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国际疾病分类第九版(ICD - 9)与精神疾病诊断与统计手册第三版修订版(DSM - III - R)对抑郁症诊断的差异与趋同

Divergence and convergence of diagnoses for depression between ICD-9 and DSM-III-R.

作者信息

Hiller W, Mombour W, Rummler R, Mittelhammer J

机构信息

Max-Planck-Institute of Psychiatry, München, Federal Republic of Germany.

出版信息

Eur Arch Psychiatry Neurol Sci. 1988;238(1):39-46. doi: 10.1007/BF00381079.

Abstract

Contrasting the classification systems ICD-9 and DSM-III-R, a comparison of diagnoses for unipolar depressive disorders is presented from a sample of 168 psychiatric outpatients. A relatively clear correspondence existed between ICD-9 endogenous depression and DSM-III-R major depression. Neurotic depression (ICD-9) divided into either dysthymia or major depression in DSM-III-R. A generally greater variety of corresponding ICD-9 diagnoses was observed for DSM-III-R categories, since patients with eating disorders, alcohol or drug dependence, or with neuroses other than depressive type often received an additional specific DSM-III-R diagnosis for depression. For ICD-9 diagnostics, a decreased threshold was found for diagnosing depressive reaction, as compared with the equivalent DSM-III-R diagnosis of adjustment disorder with depressed mood. A new technique is introduced in order to adjust corresponding proportions according to base rate differences.

摘要

对比国际疾病分类第九版(ICD - 9)和精神疾病诊断与统计手册第三版修订本(DSM - III - R),从168名精神科门诊患者样本中呈现了单相抑郁症诊断的比较情况。ICD - 9中的内源性抑郁症与DSM - III - R中的重度抑郁症之间存在相对明确的对应关系。ICD - 9中的神经症性抑郁症在DSM - III - R中分为恶劣心境或重度抑郁症。对于DSM - III - R类别,观察到的相应ICD - 9诊断种类通常更多,因为患有饮食失调、酒精或药物依赖或除抑郁型以外神经症的患者,往往会因抑郁症而额外获得一个特定的DSM - III - R诊断。与DSM - III - R中“伴抑郁情绪的适应障碍”这一等同诊断相比,在ICD - 9诊断中,发现诊断抑郁反应的阈值降低。引入了一种新技术,以便根据基础率差异调整相应比例。

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