Seltzer B, Sherwin I
Am J Psychiatry. 1978 Jan;135(1):13-21. doi: 10.1176/ajp.135.1.13.
The authors found that all but 3 of 80 randomly chosen patients in a Veterans Administration hospital who had been given a primary nonspecific neuropsychiatric diagnosis (organic brain syndrome, organic psychosis, chronic brain syndrome, etc.) could be assigned to specific diagnostic categories. Diagnosis was based on chart review and thorough neurological and clinical evaluation. Senile and alcoholic dementia and Korsakoff's syndrome were seen most often, and 15% of the patients were diagnosed as having functional disorders of the mental state. The authors review the organic brain syndrome diagnosis in light of this and other evidence. They believe that fractionation into more specific diagnoses is essential to further understanding of this group of diseases. Use of the general term can result in inappropriate or no treatment; further, it hampers essential psychological, pharmacological, and biomedical research on these disorders.
作者发现,在一家退伍军人管理局医院随机挑选的80例最初被诊断为非特异性神经精神疾病(器质性脑综合征、器质性精神病、慢性脑综合征等)的患者中,除3例之外,其余患者均可归入特定的诊断类别。诊断基于病历审查以及全面的神经学和临床评估。老年性和酒精性痴呆以及柯萨科夫综合征最为常见,15%的患者被诊断为存在精神状态功能性障碍。作者根据这一证据及其他证据对器质性脑综合征诊断进行了综述。他们认为,进一步细分至更具体的诊断对于深入了解这组疾病至关重要。使用通用术语可能导致治疗不当或未进行治疗;此外,它还阻碍了对这些疾病进行必要的心理学、药理学和生物医学研究。