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心境环模型:DSM-5 视角下的再审视证据。

Mood Spectrum Model: Evidence reconsidered in the light of DSM-5.

机构信息

Antonella Benvenuti, Mario Miniati, Antonio Callari, Michela Giorgi Mariani, Mauro Mauri, Liliana Dell'Osso, Department of Clinical and Experimental Medicine, University of Pisa, 56100 Pisa, Italy.

出版信息

World J Psychiatry. 2015 Mar 22;5(1):126-37. doi: 10.5498/wjp.v5.i1.126.

Abstract

AIM

to investigate studies conducted with the Mood Spectrum Structured Interviews and Self-Report versions (SCI-MOODS and MOODS-SR).

METHODS

We conducted a review of studies published between 1997 and August 2014. The search was performed using Pubmed and PsycINFO databases. Analysis of the papers followed the inclusion and exclusion criteria recommended by the PRISMA Guidelines, namely: (1) articles that presented a combination of at least two terms, "SCI-MOODS" [all fields] or "MOODS-SR" [all fields] or "mood spectrum" [all fields]; (2) manuscript in English; (3) original articles; and (4) prospective or retrospective original studies (analytical or descriptive), experimental or quasi-experimental studies. Exclusion criteria were: (1) other study designs (case reports, case series, and reviews); (2) non-original studies including editorials, book reviews and letters to the editor; and (3) studies not specifically designed and focused on SCI-MOODS or MOODS-SR.

RESULTS

The search retrieved 43 papers, including 5 reviews of literature or methodological papers, and 1 case report. After analyzing their titles and abstracts, according to the eligibility criteria, 6 were excluded and 37 were chosen and included. The SCI-MOODS and the MOODS-SR have been tested in published studies involving 52 different samples across 4 countries (Italy, United States, Spain and Japan). The proposed mood spectrum approach has demonstrated its usefulness mainly in 3 different areas: (1) Patients with the so-called "pure" unipolar depression that might manifest hypomanic atypical and/or sub-threshold aspects systematically detectable with the mood questionnaire; (2) Spectrum features not detected by other instruments are clinically relevant, because they might manifest in waves during the lifespan, sometimes together, sometimes alone, sometimes reaching the severity for a full-blown disorder, sometimes interfering with other mental disorders or complicating the course of somatic diseases; and (3) Higher scores on the MOODS-SR factors assessing "psychomotor disturbances", "mixed instability" and "suicidality" delineate subtypes of patients characterized by the more severe forms of mood disorders, the higher risk for psychotic symptoms, and the lower quality of life after the remission of the full-blown-episode.

CONCLUSION

The mood spectrum model help researchers and clinicians in the systematic assessment of those areas of psychopathology that are still neglected by the Diagnostic and Statistical Manual of Mental Disorders 5 classification.

摘要

目的

调查使用心境谱结构化访谈和自我报告版本(SCI-MOODS 和 MOODS-SR)进行的研究。

方法

我们对 1997 年至 2014 年 8 月期间发表的研究进行了回顾。使用 Pubmed 和 PsycINFO 数据库进行了检索。根据 PRISMA 指南推荐的纳入和排除标准对论文进行了分析,标准如下:(1)至少有两个术语的文章,即“SCI-MOODS”[所有字段]或“MOODS-SR”[所有字段]或“心境谱”[所有字段];(2)英文手稿;(3)原始文章;(4)前瞻性或回顾性原始研究(分析或描述性),实验或准实验研究。排除标准为:(1)其他研究设计(病例报告、病例系列和评论);(2)非原创性研究,包括社论、书评和给编辑的信;(3)不是专门设计并专注于 SCI-MOODS 或 MOODS-SR 的研究。

结果

检索到 43 篇论文,其中包括 5 篇文献综述或方法学论文,以及 1 篇病例报告。根据入选标准,分析其标题和摘要后,排除了 6 篇论文,选择了 37 篇论文并纳入分析。SCI-MOODS 和 MOODS-SR 已在涉及 4 个国家(意大利、美国、西班牙和日本)的 52 个不同样本的已发表研究中进行了测试。所提出的心境谱方法主要在以下 3 个不同领域证明了其有用性:(1)可能表现出系统可检测的轻躁狂非典型和/或阈下特征的所谓“纯”单相抑郁患者;(2)心境问卷无法检测到的其他仪器的谱特征具有临床相关性,因为它们可能在生命过程中呈波状出现,有时同时出现,有时单独出现,有时达到严重程度的全面障碍,有时与其他精神障碍相互干扰,或使躯体疾病的病程复杂化;(3)MOODS-SR 因子评估的“精神运动障碍”、“混合不稳定”和“自杀倾向”得分较高,可描绘出以心境障碍更为严重形式为特征的患者亚型,具有更高的精神病症状风险,以及全面发作缓解后生活质量较低。

结论

心境谱模型有助于研究人员和临床医生对精神障碍诊断和统计手册 5 分类仍未涉及的领域进行系统评估。

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