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首页> 外文期刊>Journal of psychiatric practice. >The borders of mental disorder in psychiatry and the DSM: past, present, and future.
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The borders of mental disorder in psychiatry and the DSM: past, present, and future.

机译：精神病学和DSM中精神障碍的边界：过去，现在和将来。

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Over the past 60 years, the Diagnostic and Statistical Manual of Mental Disorders (DSM) has evolved from early efforts to collect statistical information to a modern compendium of mental disorders that can be reliably diagnosed, but have not been validated. Throughout this history, DSM architects have struggled with the seemingly fundamental, but complex question of how to define a mental disorder. Current proposals indicate that a spectrum model of mental illness will be embraced in DSM-5, prompting renewed concern and debate about pathologizing normal existence. While a spectrum view of mental illness may reflect biologic reality and help pave the path towards validated models of psychiatric disorder, diagnostic expansion does have important practical implications and could give rise to problems in clinical work and society at large, including the further sanctioning of a shift from psychiatric treatment to neuroenhancement. Debates about what should or should not be considered a mental illness in DSM-5 are likely to remain unresolved and, in the future, must be framed according to contextual utility. Diagnosis and thresholds of pathology are ultimately value-based so that careful analysis and perhaps even different definitions of disorder may be required to guide decision-making in research, clinical work, and public policy.
机译：在过去的60年中，《精神疾病诊断和统计手册》（DSM）已从早期收集统计信息的努力演变为可以可靠地诊断但尚未得到验证的现代精神疾病概要。在整个这段历史中，DSM架构师一直在努力解决如何定义精神障碍这一看似基本但复杂的问题。当前的建议表明，DSM-5将包含一种精神疾病的频谱模型，这引起了人们的再次关注，并引发了有关使正常存在病理化的争论。虽然精神疾病的频谱观点可能反映出生物学的现实，并有助于为验证的精神疾病模型铺平道路，但诊断的扩展确实具有重要的实际意义，并可能在临床工作和整个社会中引起问题，包括进一步制裁从精神病治疗转向神经增强。关于DSM-5中应考虑或不应该考虑的精神疾病的争论可能仍未解决，将来，必须根据上下文的实用性进行界定。病理的诊断和阈值最终都是基于价值的，因此可能需要仔细分析甚至可能是不同的疾病定义，以指导研究，临床工作和公共政策的决策。

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