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神经发育障碍(自闭症谱系障碍和注意力缺陷多动障碍):《精神疾病诊断与统计手册》第5版、《国际疾病分类》第10版和第11版。

Neurodevelopmental Disorders (ASD and ADHD): DSM-5, ICD-10, and ICD-11.

作者信息

Doernberg Ellen, Hollander Eric

机构信息

Autism and Obsessive-Compulsive Spectrum Program and the Anxiety and Depression Program,Department of Psychiatry and Behavioral Science,Albert Einstein College of Medicine and Montefiore Medical Center,Bronx,New York,USA.

出版信息

CNS Spectr. 2016 Aug;21(4):295-9. doi: 10.1017/S1092852916000262. Epub 2016 Jul 1.

Abstract

Neurodevelopmental disorders, specifically autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) have undergone considerable diagnostic evolution in the past decade. In the United States, the current system in place is the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), whereas worldwide, the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) serves as a general medical system. This review will examine the differences in neurodevelopmental disorders between these two systems. First, we will review the important revisions made from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) to the DSM-5, with respect to ASD and ADHD. Next, we will cover the similarities and differences between ASD and ADHD classification in the DSM-5 and the ICD-10, and how these differences may have an effect on neurodevelopmental disorder diagnostics and classification. By examining the changes made for the DSM-5 in 2013, and critiquing the current ICD-10 system, we can help to anticipate and advise on the upcoming ICD-11, due to come online in 2017. Overall, this review serves to highlight the importance of progress towards complementary diagnostic classification systems, keeping in mind the difference in tradition and purpose of the DSM and the ICD, and that these systems are dynamic and changing as more is learned about neurodevelopmental disorders and their underlying etiology. Finally this review will discuss alternative diagnostic approaches, such as the Research Domain Criteria (RDoC) initiative, which links symptom domains to underlying biological and neurological mechanisms. The incorporation of new diagnostic directions could have a great effect on treatment development and insurance coverage for neurodevelopmental disorders worldwide.

摘要

在过去十年中,神经发育障碍,特别是自闭症谱系障碍(ASD)和注意力缺陷多动障碍(ADHD)经历了相当大的诊断演变。在美国,目前使用的系统是《精神疾病诊断与统计手册》第五版(DSM-5),而在全球范围内,《国际疾病分类及相关健康问题统计分类》第十版(ICD-10)作为通用医疗系统。本综述将探讨这两个系统在神经发育障碍方面的差异。首先,我们将回顾从《精神疾病诊断与统计手册》第四版文本修订版(DSM-IV-TR)到DSM-5在ASD和ADHD方面所做的重要修订。接下来,我们将涵盖DSM-5和ICD-10中ASD和ADHD分类的异同,以及这些差异如何可能影响神经发育障碍的诊断和分类。通过研究2013年DSM-5的变化,并对当前的ICD-10系统进行批判,我们可以帮助预测并为将于2017年上线的ICD-11提供建议。总体而言,本综述旨在强调朝着互补诊断分类系统发展的重要性,牢记DSM和ICD在传统和目的上的差异,并且这些系统是动态变化的,因为我们对神经发育障碍及其潜在病因有了更多了解。最后,本综述将讨论替代诊断方法,如研究领域标准(RDoC)倡议,该倡议将症状领域与潜在的生物学和神经学机制联系起来。纳入新的诊断方向可能会对全球神经发育障碍的治疗发展和保险覆盖产生重大影响。

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