Möller Hans-Jürgen
Department of Psychiatry and Psychotherapy, LMU, Munich.
Psychiatr Pol. 2018 Aug 24;52(4):611-628. doi: 10.12740/PP/91040.
Twenty years after publication of the previous version, the new and completely revised version of the US diagnostic system of psychiatric disorders, the Diagnostic and Statistical Manual of Mental Disorders - DSM-5, was introduced in 2013. Over the course of its preparation, which took many years, current knowledge was summarized and the respective consequences for the classification and diagnosis of psychiatric disorders were discussed in groups of high-ranking experts. In many regards, DSM-5 does not fulfil the original plans and expectations; however, for the most part it can be seen as an acceptable summary of current knowledge on mental disorders. Although universities and research groups throughout the world have shown great interest in DSM-5, in countries outside the USAthe ICD-10 is still the mandatory classification system, until the official introduction of the ICD-11. From many perspectives, DSM-5 can be seen as a kind of predecessor model for ICD-11. However, ICD-11, despite the original plan for it to be very similar to DSM-5, will find many of its own solutions. This paper presents some important issues on DSM-5 that will be of interest to clinicians working in the field of mental disorders. In addition, it uses some examples to illustrate how DSM-5 operationally defines some disorders and how it differs from ICD-10 and DSM-IV.
在美国精神疾病诊断系统上一版发布二十年后,2013年推出了全新且经过全面修订的版本——《精神疾病诊断与统计手册》第五版(DSM-5)。在历经多年的编写过程中,总结了当前的知识,并由高级专家小组讨论了其对精神疾病分类和诊断的相应影响。在许多方面,DSM-5并未实现最初的计划和期望;然而,在很大程度上它可被视为当前关于精神疾病知识的可接受总结。尽管世界各地的大学和研究团体对DSM-5表现出极大兴趣,但在美国以外的国家,在ICD-11正式推出之前,ICD-10仍是强制使用的分类系统。从多个角度来看,DSM-5可被视为ICD-11的一种前身模型。然而,ICD-11尽管最初计划与DSM-5非常相似,但将会找到许多自身的解决方案。本文介绍了一些关于DSM-5的重要问题,这些问题将引起精神疾病领域临床医生的兴趣。此外,本文还通过一些例子来说明DSM-5如何在操作上定义某些疾病,以及它与ICD-10和DSM-IV有何不同。