在精神病诊断框架中注意自然现象和人类构造之间的差距
Seon-Cheol Park1, Masoud Kamali2, Andrew A Nierenberg3
1Department of Psychiatry, Hanyang University, Seoul, Republic of Korea; Department of Psychiatry, Hanyang University Guri Hospital, Guri, Republic of Korea; Hanyang Institute of Bioscience and Biotechnology, Hanyang University, Seoul, Republic of Korea.
Asian journal of psychiatry
|August 22, 2025
概括
精神病诊断辩论现实主义与名义主义. 像DSM-5这样的现有系统面临挑战, 但整合患者经验,网络分析和实用方法提供了更具适应性,以患者为中心的模型.
科学领域:
- 精神病学与心理健康
- 科学哲学
- 医学分类
背景情况:
- 精神病诊断在现实主义 (生物基础) 和名义主义 (人类定义的类别) 之间进行辩论.
- 精神疾病诊断和统计手册 (DSM) 已经发展, 但缺乏强大的生物标志物.
- 目前的分类系统 (如DSM-5) 呈现出高度的异质性,并发病性和模糊的诊断界限.
研究的目的:
- 探讨精神病诊断中的现实主义与名义主义之间的紧张关系.
- 识别当前分类诊断系统的局限性.
- 提出一个更具适应性,以患者为中心的精神病学分类模型.
主要方法:
- 诊断范式的文献审查和概念分析.
- 补充视角的检查:现象心理病理学,网络分析和务实方法.
- 综合不同观点提出一个综合模型.
主要成果:
- 尽管诊断的进化, 强大的生物标志物对于精神疾病仍然难以捉摸.
- 在DSM-5中,分类诊断有助于显著的异质性和并发症.
- 现象学,网络和实用方法为改善诊断模型提供了宝贵的见解.
结论:
- 对于精神病诊断来说,纯粹的分类方法存在固有的局限性.
- 整合患者生活经验,网络模型和实用临床实用性可以创建更细致的诊断框架.
- 这种综合模型旨在弥合心理健康中的客观现象和主观分类之间的差距.
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