Rosenleitner Jan, Rittmannsberger Hans
Abteilung Psychiatrie 1, Landes-Nervenklinik Wagner-Jauregg, Wagner-Jauregg-Weg 15, 4020, Linz, Österreich.
Neuropsychiatr. 2013;27(4):212-6. doi: 10.1007/s40211-013-0082-6. Epub 2013 Sep 26.
Religious beliefs can lead to difficulties in psychiatric diagnosis, when it comes to distinguishing between faith and delusion. Delusion is defined as a false assessment of reality combined with subjective certainty, which is in contrast with the reality of the social environment. The problem with this definition is that reality cannot be examined with scientific methods/criteria and that the assessment of reality itself underlies historical and cultural fluctuations. The current diagnostic manuals for psychiatric disorders DSM 5 and ICD-10 require, that the content of the belief has to be inadequate even in the subculture of the patient (ICD-10) and that the cultural and socioeconomic background of the patient has to be taken into account (DSM 5). On the basis of this case-report and of selected publications on this topic we want to discuss this diagnostic problem. After that we present a diagnostic model for delusion, which is easy to handle in the daily routine of psychiatrists.
在区分信仰与妄想时，宗教信仰可能会给精神疾病的诊断带来困难。妄想被定义为对现实的错误评估并伴有主观确定性，这与社会环境的现实情况相悖。该定义的问题在于，现实无法用科学方法/标准进行检验，而且对现实本身的评估存在历史和文化的波动。当前的精神疾病诊断手册《精神疾病诊断与统计手册第5版》（DSM 5）和《国际疾病分类第10版》（ICD - 10）要求，即使在患者的亚文化中，信仰的内容也必须是不充分的（ICD - 10），并且必须考虑患者的文化和社会经济背景（DSM 5）。基于这个病例报告以及关于该主题的部分出版物，我们想要探讨这个诊断问题。之后，我们提出一种妄想的诊断模型，该模型在精神科医生的日常工作中易于操作。
