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DSMにおける除外規定の概念的進化：1つの診断が別の診断を除外すべき時期を決定する際の問題点
1Lancaster University, UK.
Studies in history and philosophy of science
|January 15, 2026
まとめ
精神障害の診断・統計マニュアル（DSM）における除外基準は、信頼性の高い診断に不可欠であるが、定義が難しい。その曖昧さはDSMに課題を突きつける。
科学分野:
- 精神医学
- 精神病理学
- 診断分類
背景:
- DSMの診断基準には、併存診断を防ぐための除外基準が含まれている。
- 除外基準は、診断の排他性を明確にし、信頼性の高い有病率測定を保証する。
研究 の 目的:
- DSMシリーズ全体を通じた除外基準の概念化を追跡すること。
- 精神科診断における除外基準の必要性と課題を分析すること。
主な方法:
- DSM版全体を通じた除外基準の歴史的分析。
- 除外規定に対する理論的、存在論的、および実用的な影響の検討。
主要な成果:
- 除外基準は、信頼性の高い精神科診断に必要である。
- 適切な除外基準を定義することは、重大かつ持続的な困難をもたらす。
- 除外規定は、複雑な理論的および実用的な判断を反映し、緊張関係を生じさせる。
結論:
- 除外基準は不可欠であるが、その策定は解決不能である。
- 理論的および実用的な要因への依存は、DSMの客観性と普遍的な適用性に疑問を投げかける。
- 精神疾患の個体化の困難さは、確定的な除外規定の開発と「自然分類」の概念を妨げる。
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