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[《精神疾病诊断与统计手册》第五版与文化]

[DSM-5 and culture].

作者信息

de Jong J T V M

机构信息

Institute for Social Science Research, UvA, VU mc, Amsterdam.

出版信息

Tijdschr Psychiatr. 2012;54(9):807-18.

Abstract

BACKGROUND

The leading diagnostic classification system used in the Dutch mental health care system is the DSM-IV(Diagnostic and Statistical Manual of Mental Disorders). The next version, DSM-5, will probably be published in 2013. The new version aims to pay more attention to cultural diversity; this will have implications for treatment and research.

AIM

To discuss the most important aspects of DSM-5 that have culture relevance.

METHOD

A Medline search was conducted for the period 1990- 2011 on the basis of the search terms 'DSM', 'ICD', 'DSM-classification, 'psychiatric classification', 'psychiatric diagnosis', 'culture' and 'diversity'.

RESULTS

Taking the example of depression and anxiety, one must conclude that the diagnostic system does not achieve its aims. It might be possible to compensate for this shortcoming by introducing a dimensional-categorical system. Such a system would be particularly important for cultural psychiatry and psychology in relation to matters such as subsyndromal symptom categories, experience of illness, behaviour during illness, the transition from normality to deviancy, culturally responsive research, and links to cultural neuroscience.

CONCLUSION

It looks as if such a major paradigm shift will not occur until DSM-6.

摘要

背景

荷兰精神卫生保健系统中使用的主要诊断分类系统是《精神疾病诊断与统计手册》第四版(DSM-IV)。其下一版,即DSM-5,可能将于2013年出版。新版本旨在更加关注文化多样性;这将对治疗和研究产生影响。

目的

探讨DSM-5中与文化相关的最重要方面。

方法

基于搜索词“DSM”、“ICD”、“DSM分类”、“精神科分类”、“精神科诊断”、“文化”和“多样性”,对1990年至2011年期间的Medline进行搜索。

结果

以抑郁症和焦虑症为例,人们必须得出诊断系统未实现其目标的结论。通过引入维度-分类系统可能弥补这一缺陷。这样一个系统对于文化精神病学和心理学在亚综合征症状类别、疾病体验、患病期间的行为、从正常到异常的转变、文化适应性研究以及与文化神经科学的联系等方面尤为重要。

结论

在DSM-6之前似乎不会发生如此重大的范式转变。

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