Schneider W, Janssen P L
Abteilung Psychosomatik und Psychotherapie, Universität Rostock.
Z Arztl Fortbild (Jena). 1995 May;89(2):109-13.
The principles of operational psychiatric diagnostic systems like DSM-III-R, DSM-IV and ACD-10 are shown at the beginning of the paper. On this background, the classification of the anxiety disorders in ICD-10 and the most important diagnostic guidelines and criteria are explained. The "diagnostic criteria for research" study in Germany in the field of psychosomatics and psychotherapy has shown good interrater reliability which is an important characteristic of the quality of the diagnosis. At last, essential shortcomings of ICD-10 from the perspective of psychosomatics/psychotherapy are discussed. For example, the disease conceptualization and the low treatment validity are missing because important diagnostic characteristics like personality structure, the specific conflicts of the patient, characteristics of learning and the coping mechanism are missing in ICD-10 and DSM.
诸如《精神疾病诊断与统计手册》第三版修订本（DSM-III-R）、《精神疾病诊断与统计手册》第四版（DSM-IV）以及《国际疾病分类》第十版（ICD-10）等操作性精神疾病诊断系统的原则在本文开头予以展示。在此背景下，对ICD-10中焦虑症的分类以及最重要的诊断指南和标准进行了解释。德国在身心医学与心理治疗领域开展的“研究用诊断标准”研究显示出了良好的评分者间信度，这是诊断质量的一个重要特征。最后，从身心医学/心理治疗的角度讨论了ICD-10的主要缺陷。例如，由于ICD-10和DSM中缺少诸如人格结构、患者的特定冲突、学习特征以及应对机制等重要诊断特征，因而缺乏疾病概念化且治疗效度较低。
