Pavlichenko A V, Kulygina M A, Kostyuk G P
Alekseev Psychiatric Clinical Hospital No. 1, Moscow, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2020;120(6. Vyp. 2):5-12. doi: 10.17116/jnevro20201200625.
The concepts of schizophrenia and other primary psychotic disorders have been changed a lot since their beginnings more than century ago due to many factors such as the dominance of a certain hypothesis during a particular period of time, the development of new clinical research and specific treatments as well as different understanding of the boundaries between mental disorders. It was appeared the diagnosis of schizophrenia spectrum disorders which still based only on clinical symptoms. Whether psychotic disorders can be better represented dimensionally or categorically remains a challenging question. Regarding schizophrenia and other primary psychotic disorders, there are some important changes in DSM-5 and ICD-11 concerning the use of quantitative assessment of psychopathological domains, course of psychosis and remission as well as giving more attention to cognitive issues. The main differences between these classifications are the structure of corresponding sections and different criteria of some disorders. Before the ICD-11 implementation in 2022 into clinical practice, it is highly recommended to conduct a set of trainings for clinicians along with the comments to Diagnostic guidelines for Schizophrenia and other primary psychotic disorders.
自一个多世纪前精神分裂症及其他原发性精神障碍的概念首次出现以来,由于诸多因素,如特定时期某种假说的主导地位、新临床研究和特定治疗方法的发展以及对精神障碍界限的不同理解,这些概念发生了很大变化。精神分裂症谱系障碍的诊断曾仅基于临床症状。精神障碍究竟是按维度还是按类别能得到更好的呈现,仍然是一个具有挑战性的问题。关于精神分裂症和其他原发性精神障碍,《精神疾病诊断与统计手册》第5版(DSM-5)和《国际疾病分类》第11版(ICD-11)在精神病理学领域的定量评估、精神病病程和缓解情况的使用以及对认知问题的更多关注方面有一些重要变化。这些分类之间的主要差异在于相应章节的结构以及某些障碍的不同标准。在2022年ICD-11投入临床实践之前,强烈建议为临床医生开展一系列培训,并附上对《精神分裂症及其他原发性精神障碍诊断指南》的注释。