The bereavement exclusion and DSM-5.
The bereavement exclusion and DSM-5.
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丧亲之痛排除和 DSM-5。
DOI：
10.1002/da.21927
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发表时间：
2012
影响因子：
7.4
通讯作者：
Young,IlanitTal
中科院分区：
文献类型：
--
作者：
Zisook,Sidney;Corruble,Emmanuelle;Duan,Naihua;Iglewicz,Alana;Karam,ElieG;Lanouette,Nicole;Lanuoette,Nicole;Lebowitz,Barry;Pies,Ronald;Reynolds,Charles;Seay,Kathryn;KatherineShear,M;Simon,Naomi;Young,IlanitTal
背景在DSM-III(其中DSM是诊断和统计手册)之前，一系列研究表明，在丧失亲人之后，主要的抑郁综合征是常见的，并且这些症状通常是短暂的，不需要治疗。在很大程度上基于这些研究，决定排除诊断的重大抑郁发作(MDE)，如果症状可以“更好地解释丧亲之痛比MDE”，除非症状严重和非常损害。因此，自1980年DSM-III出版以来，美国精神病学的官方立场一直是，最近的丧亲之痛可能是诊断MDE的排除标准。这篇评论文章试图回答这样一个问题：“现有最好的研究是否支持在DSM-5中继续‘排除丧亲之痛’(BE)？我们之前讨论了DSM-5情绪障碍工作组提出的将BE从DSM-5中删除的建议。方法之前的综述基于2006年发表的研究评估了BE的有效性。目前的综述增加了自2006年以来发表的研究，并批判性地检查了支持和反对在DSM-5中保留BE的论点。结果大多数数据表明，丧亲相关的抑郁症与任何其他背景下的MDE没有区别；它同样受到遗传的影响，最有可能发生在有MDE个人和家族病史的个人中，具有相似的人格特征和共病模式，同样可能是慢性和/或复发的，以及对抗抑郁药物有反应。结论我们得出结论，DSM-5中不应该保留BE。
BackgroundPre‐DSM‐III (where DSM is Diagnostic and Statistical Manual), a series of studies demonstrated that major depressive syndromes were common after bereavement and that these syndromes often were transient, not requiring treatment. Largely on the basis of these studies, a decision was made to exclude the diagnosis of a major depressive episode (MDE) if symptoms could be “better accounted for by bereavement than by MDE” unless symptoms were severe and very impairing. Thus, since the publication of DSM‐III in 1980, the official position of American Psychiatry has been that recent bereavement may be an exclusion criterion for the diagnosis of an MDE. This review article attempts to answer the question, “Does the best available research favor continuing the ‘bereavement exclusion’ (BE) in DSM‐5?” We have previously discussed the proposal by the DSM‐5 Mood Disorders Work Group to remove the BE from DSM‐5.MethodsPrior reviews have evaluated the validity of the BE based on studies published through 2006. The current review adds research studies published since 2006 and critically examines arguments for and against retaining the BE in DSM‐5.ResultsThe preponderance of data suggests that bereavement‐related depression is not different from MDE that presents in any other context; it is equally genetically influenced, most likely to occur in individuals with past personal and family histories of MDE, has similar personality characteristics and patterns of comorbidity, is as likely to be chronic and/or recurrent, and responds to antidepressant medications.ConclusionsWe conclude that the BE should not be retained in DSM‐5.