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《精神疾病诊断与统计手册》第五版修订版:已完成一半的革命

[The 5th revised edition of the DSM: a revolution half-accomplished].

作者信息

Siracusano Alberto, Ribolsi Michele, Niolu Cinzia

出版信息

Recenti Prog Med. 2014 Apr;105(4):141-3. doi: 10.1701/1459.16119.

Abstract

To date, the diagnosis of mental disorders has been based on clinical observation and the 5th revised edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published in May 2013, has confirmed this approach placing disorders in discrete statistical categories like the preceding editions. This has disappointed the expectations of those who hypothesized the revolution of a "neuroscience based DSM", where the psychiatric diagnoses are based on the identification of sensitive biological markers. Another controversial point is that, according to several authors, the DSM-5 does not provide a clear definition of the boundaries between mental disorders and the range of normality. However, in the new edition of the DSM, there are several interesting changes, such as the introduction of the "dimensions" that are aimed to bridge the gap between the historical categorical approach and the new research data and the reclassification and the redefinition of most categories. Purpose of this editorial is to provide a brief overview of these changes and critical aspects.

摘要

迄今为止,精神障碍的诊断一直基于临床观察,2013年5月出版的《精神疾病诊断与统计手册》第5版修订版(DSM-5)也证实了这种方法,即像之前的版本一样将疾病归入离散的统计类别。这让那些设想“基于神经科学的DSM”变革的人感到失望,在这种设想中,精神科诊断基于敏感生物标志物的识别。另一个有争议的问题是,几位作者认为,DSM-5没有明确界定精神障碍与正常范围之间的界限。然而,在DSM的新版本中,有一些有趣的变化,例如引入了“维度”,旨在弥合历史分类方法与新研究数据之间的差距,以及对大多数类别的重新分类和重新定义。本社论的目的是简要概述这些变化和关键方面。

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