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[《精神疾病诊断与统计手册》第五版:精神病学在医学中的最终纳入?]

[DSM-5: the definitive inclusion of psychiatry in medicine?].

作者信息

Figueroa Gustavo

机构信息

Departamento de Psiquiatría, Universidad de Valparaíso, Valparaíso, Chile.

出版信息

Rev Med Chil. 2019 Apr;147(4):475-479. doi: 10.4067/S0034-98872019000400475.

Abstract

DSM-5 is a significant factor in promoting the "remedicalization" of psychiatry as the focus of psychiatric knowledge, developed by the evidence-based medicine movement, shifted from the clinically-based biopsychosocial model to a research-based medical model. DSM-5 purposes are 1]clinical: diagnosis, prevention, early identification, management, outcome, assessment of improvement; 2] clinical research: etiology, course, effective treatments, cost-effective treatments, reliability and validity and utility of diagnosis; 3] a worldwide common language of diagnostic criteria used by mental health professionals; and 4] to improve communication with users of services, caregivers, and society in general. In the absence of a "gold standard" there are two basic questions still without answers 1] what kind of entities are psychiatric disorders?; and 2] How to integrate the multiple explanatory perspectives of psychiatric illness?.

摘要

《精神疾病诊断与统计手册》第五版(DSM - 5)是推动精神病学“重新医学化”的一个重要因素。随着循证医学运动的发展,精神病学知识的重点已从基于临床的生物心理社会模型转向基于研究的医学模型。DSM - 5的目的包括:1]临床方面:诊断、预防、早期识别、管理、预后、改善评估;2]临床研究方面:病因、病程、有效治疗方法、性价比高的治疗方法、诊断的可靠性、有效性及实用性;3]作为心理健康专业人员使用的一种全球通用的诊断标准语言;4]改善与服务使用者、护理人员及整个社会的沟通。在缺乏“金标准”的情况下,仍有两个基本问题没有答案:1]精神疾病是何种实体?;2]如何整合对精神疾病多种解释视角?

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