DSM-5躯体症状障碍与DSM-Ⅳ躯体形式障碍的 比较研究

目的 比较 DSM-5 躯体症状障碍（SSD）与 DSM-Ⅳ躯体形式障碍（SFD）一致性以及两标准 在躯体和心理维度的差异。方法 从中国地质大学（武汉）附属武汉心理医院的就诊患者中抽取 197 例, 采用临床面谈和定式工具收集病史和评估症状,依照 DSM-5 SSD 和 DSM-Ⅳ SFD 两标准将被试者分组, 并使用 SPSS 进行统计分析。结果 （1）根据 DSM-Ⅳ标准诊断为 SFD 患者 113 例（57.4%）,根据 DSM-5 标 准诊断为 SSD 患者 105 例（53.3%）。（2）DSM-5 中 SSD 与 DSM-Ⅳ中 SFD 诊断的一致性较低（Kappa=0.200）, 仅诊断为 SSD 但未诊断为 SFD 的患者表现出更严重的心理障碍。结论 与 DSM-Ⅳ中 SFD 诊断标准相 比,心理症状增强了 DSM-5 中 SSD 的预测有效性和临床实用性,采用 DSM-5 中 SSD 诊断标准比 DSM-Ⅳ 中 SFD 诊断标准更能识别出心理受损的患者。     

DSM-5囤积障碍诊断在中国是否适用?（英文）

囤积障碍(hoarding disorder),作为新近被纳入DSM-5强迫症和相关障碍部分的一个独立疾病,与强迫症(obsessive-compulsive disorder,OCD)相比具有明显不同的症状和病因。然而,在中国,人们认可储藏个人财物并认为这是正常的,这种新的诊断方法在中国的效度还有待证明。我们研究了东亚地区有关病理性囤积的可用数据,并发现囤积是比较常见的情况,而且出现的症状也类似于西方国家的报道。我们认为,DSM-5中定义的囤积障碍在中国是一种合理的临床实体,虽然临床医生在作出该诊断时必须小心区分病理性囤积与文化上所认可的节俭,前者令患者非常痛苦并且明显妨碍其社会和职业功能,而后者与痛苦或社交障碍都不相关的。     

ICD-11与DSM-5关于双相障碍诊断标准的异同

本文目的是对ICD-11、DSM-5这两套诊断系统关于双相障碍的诊断异同进行比较。双相及相关障碍是发作性的心境障碍,由反复躁狂发作、轻躁狂发作以及抑郁发作为临床表现。本文将通过对双相障碍在两个诊断系统中的诊断要点进行讨论,以期增进临床工作者对两套诊断系统相应内容的理解。     

ICD-11与DSM-5关于排泄障碍诊断标准的异同

本文目的是对《精神障碍诊断与统计手册（第5版）》（DSM-5）和《国际疾病分类（第11版）》（ICD-11）中排泄障碍诊断标准的异同进行比较。排泄障碍的临床特征是不恰当的尿液和粪便的排泄,明显引起患者痛苦或功能损害。为了提高精神心理工作者对相应内容的理解,本文对排泄障碍的在两套诊断系统中的诊断要点进行总结和对比。     

ICD-11与DSM-5关于抑郁障碍诊断标准的异同

本文目的是对ICD-11和DSM-5这两套诊断系统中抑郁障碍的诊断异同进行比较。抑郁障碍以抑郁心境、兴趣减退、失眠、食欲下降、体重变化以及自杀意念等为临床表现。本文通过对抑郁障碍在两个诊断系统中的诊断要点进行讨论,以期增进临床工作者对两套诊断系统相应内容的理解。     

ICD-11和DSM-5中孤独症谱系障碍诊断标准比较

孤独症谱系障碍(Autism Spectrum Disorders,ASD)是一种常见的神经发育障碍.目前孤独症谱系障碍诊断主要依靠国际疾病分类(ICD)和精神障碍诊断和统计手册(DSM)这两大系统.世界卫生组织发布了《国际疾病分类》第11版(ICD-11),ASD的诊断标准有了新的修改和变动.及时、准确认识并把握IC...     

ICD-11与DSM-5关于分离障碍诊断标准的异同

本文目的是对《国际疾病分类（第11版）》（ICD-11）和《精神障碍诊断与统计手册（第5版）》（DSM-5）这两套诊断系统中分离障碍这一谱系的精神障碍诊断标准的异同进行比较。分离障碍的临床特征是一个或多个精神过程不自主的整合性中断。本文通过对分离障碍在两套诊断系统中的诊断特征的异同进行讨论,以期增进精神医学工作者对两套诊断系统相应内容的理解。     

ICD-11与DSM-5关于焦虑障碍诊断标准的异同

本文目的是对《国际疾病分类(第11版)》(ICD-11)和《精神障碍诊断与统计手册(第5版)》(DSM-5)这两套诊断系统中焦虑障碍诊断标准的异同进行比较。焦虑障碍以过度恐惧、担忧以及有相关行为紊乱为临床表现。本文通过对焦虑障碍在两个诊断系统中的诊断要点进行讨论,以期增进临床工作者对两套诊断系统相应内容的理解。     

ICD-11与DSM-5关于应激相关障碍诊断标准的异同

本文目的是对《国际疾病分类(第11版)》(ICD-11)和《精神障碍诊断与统计手册(第5版)》(DSM-5)这两套诊断系统中应激相关障碍的诊断标准异同进行比较。应激相关障碍与暴露于应激源或创伤事件直接相关,造成个体情绪、认知以及行为的一系列改变和功能损害。本文通过对两套诊断系统中应激相关障碍诊断特征的异同进行探讨,以期增进精神心理工作者对两套诊断系统相应内容的理解。     

DSM-5精神障碍分类的新特征

《精神疾病诊断与统计手册》第5版(DSM—5)经过欧美等国家上千名精神病学专家多年的艰苦努力在2013年5月出版,一时间在全世界精神病学界引起竞相讨论,因为它对未来世界精神病学的临床、科研以及即将在2016年发布的ICD-11都将产生巨大影响[1-2].现对DSM-5精神障碍分类新特征综述如下.     

