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DSM-5 中的精神病性障碍:变更概述。

Psychotic disorders in DSM-5: summary of changes.

机构信息

Department of Psychiatry and Pharmacology, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD, USA.

出版信息

Asian J Psychiatr. 2013 Jun;6(3):266-8. doi: 10.1016/j.ajp.2013.04.001. Epub 2013 Apr 19.

Abstract

Key issues related to the diagnosis of schizophrenia and other psychotic disorders addressed in DSM-5 were more precisely defining diagnostic boundaries between different psychotic disorders, reducing spurious comorbidity, improving coherence across the diagnostic manual, and enhancing validity without loss of reliability. New information about the nature of these disorders generated since DSM-IV was incorporated into their definition. Resulting changes in DSM-5 include elimination of the classic subtypes of schizophrenia, elimination of special treatment of Schneiderian 'first-rank symptoms', more precise delineation of schizoaffective disorder from schizophrenia and psychotic mood disorders, and clarification of the nosologic status of catatonia and its consistent treatment across the manual. Changes in section 3 of the manual include addition of a new category of "attenuated psychosis syndrome" as a condition for further study and addition of unique psychopathological dimensions (that represent treatment targets across disorders). The specific nature of these revisions in the DSM-5 criteria for schizophrenia and other psychotic disorders along with their rationale are summarized in this article.

摘要

DSM-5 中涉及精神分裂症和其他精神病性障碍诊断的关键问题是更精确地定义不同精神病性障碍之间的诊断界限,减少虚假共病,提高诊断手册的一致性,并在不影响可靠性的情况下提高有效性。自 DSM-IV 以来,关于这些障碍性质的新信息被纳入其定义。DSM-5 中的更改包括消除精神分裂症的经典亚型,消除 Schneiderian“一级症状”的特殊治疗,更精确地区分精神分裂症和精神病性情绪障碍,以及澄清紧张症的分类地位及其在整个手册中的一致治疗。手册第 3 节的更改包括增加一个新的“轻度精神病综合征”类别作为进一步研究的条件,并增加独特的精神病理学维度(代表跨障碍的治疗目标)。本文总结了 DSM-5 中精神分裂症和其他精神病性障碍标准的这些修订的具体性质及其基本原理。

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