Deniker P
Encephale. 1979;5(5 Suppl):407-18.
The present nosology of the affective disorders seems accurate enough to enable valid definitions and classifications to be made, despite the differences between the countries and the methods of approach. Nevertheless, there has been much controversy regarding different clinical types, similar or opposite, and notably about whether the pathogenesis and etiology are single multiple. Consideration must be given not only to the clinical form presenting but also to the course (episodic, recurrent or chronic) and to the circadian variations. Moreover, it is absolutely essential to distinguish in the nosology, on the one hand, the clinical picture proper and, on the other hand, the aetiology or the psychic structure. Thus, a simple depression may be related to an endogenous process and a melancholic state may be reactive. The theoretical problems of classification may justify the use of multivariate analysis. However, it is doubtful whether sophisticated methods are absolutely necessary in clinical practice.
尽管不同国家之间以及研究方法存在差异,但目前情感障碍的疾病分类学似乎足够准确,能够进行有效的定义和分类。然而,关于不同的临床类型,无论是相似的还是相反的,尤其是关于发病机制和病因是单一还是多样的,一直存在很多争议。不仅要考虑所呈现的临床形式,还要考虑病程(发作性、复发性或慢性)以及昼夜变化。此外,在疾病分类学中,至关重要的是一方面要区分恰当的临床症状,另一方面要区分病因或心理结构。因此,单纯的抑郁症可能与内源性过程有关,而忧郁状态可能是反应性的。分类的理论问题可能证明使用多变量分析是合理的。然而,在临床实践中是否绝对需要复杂的方法值得怀疑。