破坏性心境失调障碍的诊断与治疗的思考

概述：美国精神障碍诊断与统计分册第5版新增一个诊断类别为破坏性心境失调障碍,但是临床实践中对此认识仍然较为有限。因此,本文就该诊断类别的由来、诊断要点、治疗以及对临床实践的启示作一介绍,供临床参考。     

Characteristics and Psychiatric Symptoms of Internet Gaming Disorder among Adults Using Self-Reported DSM-5 Criteria

ObjectiveThe Section III of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) proposed nine diagnostic criteria and five cut-point criteria for Internet Gaming Disorder (IGD). We aimed to examine the efficacy of such criteria.MethodsAdults (n=3041, men: 1824, women: 1217) who engaged in internet gaming within last 6 months completed a self-report online survey using the suggested wordings of the criteria in DSM-5. Major characteristics, gaming behavior, and psychiatric symptoms of IGD were analyzed using ANOVA, chi-square, and correlation analyses.ResultsThe sociodemographic variables were not statistically significant between the healthy controls and the risk group. Among the participants, 419 (13.8%) were identified and labeled as the IGD risk group. The IGD risk group scored significantly higher on all motivation subscales (p<0.001). The IGD risk group showed significantly higher scores than healthy controls in all nine psychiatric symptom dimensions, i.e., somatization, obsession-compulsion, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism (p<0.001).ConclusionThe IGD risk group showed differential psychopathological manifestations according to DSM-5 IGD diagnostic criteria. Further studies are needed to evaluate the reliability and validity of the specific criteria, especially for developing screening instruments.     

An evaluation of the DSM-5 factor structure for posttraumatic stress disorder in survivors of traumatic injury

Confirmatory factor analytic studies of the latent structure of DSM-5 PTSD symptoms using self-report data (Elhai et al., 2012, Miller et al., 2013) have found that the four-factor model implied by the DSM-5 diagnostic criteria provided adequate fit to their data. However, the fit of this model is yet to be assessed using data derived from gold standard structured interview measures. This study evaluated the fit of the DSM-5 four-factor model and an alternative four-factor model in 570 injury survivors six years post-injury using the Clinician Administered PTSD Scale (Blake et al., 1990), updated to include items measuring new DSM-5 symptoms. While both four-factor models fitted the data well, very high correlations between the ‘Intrusions’ and ‘Avoidance’ factors in both models and between the ‘Negative Alterations in Cognitions and Mood’ and ‘Arousal and Reactivity’ factors in the DSM-5 model and the ‘Dysphoria’ and ‘Hyperarousal’ factors in the alternative model were evident, suggesting that a more parsimonious two-factor model combining these pairs of factors may adequately represent the latent structure. Such a two-factor model fitted the data less well according to χ² difference testing, but demonstrated broadly equivalent fit using other fit indices. Relationships between the factors of each of the four-factor models and the latent factors of Fear and Anxious-Misery/Distress underlying Internalizing disorders (Krueger, 1999) were also explored, with findings providing further support for the close relationship between the Intrusion and Avoidance factors. However, these findings also suggested that there may be some utility to distinguishing Negative Alterations in Cognition and Mood symptoms from Arousal and Reactivity symptoms, and/or Dysphoria symptoms from Hyperarousal symptoms. Further studies are required to assess the potential discriminant validity of the two four-factor models.     

DSM-5中的混合特征：存在的问题及解决方法

本文对《精神障碍诊断与统计手册（第5版）》（DSM-5）中双相障碍和抑郁障碍的混合特征诊断标准提出异议,并试提出可能的解决方法。目前,DSM-5中双相障碍的混合特征在临床使用过程中存在某些问题,特别是作为伴随特征的诊断标准,给临床带来一定的困扰。DSM-5虽然摒弃了过去抑郁和躁狂同时存在、同时符合抑郁发作和躁狂发作的严格诊断思路的标准设置,而改为存在3个或以上相反症状的诊断标准。但是两种截然相反的症状或症状群同时存在所导致的状态或特征的诊断困难的问题依然没有得到有效解决。在实际临床工作中,伴混合特征时,躁狂背景下的抑郁症状已经不典型,抑郁背景下的躁狂症状有时也失去典型躁狂的本色。因此,本文主要针对混合特征的精神病理学特点,结合临床以及部分研究观点进行分析,提出某些可能有建设性意义的设想,以期为混合特征的临床问题解决提供参考。     

Social (pragmatic) communication disorder: a research review of this new DSM-5 diagnostic category

Social (pragmatic) communication disorder (SCD) is a new diagnostic category in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). The purpose of this review is to describe and synthesize the relevant literature from language and autism spectrum disorder (ASD) research relating to pragmatic language impairment and other previously used terms that relate to SCD. The long-standing debate regarding how social communication/pragmatic impairments overlap and/or differ from language impairments, ASD, and other neurodevelopmental disorders is examined. The possible impact of the addition of SCD diagnostic category and directions for future research are also discussed.