Academic Department of Psychiatry, Kolling Institute, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, St Leonards, NSW, Australia.
CADE Clinic, Department of Psychiatry, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, Australia.
Aust N Z J Psychiatry. 2021 Jun;55(6):536-547. doi: 10.1177/00048674211022602.
This perspective piece is a detailed analysis of the critique by Gordon Parker of the mood disorders clinical practice guidelines (MDcpg), in which he claims that bipolar II disorder has been 'banished' despite its formal status in current taxonomies. In this article, I defend the reasoning used by the Committee to adopt a dimensional model for describing and managing mood disorders, in particular bipolar disorder. I also robustly contend the many erroneous inferences made by him in his regarding management recommendations within the MDcpg and demonstrate that there is no valid justification for subtyping bipolar disorder - especially in the manner proposed by the , 5th edition. Thus, I argue that it was appropriate for the MDcpg Committee to pursue an alternative model to the usual subtyping of bipolar disorder into and and conclude that the now clearly redundant model of Bipolar II should be altogether removed from our lexicon and clinical practice. Indeed, it is time to develop new and alternative models for defining bipolar disorder and among these a dimensional model should be given consideration.
这篇观点文章详细分析了 Gordon Parker 对心境障碍临床实践指南（MDcpg）的批评，他声称尽管双相情感障碍在当前的分类中有正式地位，但它已经“被放逐”了。在本文中，我为委员会采用描述和管理心境障碍（特别是双相情感障碍）的维度模型的推理辩护。我还强烈反驳他在关于 MDcpg 中管理建议的文章中提出的许多错误推论，并表明没有有效理由对双相情感障碍进行亚型分类 - 特别是按照 ，第 5 版的建议。因此，我认为 MDcpg 委员会追求一种替代模型来替代双相情感障碍的常见亚型分类，即 和 ，并得出结论，现在明显多余的双相 II 型模型应该从我们的词汇和临床实践中完全删除。事实上，现在是时候为定义双相情感障碍开发新的和替代的模型了，在这些模型中，应该考虑采用维度模型。
