精神病学 第二章精神障碍的分类与诊断标准 授课教师 王克勤 济宁医学院精神卫生学院
第一节基本概念 1 一、分类的目的： ■交流 ■研究 ■治疗 ■预防 ■预测 标准不同，结论和结果不同 济宁医院精神卫生
第一节 基本概念2 二、精神障碍分类的基轴： ■生物学： ■现象学：归类法， 纬度法 Overlap of MDD and Anxiety Disorders severe mania hypomania(mild to moderate normal/balanced mood mild to moderate depression severe depression
第一节基本概念3 三、精神障碍的诊断标准： ■症状 ■严重程度 ■病程 ■排除标准 济宁医学污
Delusions Thought Hallucinations insertion Thought Thought 、broadcasting withdrawal Thought echo (thoughts spoken out loud) Delusional !Bizarre perception delusions ! Voices discussing patient Voices giving a running commentary on patients behaviour Delusions of control Voices coming from some part of the body At least one of the above symptoms or two of the following: persistant hallucinations without clear affective content breaks in train of thought resulting in incoherent or irrelvant speed or neologisms catatonic behaviour negative symptoms significant and consistent change in behaviour Symptoms of schizophrenia.Schneider's first rank symptoms are in red;other symptoms
第一节基本概念4 四、多轴诊断： DSM IV: Axis I Axis ll Primary DSM diagnosis: Personality/ Five Axes diagnosis developmental Axis I Panic disorder disorders Aigaenpeonah Axis Ill Diabetes Axis IV Severe stressors: Divorce Axis lll ·Job1oss Relevant Axis V Serious symptoms: physica Axis IV Severity of psychosocial Axis V stressors Global assessment of level of functioning
Organic disorders Schizophrenia and related disorders 第一节基本概念5 Mood 五、等级诊断 Disorders Other Functional Illness Mental Retardation Personality disorder Fig.3 The psychiatric diagnostic hierarchy. 济宁医学院米 Diagnoses further up the ladder take precedence
第二节常用的精神障碍分类系统 1、ICD-10,2、DSM-V,3、CCMD-3 The ICD-10 DIAGNOSTIC AND STATISTICAL Classification CCMD-3 MANUA MENTAL DISORDERS of Mental and 中国精神障碍分类 Behavioural 与诊断标准 TEXT REVISION Disorders (第三版) -DSM-IV-TR- 中华医学会精神科分会编 AVER CAN PSYCHIATRIC ASSOCIATION 床科学技木版