Bronisch T, Klerman G L
Department of Psychiatry, New York Hospital-Cornell Medical College, White Plains 10605.
Psychiatr Dev. 1988 Winter;6(4):245-75.
Neurotic Depression was among the most commonly used psychiatric diagnoses until the introduction of DSM-III. Because of multiple criteria and meanings and the lack of diagnostic stability on follow-up, Neurotic Depression was not included as a category in DSM-III and will be omitted in ICD-10. This article reviews recent research on the validity of Neurotic Depression and its relationship to other types of depressive disorders. Empirical studies do not support the validity of this diagnosis. There is no unitary clinical description or phenomenological discrimination from other disorders, and limited supporting family study, laboratory investigation, or specific treatment response. Revised criteria for Neurotic Depression, derived from three recently conducted studies, need to be validated in prospective studies. Pending new research findings, the decision to omit Neurotic Depression from the classification of depressive disorders in DSM-III, DSM-III-R and in the draft of ICD-10 remains scientifically justified.
在《精神疾病诊断与统计手册》第三版（DSM-III）问世之前，神经症性抑郁症是最常用的精神科诊断之一。由于存在多种标准和含义，且随访时缺乏诊断稳定性，神经症性抑郁症在DSM-III中未被列为一个类别，在ICD-10中也将被省略。本文综述了关于神经症性抑郁症有效性及其与其他类型抑郁症关系的近期研究。实证研究不支持这一诊断的有效性。它没有统一的临床描述，也无法从现象学上与其他疾病相区分，家族研究、实验室调查或特定治疗反应的支持也很有限。源自最近三项研究的神经症性抑郁症修订标准，需要在前瞻性研究中进行验证。在有新的研究结果之前，在DSM-III、DSM-III-R以及ICD-10草案中，将神经症性抑郁症从抑郁症分类中省略的决定在科学上仍然是合理的。
