Goldberg D
Institute of Psychiatry, London, England.
Acta Psychiatr Scand Suppl. 1994;385:66-70. doi: 10.1111/j.1600-0447.1994.tb05916.x.
It is argued that two major symptom dimensions underlie common mental disorders. These are depression related symptoms on the one hand, and anxious symptoms on the other. Each of these symptom dimensions is relate to a set of social variables, but an individual patient may have social factors present that are associated with each symptom dimension, thus producing an overlapping of symptoms. Another reason why the symptom dimensions overlap is that depression and anxiety relate to reward and punishment systems respectively, and these systems are necessarily reciprocally related to one another. Finally, each of these systems is related to abnormal activities in both nor-adrenergic and 5-hydroxytryptaminergic neurones. It is argued that in order to produce a useful model for common disorders one should distinguish between three groups of factors: those producing vulnerability to anxious or depressive symptoms, those factors releasing symptoms at a particular time, and those factors which determine how long illness lasts. These three groups of factors are respectively called vulnerability, destabilisation and restitution.
有人认为，常见精神障碍有两个主要症状维度。一方面是与抑郁相关的症状，另一方面是焦虑症状。这些症状维度中的每一个都与一组社会变量相关，但个体患者可能存在与每个症状维度相关的社会因素，从而导致症状重叠。症状维度重叠的另一个原因是，抑郁和焦虑分别与奖励和惩罚系统相关，而这些系统必然相互关联。最后，这些系统中的每一个都与去甲肾上腺素能和5-羟色胺能神经元的异常活动有关。有人认为，为了建立一个适用于常见疾病的有用模型，应该区分三组因素：那些导致易患焦虑或抑郁症状的因素、那些在特定时间引发症状的因素以及那些决定疾病持续时间的因素。这三组因素分别称为易损性、失稳和恢复。
