DSM-5囤积障碍诊断在中国是否适用？

概述：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。

Is the DSM-5 hoarding disorder diagnosis valid in China?

Hoarding disorder, newly included as a separate diagnostic entity in the Obsessive-Compulsive and Related Disorders section of DSM-5, has been reported to have significantly different symptoms and etiology than obsessive-compulsive disorder (OCD). However, the validity of this new diagnosis in China – where the storing of possessions is sanctioned and normalized – remains to be proven. We considered available data about pathological hoarding in East Asia and found the condition to be relatively common and symptomatically similar to that reported in western countries. We conclude that the ‘Hoarding Disorder’ diagnosis defined in DSM-5 is a valid clinical entity in China, though when making the diagnosis clinicians must take care to differentiate pathological hoarding that is distressing to the individual and significantly interferes with social and occupational functioning from culturally sanctioned thriftiness that is not associated with either distress or social dysfunction.