Fabrega H
J Nerv Ment Dis. 1987 Jul;175(7):383-94. doi: 10.1097/00005053-198707000-00001.
This report contains a theoretical discussion of psychiatric diagnosis and reflects a broad cross-cultural perspective. The current theory that appears to underlie psychiatric diagnosis in biomedicine is outlined and examined from the standpoint of its similarities and differences to diagnostic systems in other, more elementary, systems of medicine. Problems posed by the nature of psychiatric illness, as these relate more broadly to the theory and enterprise of diagnosis and classification, are reviewed. The report addresses the nature of category structure models in psychiatry, the differences between the classification of illness and natural objects, the influence of symbolic/cultural/historical factors in psychiatric illness ascertainment, different parameters of a measurement approach to psychiatric diagnosis, and the problem of co-occurrence of psychiatric illness. Whenever possible, the rationale and system of DSM-III is used for purposes of discussion and illustration. The aim of the report is to outline and review these and related factors to conceptualize the enterprise of psychiatric illness diagnosis in a broad comparative social medical frame of reference.
本报告包含对精神科诊断的理论探讨，并反映了广泛的跨文化视角。概述了当前生物医学中精神科诊断所依据的理论，并从与其他更基础的医学诊断系统的异同角度进行了审视。回顾了精神疾病本质所带来的问题，这些问题更广泛地涉及诊断和分类的理论与实践。本报告探讨了精神病学中类别结构模型的本质、疾病分类与自然物体分类的差异、符号/文化/历史因素在精神疾病确定中的影响、精神科诊断测量方法的不同参数以及精神疾病共病问题。只要有可能，就使用《精神疾病诊断与统计手册》第三版（DSM-III）的原理和系统进行讨论和说明。本报告的目的是概述和审视这些及相关因素，以便在广泛的比较社会医学参考框架中对精神疾病诊断进行概念化。
