychopathological symptoms, which include hallucinations, formal thought disorder manifest in disorganized or odd speech, delusions, flat/inappropriate affect, avolition/apathy disorganized behavior, catatonic motor behavior, and depersonalization/derealization. The changes in the conceptualization of psychosis and in the diagnostic criteria for psychosis are documented in the various editions of the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Assocíation (from DSM-I to DSM-IV] and the International Classification of Diseases of the World Health Organization (from ICD-9 to ICD-10].
“精神病”这一术语最早于19世纪中叶被引入，用于在神经症范围内将精神疾病与神经疾病区分开来。精神病的概念已逐渐从精神疾病的通用术语，演变为主要精神疾病类别之一，它被认为是疾病过程的结果，并且最近又演变为许多精神疾病中出现的一种症状。在这一发展过程中，精神病的诊断标准从临床表现的严重程度和社会功能受损程度，转变为一组精神病理症状中一种或多种症状的存在，这些症状包括幻觉、表现为言语紊乱或怪异的形式思维障碍、妄想、情感平淡/不适当、意志缺乏/冷漠、行为紊乱、紧张性运动行为以及人格解体/现实解体。美国精神病学协会《精神疾病诊断与统计手册》（从第一版到第四版）以及世界卫生组织《国际疾病分类》（从第九版到第十版）的各个版本都记录了精神病概念化的变化以及精神病诊断标准的变化。
