Paulzen M, Schneider F
Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Uniklinik RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland,
Nervenarzt. 2014 May;85(5):533-42. doi: 10.1007/s00115-013-3985-3.
With the introduction of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) numerous changes in the area of the schizophrenia spectrum and psychotic disorders have been implemented. Establishing a metastructure based on the characteristics of the spectrum of psychopathological disturbances should improve clarity. The classical subtypes of schizophrenia were eliminated and specific psychopathological dimensions for the assessment of disease severity were added. The special role of Schneiderian first rank symptoms was abandoned and a higher delineation towards schizoaffective disorders is made. The nosological status of catatonia is clarified and occurs together with a consistent use of catatonic disturbances over all chapters. The attenuated psychosis syndrome is added as a new condition for further study. The shared psychotic disorder in the sense of a folie à deux is no longer maintained. However, the initial goal to integrate more disorder-specific etiopathogenetic information into the reconceptualization could not be achieved. Contemporaneously to the development process of DSM-5 the National Institute of Mental Health (NIMH) carried out the research domain criteria project (RDoC) attempting to incorporate the current growth in knowledge of genetics, neurocognitive and cognitive sciences in future diagnostic systems. This article gives an overview of the changes that have been made within the revision process from DSM-IV to DSM-5.
随着《精神疾病诊断与统计手册》第五版(DSM - 5)的推出,精神分裂症谱系及精神障碍领域实施了众多变革。基于精神病理障碍谱系特征建立元结构应能提高清晰度。精神分裂症的经典亚型被取消,并增加了用于评估疾病严重程度的特定精神病理维度。舍弃了施耐德一级症状的特殊地位,并对精神分裂症性情感障碍进行了更明确的划分。明确了紧张症的疾病分类地位,并在所有章节中对紧张症性障碍进行了一致的使用。新增了精神病性症状衰减综合征作为有待进一步研究的新病症。不再保留感应性精神病意义上的共享精神病性障碍。然而,将更多疾病特异性病因发病信息纳入重新概念化的最初目标未能实现。在DSM - 5的制定过程同时,美国国立精神卫生研究所(NIMH)开展了研究领域标准项目(RDoC),试图将当前遗传学、神经认知和认知科学知识的增长纳入未来的诊断系统。本文概述了从DSM - IV到DSM - 5修订过程中所做的更改。