澄清关于抑郁症的几个术语问题# WaterWorld - 未名水世界
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抑郁症(Major Depressive Disorder)与精神病性抑郁 (Psychotic depression)与燥郁
症(Bipolar disorder)均为独立的疾病实体,相互之间没有概念从属关系。张纯如的
诊断最初是抑郁症(Major Depressive Disorder),后来有医生诊断燥郁症(Bipolar
disorder)。这两个疾病都没有妄想表现。
1. 抑郁症是独立的疾病实体。 Clinical depression goes by many names --
depression, "the blues," biological depression, major depression.
http://psychcentral.com/disorders/depression/
关于抑郁症的诊断标准。附录1 :DSM-4 Criteria for Major Depressive Disorder (
MDD) ,与附录2:DSM-5 Criteria for Major Depressive Episode, 在具体内容上没
有不同。都没有妄想表现。关于这两个术语究竟有什么区别,这里有清楚的解释:
A major depressive episode is a period characterized by the symptoms of
major depressive disorder。
2. 精神病性抑郁是独立的疾病实体。Psychotic depression is characterized by
not only depressive symptoms, but also by hallucinations (seeing or hearing
things that aren’t really there) or delusions (irrational thoughts and
fears).
http://psychcentral.com/lib/psychotic-depression/0001291
3. 燥郁症是独立的疾病实体。在燥郁症中有多种分类。燥郁症没有妄想表现。
Bipolar disorder, also known by its older name "manic depression," is a
mental disorder that is characterized by serious mood swings. A person with
bipolar disorder experiences alternating “highs” (what clinicians call “
mania“) and “lows” (also known as depression).
During a manic phase, symptoms include:
• heightened sense of self-importance
• exaggerated positive outlook
• significantly decreased need for sleep
• poor appetite and weight loss
• racing speech, flight of ideas, impulsiveness
• ideas that move quickly from one subject to the next
• poor concentration, easy distractibility
• increased activity level
• excessive involvement in pleasurable activities
• poor financial choices, rash spending sprees
• excessive irritability, aggressive behavior
During a depressed phase, symptoms include:
• feelings of sadness or hopelessness
• loss of interest in pleasurable or usual activities
• difficulty sleeping; early-morning awakening
• loss of energy and constant lethargy
• sense of guilt or low self-esteem
• difficulty concentrating
• negative thoughts about the future
• weight gain or weight loss
• talk of suicide or death
http://psychcentral.com/lib/symptoms-of-bipolar-disorder-manic-
附录1:DSM-4 Criteria for Major Depressive Disorder (MDD)
• Depressed mood or a loss of interest or pleasure in daily activities
for more than two weeks.
• Mood represents a change from the person's baseline.
• Impaired function: social, occupational, educational.
• Specific symptoms, at least 5 of these 9, present nearly every day:
1. Depressed mood or irritable most of the day, nearly every day, as
indicated by either subjective report
(e.g., feels sad or empty) or observation made by others (e.g., appears
tearful).
2. Decreased interest or pleasure in most activities, most of each day
3. Significant weight change (5%) or change in appetite
4. Change in sleep: Insomnia or hypersomnia
5. Change in activity: Psychomotor agitation or retardation
6. Fatigue or loss of energy
7. Guilt/worthlessness: Feelings of worthlessness or excessive or
inappropriate guilt
8. Concentration: diminished ability to think or concentrate, or more
indecisiveness
9. Suicidality: Thoughts of death or suicide, or has suicide plan
附录2:Criteria for Major Depressive Episode: DSM-5
A. Five (or more) of the following symptoms have been present during the
same 2-week period and represent a change from previous functioning; at
least one of the symptoms is either (1) depressed mood or (2) loss of
interest or pleasure.
Note: Do not include symptoms that are clearly due to a general medical
condition, or mood-incongruent delusions or hallucinations.
1. Depressed mood most of the day, nearly every day, as indicated by either
subjective report (e.g., feels sad or empty) or observation made by others (
e.g., appears tearful). Note: In children and adolescents, can be irritable
mood.
2. Markedly diminished interest or pleasure in all, or almost all,
activities most of the day, nearly every day (as indicated by either
subjective account or observation made by others).
3. Significant weight loss when not dieting or weight gain (e.g., a change
of more than 5 percent of body weight in a month), or decrease or increase
in appetite nearly every day. Note: In children, consider failure to make
expected weight gains.
4. Insomnia or hypersomnia nearly every day.
5. Psychomotor agitation or retardation nearly every day (observable
byothers, not merely subjective feelings of restlessness or being slowed
down).
6. Fatigue or loss of energy nearly every day.
7. Feelings of worthlessness or excessive or inappropriate guilt (whichmay
be delusional) nearly every day (not merely self-reproach or guilt about
being sick).
8. Diminished ability to think or concentrate, or indecisiveness, nearly
every day (either by subjective account or as observed by others).
9. Recurrent thoughts of death (not just fear of dying), recurrent suicidal
ideation without a specific plan, or a suicide attempt or a specific plan
for committing suicide.
B. The symptoms cause clinically significant distress or impairment in
social, occupational or other important areas of functioning.
