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关于强迫及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)这两套诊断系统中强迫及相关障碍诊断标准的异同进行比较。强迫及相关障碍以持续的强迫思维和/或反复的强迫行为为主要临床表现。本文通过对强迫及相关障碍在两套诊断系统中的诊断特征进行比较,以期增进广大精神医学及心理工作者对两套诊断系统相应内容的理解。     

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关于躯体症状及相关障碍诊断标准的异同

本文目的是对躯体症状及相关障碍的诊断标准在《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)中的异同进行比较。躯体症状及相关障碍的临床特征是有显著的躯体症状,造成了明显的功能损害和痛苦。本文通过探讨躯体症状及相关障碍在两套诊断系统中的异同,以提高精神医学工作者对相应内容的掌握。     

ICD-11与DSM-5关于喂食及进食障碍诊断标准的异同

本文目的是对喂食及进食障碍诊断标准在《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)的异同进行比较。喂食及进食障碍的临床特征是存在喂食或进食相关行为的持续性紊乱,导致食物消耗或吸收的改变,并显著损害躯体健康和社会功能。本文对喂食及进食障碍在两套诊断系统中的异同进行对比,以提高精神及心理工作者对相应内容的理解。     

ICD-11与DSM-5关于性功能失调诊断标准的异同

本文目的是对性功能失调在《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)中诊断标准的异同进行比较.性功能失调是指成年人难以体验满意的性活动的各种形式.本文对两套诊断系统中性功能失调的诊断要点进行总结和比较,以提高精神心理工作者对相应内容的理解.     

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关于睡眠-觉醒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）中睡眠-觉醒障碍诊断标准的异同进行比较。睡眠-觉醒障碍的核心特征是患者对睡眠的质量、持续时间和昼夜节律不满意，导致日间痛苦和社会功能受损。本文对两套诊断系统中的诊断要点进行总结和比较，以提高精神心理工作者对相应内容的理解。     

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。     

三种诊断标准对精神分裂症和心境障碍的诊断比较

为了解国内的精神疾病诊断标准与国际标准间的异同，使用美国精神障碍诊断与统计手册第３版修订本定式临床检查提纲（ＳＣＩＤ－Ｐ），作为国际疾病分类第１０版（ＩＣＤ－１０）、中国精神疾病分类方案与诊断标准第２版修订本（ＣＣＭＤ－２－Ｒ）和美国精神障碍诊断与统计手册第４版（ＤＳＭ－ＩＶ）的症状评定工具，对临床初步诊断为精神分裂症的１１４例患者及心境障碍的８２例患者进行上述３种诊断系统间的诊断比较。结果表明：３种标准对精神分裂症的诊断一致性差（Ｐ＜０．０５），差异原因与各标准病程规定不同有关；两两标准间的诊断一致性好。３种诊断标准对心境障碍的诊断一致性较好（Ｐ＞０．０５）；两两标准间的诊断一致性亦好。以ＩＣＤ－１０作为“金标准”，用ＣＣＭＤ－２－Ｒ及ＤＳＭ－ＩＶ诊断两种疾病均具有较好的敏感性和特异性；ＣＣＭＤ－２－Ｒ诊断精神分裂症和ＤＳＭ－ＩＶ诊断心境障碍更加准确。另外，本研究还显示ＳＣＩＤ－Ｐ及３种诊断标准具有较高的信度。提示ＣＣＭＤ－２－Ｒ，ＤＳＭ－ＩＶ均已向ＩＣＤ－１０靠拢。     

Classification of primary headaches

Given the range of disorders that produce headache, a systematic approach to classification and diagnosis is an essential prelude to clinical management. For the last 15 years, the diagnostic criteria of the International Headache Society (IHS) have been the accepted standard. The second edition of The International Classification of Headache Disorders (January 2004) reflects our improved understanding of some disorders and the identification of new disorders. Neurologists who treat headache should become familiar with the revised criteria. Like its predecessor, the second edition of the IHS classification separates headache into primary and secondary disorders. The four categories of primary headaches include migraine, tension-type headache, cluster headache and other trigeminal autonomic cephalalgias, and other primary headaches. There are eight categories of secondary headache. Important changes in the second edition include a restructuring of these criteria for migraine, a new subclassification of tension-type headache, introduction of the concept of trigeminal autonomic cephalalgias, and addition of previously unclassified primary headaches. Several disorders were eliminated or reclassified. In this article, the authors present an overview of the revised IHS classification, highlighting the primary headache disorders and their diagnostic criteria. They conclude by presenting an approach to headache diagnosis based upon these criteria.     

