School of Child Neuropsychiatry, University of Modena and Reggio Emilia, Modena, Italy.
Department of Psychiatry & Robinson College, University of Cambridge, Cambridge, United Kingdom.
Psychopathology. 2022;55(1):10-15. doi: 10.1159/000520087. Epub 2021 Nov 19.
Short-lived psychotic disorders as currently listed under "acute and transient psychotic disorder," ICD-11 Classification of Mental, Behavioural, and Neurodevelopmental Disorders, and "brief psychotic disorder," Diagnostic and Statistical Manual of Mental Disorders (DSM-5), constitute a point of divergence in the classification of psychotic disorders between the 2 diagnostic systems, which reveals the lack of knowledge about these conditions. Whether this is due to conceptual shortcomings inherent to the categories themselves and which spill over onto research or reflects a mismatch between the diagnostic criteria used and research techniques needs clarification. This study aimed to examine conceptual issues involved in the development of the above categories and shows that little continuity exists between earlier nosological concepts such as bouffée délirante, cycloid psychosis, and reactive psychosis and modern descriptive categories used to classify short-lived psychotic disorders. It seems likely that shortcomings in terms of symptom completeness, specificity, and heterogeneity, in addition to changes in definition and diagnostic criteria in successive DSM and ICD versions, have hampered empirical research, making it difficult to enhance the understanding of these conditions and achieve a closer concordance between the 2 classificatory systems.
目前在《国际疾病分类》第 11 版（ICD-11）精神、行为和神经发育障碍分类中的“急性和短暂性精神病性障碍”和《精神障碍诊断与统计手册》第 5 版（DSM-5）中的“短暂性精神病性障碍”中列出的短暂性精神病性障碍，是这两种诊断系统在精神病性障碍分类中的分歧点，这表明人们对这些病症缺乏了解。这种情况是由于这些类别本身固有的概念缺陷，并影响到研究，还是反映了所使用的诊断标准与研究技术之间不匹配，尚需澄清。本研究旨在探讨上述分类发展中涉及的概念问题，并表明，早期的精神病学概念，如妄想发作、循环性精神病和反应性精神病，与现代用于分类短暂性精神病性障碍的描述性类别之间几乎没有连续性。除了在 DSM 和 ICD 连续版本中定义和诊断标准的变化外，症状完整性、特异性和异质性方面的缺陷，以及在精神病学概念方面的变化，似乎都阻碍了实证研究，使得难以加深对这些病症的理解，并实现两种分类系统之间更紧密的一致性。
