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《精神疾病诊断与统计手册》第五版与神经认知障碍

DSM-5 and neurocognitive disorders.

作者信息

Simpson Joseph R

机构信息

Dr. Simpson is Staff Psychiatrist, Los Angeles County Jail Mental Health Services, and Clinical Associate Professor, Department of Psychiatry and Behavioral Sciences, University of Southern California Keck School of Medicine, Los Angeles, CA.

出版信息

J Am Acad Psychiatry Law. 2014;42(2):159-64.

Abstract

The newest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) introduces several changes in the diagnostic criteria for dementia and other cognitive disorders. Some of these changes may prove helpful for clinical and forensic practitioners, particularly when evaluating less severe cognitive impairments. The most substantial change is that the cognitive disorder-not otherwise specified category found in prior editions has been eliminated. Those disorders that do not cause sufficient impairment to qualify for a diagnosis of dementia are now defined as neurocognitive disorders and placed on a spectrum with the more severe conditions. The concept of social cognition is also introduced as one of the core functional domains that can be affected by a neurocognitive disorder. This concept may be particularly significant in the evaluation of patients with non-Alzheimer's dementias, such as frontotemporal dementia. With the aging of the population and the increasing recognition of the possibility of long-lasting cognitive deficits after traumatic brain injury, the need for assessment of cognitive disorders in medicolegal contexts is certain to increase. Forensic psychiatrists who perform these evaluations should understand the conceptualization of Neurocognitive Disorders as presented in DSM-5 and how it differs from prior diagnostic systems.

摘要

最新版的《精神疾病诊断与统计手册》(DSM - 5)对痴呆及其他认知障碍的诊断标准做出了多项更改。其中一些更改可能对临床和法医从业者有所帮助,尤其是在评估不太严重的认知障碍时。最重大的变化是,先前版本中存在的“未另行说明的认知障碍”类别已被取消。那些未造成足以符合痴呆诊断标准的损害的疾病,现在被定义为神经认知障碍,并与更严重的情况归为同一谱系。社会认知概念也被引入,作为可能受神经认知障碍影响的核心功能领域之一。这一概念在评估非阿尔茨海默病性痴呆患者(如额颞叶痴呆)时可能尤为重要。随着人口老龄化以及对创伤性脑损伤后长期认知缺陷可能性的认识不断提高,在法医学背景下评估认知障碍的需求肯定会增加。进行这些评估的法医精神病学家应了解DSM - 5中提出的神经认知障碍的概念化,以及它与先前诊断系统的不同之处。

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