亚型分类在理解精神分裂症疾病进程中的作用:“缺陷综合征”举例  

The role of subtypes in understanding disease processes within schizophrenia:a case example of ‘Deficit Syndrome’

作　　者：杨欣译[1] 杜明哲[2] 刘慧婷[2] Mark OPLER 

机构地区：[1]哥伦比亚大学流行病学研究室 [2]哥伦比亚大学心理学研究室 [3]纽约大学流行病学研究室

出　　处：《上海精神医学》2011年第2期109-111,共3页Shanghai Archives of Psychiatry

摘　　要：徐教授[1]对精神分裂症亚型的应用进行了贴切而有说服力的描述,提出了今后需要继续以其他方式对其进行分型的观点。他指出,作为可观察到的临床＂表型＂,精神分裂症的分型很早就得以使用,并且一直被用于指导精神分裂症的诊断和治疗。尽管历史悠久,但是来自上海和西方国家的研究表明[2,3],由美国和欧洲国家所定义的精神分裂症亚型中,除了偏执型和未定型精神分裂症以外,其他亚型很少使用,仅有不足5%的精神分裂症患者被诊断为这些亚型。而且,广泛使用的亚型诊断并不稳定：在整个疾病过程中,Professor Xu[1]provides a thoughtful and eloquent description of the utilization of schizophrenia subtypes,and presents a compelling argument for their continued use in modified form.He notes that subtypes in schizophrenia have a rich history as observable clinical ＇phenotypes＇ and have been used to guide prognosis and treatment for generations.Despite this history,reports from Shanghai and from Western researchers[2,3]indicate that except for paranoid and undifferentiated schizophrenia most of the other subtypes of schizophrenia defined in the United States and Europe are rarely used;less than 5% of patients with schizophrenia receive these diagnoses.Moreover,the more commonly used subtypes are not stable over time：only a small proportion of those diagnosed with the paranoid subtype and an even a smaller proportion diagnosed as undifferentiated subtype retain the diagnosis over the course of their illness[4].These issues and the long-standing problem of the varying the number of ＇core＇ subtypes identified by different statistical methods—from two to six[3]—raise serious questions about the validity of subtyping schizophrenia.Consequently,the drafting committee for the proposed DSM-5 has made a deliberate decision to eliminate subtypes of schizophrenia and to emphasize dimensions of psychosis in their stead.

关 键 词：精神分裂症亚型 亚型分类 缺陷综合征 疾病进程 未定型精神分裂症 精神分裂症患者 西方国家 欧洲国家 

分 类 号：R749.3[医药卫生—神经病学与精神病学]