Walvoort S J W, Wester A J, Doorakkers M C, Kessels R P C, Egger J I M
Tijdschr Psychiatr. 2016;58(5):397-401.
It is evident from the dsm-iv-tr that alcohol-related impairment is extremely difficult to classify accurately. As a result, cognitive deficits can easily be overlooked. The dsm-5, however, incorporates a new category, namely 'neurocognitive disorders', which may lead to significant improvements in clinical practice.
To compare the classification of alcohol-related cognitive dysfunction in dsm-iv-tr and dsm-5 and to discuss the clinical relevance of the revised classification in the dsm-5.
We compare the chapters of the dsm-iv-tr and the dsm-5 concerning alcohol-related cognitive impairment and describe the changes that have been made.
The dsm-5 puts greater emphasis on alcohol-related neurocognitive impairment. Not only does dsm-5 distinguish between the degree of severity (major or minor neurocognitive disorder), it also distinguishes between the type of impairment (non-amnestic-type versus confabulating-amnestic type). It also makes a distinction between the durations of impairment (behavioural and/or persistent disorders).
The dsm-5 gives a clearer description of alcohol-related neurocognitive dysfunction than does dsm-iv-tr and it stresses the essential role of neuropsychological assessment in the classification, diagnosis, and treatment of neurocognitive disorders.
从《精神疾病诊断与统计手册》第四版修订版(DSM-IV-TR)中可以明显看出,与酒精相关的损害极难准确分类。因此,认知缺陷很容易被忽视。然而,《精神疾病诊断与统计手册》第五版(DSM-5)纳入了一个新类别,即“神经认知障碍”,这可能会给临床实践带来显著改善。
比较DSM-IV-TR和DSM-5中与酒精相关的认知功能障碍的分类,并讨论DSM-5中修订分类的临床相关性。
我们比较了DSM-IV-TR和DSM-5中有关与酒精相关的认知损害的章节,并描述了所做的更改。
DSM-5更加强调与酒精相关的神经认知损害。DSM-5不仅区分了严重程度(重度或轻度神经认知障碍),还区分了损害类型(非遗忘型与虚构遗忘型)。它还区分了损害的持续时间(行为性和/或持续性障碍)。
与DSM-IV-TR相比,DSM-5对与酒精相关的神经认知功能障碍给出了更清晰的描述,并且强调了神经心理学评估在神经认知障碍的分类、诊断和治疗中的重要作用。