Reichenfeld H F
Department of Psychiatry, University of Ottawa, School of Medicine, Ontario, Canada.
Psychiatr J Univ Ott. 1990 Nov;15(4):189-93.
Although the usefulness of making a formal diagnosis in helping an individual deal with his/her 'problems' continues to be debated in all areas of medicine--"Il n'y a pas de maladies; il n'y a que des malades"--it is generally accepted that the initial interaction between doctor/healer/therapist and patient/client will consist of an attempt to fit the problem into one or more categories, to develop a diagnostic formulation. In the search for specificity and scientific accuracy increasingly sophisticated methods of selecting criteria have been developed to allow the assignment of a diagnosis. Examples will be given that even in the field of general medicine, a hierarchy of certainty versus uncertainty has to be accepted if potentially dangerous diagnostic errors are to be avoided. A similar approach has been proposed as a means of improving the decision making process in psychiatry. In the course of an epidemiological investigation into the prevalence of psychopathology among residents of longterm institutions, a simplified categorization into certain or suspected diagnoses is described. A semi-structured screening interview was developed for the study and will be discussed.
尽管在医学的各个领域，对做出正式诊断以帮助个体应对其“问题”的实用性仍存在争议——“没有疾病，只有病人”——但人们普遍认为，医生/治疗师与患者/客户之间的初始互动将包括尝试将问题归入一个或多个类别，以形成诊断表述。在寻求特异性和科学准确性的过程中，已经开发出越来越复杂的选择标准方法，以便进行诊断。将给出一些例子，说明即使在普通医学领域，如果要避免潜在的危险诊断错误，就必须接受确定性与不确定性的等级划分。有人提出了一种类似的方法，作为改善精神病学决策过程的一种手段。在对长期机构居民精神病理学患病率进行的一项流行病学调查过程中，描述了一种简化为确定或疑似诊断的分类方法。为该研究开发了一种半结构化筛查访谈，并将进行讨论。
