Doerr-Zegers Otto, Irarrázaval Leonor, Mundt Adrian, Palette Virginie
Center for Studies on Phenomenology and Psychiatry, Faculty of Medicine, Universidad Diego Portales, Santiago, Chile.
Psychopathology. 2017;50(4):273-281. doi: 10.1159/000477775. Epub 2017 Aug 9.
This paper proposes a phenomenological approach to the diagnosis of depression, with the aim of overcoming the broadness and nonspecificity of the concept of major depressive disorder (MDD) in current systems of diagnostic classification of mental disorders. Firstly, we outline the methodological limitations of the current classification systems for the diagnosis of MDD. Secondly, we offer a conceptual differentiation between a "symptomatological" versus a "phenomenological" diagnosis of depression. Thirdly, we propose characteristic "disturbances of embodiment" as the fundamental phenomena of "core depression", which manifest themselves in 3 dimensions: embodied self, embodied intentionality, and embodied time. A more useful diagnosis of depression may be achieved by describing the phenomena that constitute a core depression, in order to avoid the overdiagnosis of MDD and its negative consequences in clinical practice.
本文提出了一种抑郁症诊断的现象学方法,旨在克服当前精神障碍诊断分类系统中重度抑郁症(MDD)概念的宽泛性和非特异性。首先,我们概述了当前MDD诊断分类系统的方法局限性。其次,我们对抑郁症的“症状学”诊断与“现象学”诊断进行了概念区分。第三,我们提出特征性的“具身障碍”作为“核心抑郁症”的基本现象,其在三个维度上表现出来:具身自我、具身意向性和具身时间。通过描述构成核心抑郁症的现象,可能会实现对抑郁症更有效的诊断,以避免在临床实践中对MDD的过度诊断及其负面后果。