Dysthymic disorder: psychopathology of proposed chronic depressive subtypes.
Dysthymic disorder: psychopathology of proposed chronic depressive subtypes.
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心境恶劣障碍：所提出的慢性抑郁亚型的精神病理学。
DOI：
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发表时间：
1983
影响因子：
17.7
通讯作者：
H. Akiskal
中科院分区：
文献类型：
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作者：
H. Akiskal
作者为理解低度慢性抑郁症的精神病理学发展了一个病因学框架：1)迟发性原发抑郁症伴残留的慢性，2)慢性继发性吞咽困难，发病年龄可变，被认为是非情感性“神经性”障碍或对长期丧失能力的内科疾病反应的症状图的一部分，以及3)早发性特征性抑郁症，包括a)在暴风雨般的早期客体关系背景下发展起来的性格谱障碍和b)亚情感性心境障碍，概念化为原发情感性疾病的基因减弱形式。家族史、REM潜伏期和药物反应性的差异支持这些差异。作者还提出了识别胸腺感觉反应性亚情绪性恶劣心境的可操作性标准。
The author develops a nosologic framework for understanding the psychopathology of low-grade chronic depressions: 1) late-onset primary depressions with residual chronicity, 2) chronic secondary dysphorias, having a variable onset age and considered part of the symptomatic picture of nonaffective "neurotic" disorders or reactions to longstanding incapacitating medical diseases, and 3) early-onset characterologic depressions, which include a) character-spectrum disorders developing in the setting of tempestuous early object relationships and b) subaffective dysthymic disorders, conceptualized as genetically attenuated forms of primary affective illnesses. Differences in family history, REM latency, and pharmacologic responsiveness are presented in support of these distinctions. The author also proposes operational criteria to identify a thymoleptic-responsive subaffective dysthymic group.