悲伤辩论,DSM和临床实践
1Department of Psychiatry, Yale University School of Medicine, New Haven, CT.
Journal of psychiatric practice
|July 26, 2024
概括
"精神疾病诊断和统计手册" (DSM) 在将悲伤与抑郁症区分开来方面有所发展. 将长期悲伤障碍与严重抑郁症区分开来,带来了临床挑战,这表明需要个性化治疗方法.
科学领域:
- 精神病学是一个精神病学.
- 临床心理学 临床心理学
- 心理健康 心理健康
背景情况:
- 悲伤和抑郁之间的区别一直是心理健康领域的一个长期争论.
- 精神疾病诊断和统计手册 (DSM) 经过了修订,以解决悲伤的分类及其与抑郁症的关系.
研究的目的:
- 在DSM系列中跟踪悲伤和抑郁症分类的演变.
- 审查正在进行的关于将悲伤与抑郁症和长期悲伤障碍区分开来的辩论.
- 评估区分长期悲伤障碍与严重抑郁和正常悲伤的临床可行性.
主要方法:
- 对DSM版本 (DSM-III,DSM-IV,DSM-5) 关于丧亲排除标准的历史分析.
- 关于长期悲伤障碍和严重抑郁症的诊断标准的文献和辩论的审查.
- 对长期悲伤障碍开发的症状清单的检查.
- 对长期悲伤障碍的建议治疗方案的分析.
主要成果:
- 该DSM已经从包括丧亲排除转向消除它,专注于重大抑郁症的存在.
- 虽然长期悲伤障碍被认为是不同的,但其症状往往与抑郁症重叠,造成诊断挑战.
- 作者认为在典型的临床时间框架内区分正常悲伤,长期悲伤障碍和严重抑郁症是不现实的.
结论:
- 由于症状重叠,长期悲伤障碍和严重抑郁症之间的临床区别仍然具有挑战性.
- 当前的诊断框架可能无法充分捕捉悲伤经历的细微差别.
- 建议以人为中心的方法来治疗长期悲伤障碍,超越一般化方案.
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