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[《精神疾病诊断与统计手册》第五版中的神经认知障碍:痴呆诊断的普遍变化]

[Neurocognitive disorders in DSM-5: pervasive changes in the diagnostics of dementia].

作者信息

Maier W, Barnikol U B

机构信息

Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universität Bonn, Sigmund-Freud-Str. 25, 53115, Bonn, Deutschland,

出版信息

Nervenarzt. 2014 May;85(5):564-70. doi: 10.1007/s00115-013-3984-4.

Abstract

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) proposes an innovative chapter on neurocognitive disorders (NCD) as a substitute for the dementia, delirium and amnestic disorders chapter in DSM-IV. This NCD chapter promotes a most innovative change compared to DSM-IV. While the term delirium is preserved, the commonly used term dementia does not occur as a diagnostic entity. Neurocognitive disorders are more inclusive than dementias; they also cover early prodromal stages of dementias below the DSM-IV threshold. The diagnosis of NCDs requires essentially neuropsychological testing preferentially with standardized instruments. Special focus is given to etiological subtyping taking former diagnostic consensus processes by expert groups into consideration. The subsequent more extensive concept of NCD also allows the diagnosis of etiological-specific prodromal states of cognitive impairments. The changes from DSM-IV to DSM-5 are critically discussed.

摘要

《精神疾病诊断与统计手册》(第五版)(DSM - 5)提出了关于神经认知障碍(NCD)的创新性章节,以替代DSM - IV中关于痴呆、谵妄和遗忘障碍的章节。与DSM - IV相比,这一神经认知障碍章节带来了极具创新性的变化。虽然保留了“谵妄”一词,但常用术语“痴呆”并未作为诊断实体出现。神经认知障碍比痴呆涵盖范围更广;它们还涵盖了低于DSM - IV阈值的痴呆早期前驱阶段。神经认知障碍的诊断本质上需要优先使用标准化工具进行神经心理学测试。特别关注病因亚型分类,同时考虑专家小组以前的诊断共识过程。随后更广泛的神经认知障碍概念也允许对病因特异性的认知障碍前驱状态进行诊断。本文对从DSM - IV到DSM - 5的变化进行了批判性讨论。

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