Introducing the concept of modern depression in Japan; an international case vignette survey
Introducing the concept of modern depression in Japan; an international case vignette survey
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DOI：
10.1016/j.jad.2011.06.030
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发表时间：
2011-12-01
影响因子：
6.6
通讯作者：
Kanba, Shigenobu
中科院分区：
文献类型：
--
作者：
Kato, Takahiro A.;Shinfuku, Naotaka;Kanba, Shigenobu
目的：日本精神病学家越来越多地报告抑郁症患者似乎不符合ICD-10和DSM-IV的标准，最近被称为现代型抑郁症(MTD)。我们探讨了MTD在日本和其他国家是否常见，如果是的话，MTD患者是如何诊断和治疗的。方法：将问卷连同两个病例片段(传统型抑郁症和MTD)发送给澳大利亚、孟加拉国、印度、伊朗、日本、韩国、台湾、泰国和美国的精神科医生。结果：在247份回复中，有123份来自日本，124份来自其他国家，共收到239份有效回复。MTD在所有参与国都得到了承认，特别是在城市地区。总体来说，人格因素被认为是MTD的最可能的原因。约90%的日本精神科医生将ICD/DSM标准应用于TTD，只有约60%的医生将该标准应用于MID。结论：我们的结果表明，日本的MID似乎也在许多其他国家发生，目前的ICD/DSM标准可能不足以诊断MID。因此，作为抑郁症的一种亚型，它可能成为新的国际诊断标准的重要候选者。明确的诊断框架和关于治疗MID的干预措施的共识将是有价值的。需要进一步的临床、精神病理学和国际流行病学研究来证实我们对MID的初步发现。(C)2011爱思唯尔B.V.保留所有权利。
Aim: Japanese psychiatrists have increasingly reported patients with depression that does not seem to fit the criteria of the ICD-10 and the DSM-IV, and which has recently been called modern type depression (MTD). We explored whether MTD is frequently seen in Japan and also in other countries, and if so, how patients with MTD are diagnosed and treated.Methods: The questionnaires, with two case vignettes (traditional type depression (TTD) and MTD), were sent to psychiatrists in Australia, Bangladesh, India, Iran, Japan, Korea, Taiwan, Thailand and the USA. Participants rated their opinions about each case's prevalence in their country, etiology, diagnosis, suicide risk, and treatment using Likert scales.Results: Out of 247 responses (123 from Japan and 124 from other countries), two hundred thirty-nine valid responses were received. MTD was recognized in all participating countries, and especially in urban areas. Generally, the factor of personality was regarded as the most probable cause of MTD. Whereas about 90% of Japanese psychiatrists applied the ICD/DSM criteria to TTD, only about 60% applied the criteria to MID.Conclusion: Our results indicate that Japan's MID seems to be occurring in many other countries, and that the present ICD/DSM criteria may not be sufficient to diagnose MID. Therefore, it could be an important candidate for a new international diagnostic criterion as a subtype of depression. A clear diagnostic framework and consensus on the interventions to treat MID would be valuable. Further clinical, psychopathological and international epidemiological studies are needed to confirm our preliminary findings of MID. (C) 2011 Elsevier B.V. All rights reserved.