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对《国际疾病分类》第11次修订版中情绪障碍标准的批判。

A critique of International Classification of Diseases 11th Revision criteria for the mood disorders.

作者信息

Parker Gordon

机构信息

Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia.

出版信息

Aust N Z J Psychiatry. 2025 Aug;59(8):674-678. doi: 10.1177/00048674251356403. Epub 2025 Jul 9.

Abstract

In 2024, WHO published the Clinical Descriptions and Diagnostic Requirements for International Classification of Diseases 11th Revision Mental, Behavioural and Neurodevelopmental Disorders manual. Stated objectives were to determine valid and reliable diagnoses and defined so as to differentiate conditions both from other conditions and from normative states. This paper provides a critique of the criteria sets derived for both the depressive and the bipolar disorders. It is argued that failure to specify a minimum number of criteria for certain conditions compromises valid intrinsic and differential definitions, while additional reasons leading to the quantified low reliability of dysthymia are noted. Several idiosyncratic definitions and rulings are noted, while numerous boundary issues (differentiating disorder categories and clinical depression from normative depression) are noted. The use and application of 'postcoordination' codes (in addition to 'specifiers') appears enigmatic and potentially unserviceable.

摘要

2024年,世界卫生组织发布了《国际疾病分类第十一次修订本:精神、行为和神经发育障碍》手册中的临床描述和诊断要求。既定目标是确定有效且可靠的诊断,并进行明确界定,以便将各种病症与其他病症以及正常状态区分开来。本文对为抑郁症和双相情感障碍所制定的标准集进行了批判。有人认为,未能为某些病症规定最低标准数量,损害了有效的内在定义和鉴别定义,同时还指出了导致恶劣心境量化可靠性较低的其他原因。文中提到了一些特殊的定义和裁定,同时也指出了众多边界问题(区分疾病类别以及临床抑郁症与正常抑郁症)。“后协调”编码(除“说明符”之外)的使用和应用似乎令人费解,而且可能无法使用。

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