C. The symptoms are not due to the direct physiological effects of a
substance (e.g., adrug of abuse, a medication) or a general medical
condition (e.g., hypothyroidism).
症(Bipolar disorder)均为独立的疾病实体,相互之间没有概念从属关系。张纯如的
诊断最初是抑郁症(Major Depressive Disorder),后来有医生诊断燥郁症(Bipolar
disorder)。这两个疾病都没有妄想表现。
1. 抑郁症是独立的疾病实体。 Clinical depression goes by many names --
depression, "the blues," biological depression, major depression.
http://psychcentral.com/disorders/depression/
关于抑郁症的诊断标准。附录1 :DSM-4 Criteria for Major Depressive Disorder (
MDD) ,与附录2:DSM-5 Criteria for Major Depressive Episode, 在具体内容上没
有不同。都没有妄想表现。关于这两个术语究竟有什么区别,这里有清楚的解释:
A major depressive episode is a period characterized by the symptoms of
major depressive disorder。
2. 精神病性抑郁是独立的疾病实体。Psychotic depression is characterized by
not only depressive symptoms, but also by hallucinations (seeing or hearing
things that aren’t really there) or delusions (irrational thoughts and
fears).
http://psychcentral.com/lib/psychotic-depression/0001291
3. 燥郁症是独立的疾病实体。在燥郁症中有多种分类。燥郁症没有妄想表现。
Bipolar disorder, also known by its older name "manic depression," is a
mental disorder that is characterized by serious mood swings. A person with
bipolar disorder experiences alternating “highs” (what clinicians call “
mania“) and “lows” (also known as depression).
During a manic phase, symptoms include:
• heightened sense of self-importance
• exaggerated positive outlook
• significantly decreased need for sleep
• poor appetite and weight loss
• racing speech, flight of ideas, impulsiveness
• ideas that move quickly from one subject to the next
• poor concentration, easy distractibility
• increased activity level
• excessive involvement in pleasurable activities
• poor financial choices, rash spending sprees
• excessive irritability, aggressive behavior
During a depressed phase, symptoms include:
• feelings of sadness or hopelessness
• loss of interest in pleasurable or usual activities
• difficulty sleeping; early-morning awakening
• loss of energy and constant lethargy
• sense of guilt or low self-esteem
• difficulty concentrating
• negative thoughts about the future
• weight gain or weight loss
• talk of suicide or death
http://psychcentral.com/lib/symptoms-of-bipolar-disorder-manic-
附录1:DSM-4 Criteria for Major Depressive Disorder (MDD)
• Depressed mood or a loss of interest or pleasure in daily activities
for more than two weeks.
• Mood represents a change from the person's baseline.
• Impaired function: social, occupational, educational.
• Specific symptoms, at least 5 of these 9, present nearly every day:
1. Depressed mood or irritable most of the day, nearly every day, as
indicated by either subjective report
(e.g., feels sad or empty) or observation made by others (e.g., appears
tearful).
2. Decreased interest or pleasure in most activities, most of each day
3. Significant weight change (5%) or change in appetite
4. Change in sleep: Insomnia or hypersomnia
5. Change in activity: Psychomotor agitation or retardation
6. Fatigue or loss of energy
7. Guilt/worthlessness: Feelings of worthlessness or excessive or
inappropriate guilt
8. Concentration: diminished ability to think or concentrate, or more
indecisiveness
9. Suicidality: Thoughts of death or suicide, or has suicide plan
附录2:Criteria for Major Depressive Episode: DSM-5
A. Five (or more) of the following symptoms have been present during the
same 2-week period and represent a change from previous functioning; at
least one of the symptoms is either (1) depressed mood or (2) loss of
interest or pleasure.
Note: Do not include symptoms that are clearly due to a general medical
condition, or mood-incongruent delusions or hallucinations.
1. Depressed mood most of the day, nearly every day, as indicated by either
subjective report (e.g., feels sad or empty) or observation made by others (
e.g., appears tearful). Note: In children and adolescents, can be irritable
mood.
2. Markedly diminished interest or pleasure in all, or almost all,
activities most of the day, nearly every day (as indicated by either
subjective account or observation made by others).
3. Significant weight loss when not dieting or weight gain (e.g., a change
of more than 5 percent of body weight in a month), or decrease or increase
in appetite nearly every day. Note: In children, consider failure to make
expected weight gains.
4. Insomnia or hypersomnia nearly every day.
5. Psychomotor agitation or retardation nearly every day (observable
byothers, not merely subjective feelings of restlessness or being slowed
down).
6. Fatigue or loss of energy nearly every day.
7. Feelings of worthlessness or excessive or inappropriate guilt (whichmay
be delusional) nearly every day (not merely self-reproach or guilt about
being sick).
8. Diminished ability to think or concentrate, or indecisiveness, nearly
every day (either by subjective account or as observed by others).
9. Recurrent thoughts of death (not just fear of dying), recurrent suicidal
ideation without a specific plan, or a suicide attempt or a specific plan
for committing suicide.
B. The symptoms cause clinically significant distress or impairment in
social, occupational or other important areas of functioning.
C. The symptoms are not due to the direct physiological effects of a
substance (e.g., adrug of abuse, a medication) or a general medical
condition (e.g., hypothyroidism).