河南省某地区初中生情绪和行为相关障碍的诊断变化——1年随访

目的研究青少年情绪和行为相关障碍在1年内出现的诊断变化情况。方法于2015年4月采用整群随机抽样方法,从河南省唐河县城郊乡和舞阳县文烽乡的两所中学的初一、初二年级抽取34个班共1 500名学生,采用长处和困难筛查问卷(学生版)(SDQ)进行筛查,对334例筛查阳性者依据《精神障碍诊断与统计手册(第5版)》(DSM-5)进行诊断,符合入组标准共75例,共64例完成随访,并于半年后和1年后进行两次随访,再次依据DSM-5进行诊断。结果 9例注意缺陷/多动障碍患者中的3例、12例抑郁障碍患者中的5例、34例焦虑障碍患者中的4例、3例创伤及应激相关障碍中的2例出现诊断变化;其中抑郁障碍比焦虑障碍诊断变化更明显(P=0. 039),多转变为强迫障碍、环性心境障碍、破坏性心境失调等。结论青少年抑郁障碍诊断易出现变化,注意缺陷/多动障碍、抑郁障碍的诊断分别预示其以后更易患上焦虑障碍、双相情感障碍。     

Classification of headache disorders

Clinical diagnostic classifications are critical when clear biological markers are not available. Such is the case in many headache disorders and mental disorders. Also, it is crucial that the classification is widely accepted and utilized. A main goal of classification is to be a universal language for categorizing a disease or a set of disorders, establishing diagnostic criteria, and promoting unity in treatment. The International Headache Society published its first Classification of Headache Disorders in 1988 and its second edition in 2004. The first classification paved the way for a better understanding of the epidemiology, mechanisms, and treatment of headache disorders, and the second edition likely will magnify our knowledge. This article provides an overview of the classification system and outlines some of the major changes in the revised edition.     

The classification of stress-related disorders in ICD-10 and DSM-IV

This paper reviews the psychopathology, the nosology and classification principles of stress-related disorders, with focus on how they are characterized in ICD-10 and DSM-IV. The presence of a stressor and the reexperience of the event are the two criteria present in the three diagnostic systems: ICD-10 Research Diagnostic Criteria (RDC), ICD-10 Diagnostic Guidelines (DG), and DSM-IV. ICD-10 RDC and DSM-IV, being more strict, add two more criteria: avoidance and increased physiological arousal. ICD-10 RDC allows this to be substituted by 'inability to recall', while ICD-10 DG add a few more symptoms which are not necessary for the diagnosis but may be typical (numbness), common (anxiety and depression) or rare (acute bursts of fear or aggression). DSM-IV is the only system which mentions symptoms specific for children.     

Reliability of ICD-10 research criteria: an Arab perspective.

Within a broader World Health Organization (WHO) collaborative research around the ICD-10 diagnostic criteria for research, the Regional Office for the Eastern Mediterranean (EMRO) ICD-10 research coordinating center at the Ain Shams Institute of Psychiatry presented the data collected from 8 Arab centers, which investigated a total of 233 patients using the local psychiatric interview schedules and diagnosed according to ICD-10 criteria. Interrater reliability was found to range between an almost perfect (0.81-1) to substantial agreement (0.61-0.80) (using the kappa coefficient) in diagnosing organic mental disorders, substance use disorders, schizophrenic, schizotypal and delusional disorders, affective disorders and neurotic and stress-related disorders. The categories of psychological development and child and adolescent disorders were diagnosed less frequently and the agreement between raters was lower. Though no culture-bound syndromes were encountered in any of the centers, difficulties in diagnosis using the research criteria were identified in the domain of simple schizophrenia and dissociative versus conversion disorders. These difficulties are discussed in consideration of the experience of our psychiatrists.     

Exclusion criteria of DSM-III. A study of co-occurrence of hierarchy-free syndromes

The diagnostic criteria of the third edition of the DSM-III often state that one diagnosis cannot be made if it is "due to" another disorder. Using data from the National Institute of Mental Health Diagnostic Interview Schedule, with a sample of 11,519 subjects from a community population, we found that if two disorders were related to each other according to the DSM-III exclusion criteria, then the presence of a dominant disorder greatly increased the odds of having the excluded disorder. We also found that disorders, which DSM-III says are related to each other, were more strongly associated than disorders, which DSM-III says are unrelated. However, we also found there was a general tendency toward co-occurrence, so that the presence of any disorder increased the odds of having almost any other disorder, even if DSM-III does not list it as a related disorder. We concluded that empirical studies are needed to study the assumptions underlying the use of a diagnostic hierarchy.     

Intermittent explosive disorder as a disorder of impulsive aggression for DSM-5

A disorder of impulsive aggression has been included in DSM since the first edition. In DSM-III, this disorder was codified as intermittent explosive disorder, and it was thought to be rare. However, the diagnostic criteria for the disorder were poorly operationalized, and empirical research was limited until research criteria were developed a decade ago. Subsequently, renewed interest in disorders of impulsive aggression led to a recent series of community-based studies that have documented intermittent explosive disorder to be as common as many other psychiatric disorders. Other recent research indicates that compared with DSM-IV criteria for intermittent explosive disorder, research criteria for the disorder better identify individuals with elevated levels of aggression, impulsivity, familial risk of aggression, and abnormalities in neurobiological markers of aggression. In addition, other data strongly suggest important delimitation from other disorders previously thought to obscure the diagnostic uniqueness of intermittent explosive disorder. Overall, these data suggest that the diagnostic validity for the integrated research criteria is substantial and is now sufficient for recognition and inclusion in DSM-5.