患者那些医学无法解释的症状真的“全都是她臆想出来的”吗?
Are your patient's medically unexplained symptoms really "all in her head"?
出版信息
Med Hypotheses. 2012 Apr;78(4):542-7. doi: 10.1016/j.mehy.2012.01.031. Epub 2012 Feb 12.
Even though the definitions in the third edition of the American Psychiatric Association's Diagnostic and Statistical Manual were supposed to be descriptions of clinical syndromes, the third and later editions of the DSM have included diagnostic categories for conversion disorder and various forms of somatization disorder, which represent an assertion of causality, not an observation of a clinical syndrome. Although these "disorders" represent etiologic diagnoses, the definitions provide no validated method for establishing causality in individual cases. Nor is there any validated methodology for making a presumptive diagnosis. Thus, it is impossible to make a diagnosis of conversion disorder or a somatization disorder without making an error in reasoning. These diagnostic categories should therefore be excluded from the DSM-V.
尽管美国精神病学会《诊断与统计手册》第三版中的定义本应是对临床综合征的描述,但第三版及以后的 DSM 版本中包含了转换障碍和各种形式的躯体化障碍的诊断类别,这代表了一种因果关系的主张,而不是对临床综合征的观察。尽管这些“障碍”代表了病因诊断,但这些定义并没有为在个别病例中建立因果关系提供经过验证的方法。也没有用于进行假定诊断的经过验证的方法学。因此,如果不犯推理错误,就不可能做出转换障碍或躯体化障碍的诊断。因此,这些诊断类别应从 DSM-V 中删除。