Subtypes of substance dependence and abuse: implications for diagnostic classification and empirical research
Subtypes of substance dependence and abuse: implications for diagnostic classification and empirical research
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DOI：
10.1111/j.1360-0443.2006.01595.x
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发表时间：
2006-09-01
期刊：
影响因子：
6
通讯作者：
Caetano, Raul
中科院分区：
文献类型：
--
作者：
Babor, Thomas F.;Caetano, Raul
目的：评估一种被称为临床分型的诊断分类形式与精神病分类系统中物质滥用和依赖诊断标准可能修订的相关性。方法提出了分型的一般原理。为了探索诊断分类的影响，最近的研究中的各种亚型方案进行审查的发展新的亚型和验证的既定理论。结果自现代精神病学开始以来，酒精中毒和其他精神障碍的亚型已经提出。最近的分型研究表明，没有出现共识的性质，更少的数量，亚型，可用于表征临床异质性假设存在于人群中的物质使用障碍。虽然已经开发了几种相对简单的二元类型学（例如Cloninger I型和II型; Babor et al.的A型和B型），验证研究在这些分类的结构、同时和预测有效性方面产生了混合的结果。结论在进一步的国际研究之前，不建议在主要的精神病分类系统中采用亚型方案。
Aims To evaluate the relevance of a form of diagnostic classification called clinical subtyping in relation to possible revisions in the diagnostic criteria for substance abuse and dependence in psychiatric classification systems. Methods A general rationale for subtyping is presented. To explore the implications for diagnostic classification, recent research on a variety of subtyping schemes is reviewed in terms of the development of new subtypes and the validation of established theories. Results Subtypes of alcoholism and other psychiatric disorders have been proposed since the beginning of modern psychiatry. Recent subtyping research suggests that no consensus has emerged about the nature, much less the number, of subtypes that could be used to characterize the clinical heterogeneity assumed to be present in groups of people with substance use disorders. Although several relatively simple binary typologies have been developed (e.g. Cloninger's type I and type II; Babor et al.'s type A and type B), validation research has produced mixed results in terms of the construct, concurrent and predictive validity of these classifications. Conclusions The adoption of a subtyping scheme in the major psychiatric classification systems is not recommended until further international research is conducted.