Experience versus diagnosis as the appropriate basis for assessment of depression: A reply to the commentary from Kirmayer et al. (2017).
Experience versus diagnosis as the appropriate basis for assessment of depression: A reply to the commentary from Kirmayer et al. (2017).
复制标题
经验与诊断作为抑郁症评估的适当基础：对 Kirmayer 等人评论的答复。
DOI：
10.1016/j.socscimed.2018.01.002
复制
发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Haroz,EE
中科院分区：
文献类型：
--
作者：
Bolton,P;Haroz,EE
今年5月，我们在《社会科学与医学》杂志上发表了一篇论文，基于相关的可用定性数据，描述了全球抑郁症相关症状的异同(Haroz等人。2017年)。我们回顾了来自世界各地的定性研究，这些研究描述了抑郁症症状的组合。我们确定了全球报告的哪些症状组，以及哪些似乎只与一个或多个地区相关。我们的目的是描述世界各地抑郁症可能经历的相似和不同之处，并将这些发现与诊断和统计手册(DSM)诊断标准中描述的最常用的抑郁症描述进行比较。在我们的论文中，我们讨论了诊断和测量的含义，但我们想强调的是，我们论文的主要目标是总结和描述抑郁症的经历。鉴于我们审查的数据仅是定性的，这是唯一可能的方法，因为确定我们审查中出现的体征和症状的诊断意义需要不同的方法。这就是为什么，在将我们的结果与DSM进行比较时，我们不仅参考了诊断标准，还参考了DSM中详细描述的其他诊断和相关特征。像DSM的作者一样，我们有兴趣在诊断标准的狭窄范围之外提供对抑郁症经历的更全面的描述。我们在这篇论文中提出的这篇综述的含义是，鉴于世界各地经常描述的诊断标准之外的症状，只关注诊断标准作为抑郁症构成因素和评估的基础显然存在问题。这实际上与DSM的设计非常一致--作为一种障碍指数，以简化解释，同时承认障碍体验中存在实质性差异(Kendler，2017；Kendler，2016)。然而，这并不总是如何使用的，我们的结果强调了
In May of this year, we published a paper in Social Science and Medicine describing similarities and differences in depression-related symptoms globally, based on relevant available qualitative data (Haroz et al. 2017). We reviewed qualitative studies from around the world that described combinations of depression-like symptoms. We identified which groups of symptoms were reported globally and which seemed relevant to only one region or regions. Our purpose was to describe the similarities and differences in how depression may be experienced around the world, and to compare these findings with the most commonly used description of depression as described in the Diagnostic and Statistical Manual (DSM) diagnostic criteria.While in our paper we discussed diagnosis and implications for measurement, we would like to, emphasize that our main objective in our paper was to summarize and describe how depression is experienced. Given that the data we reviewed were qualitative only, this is the only approach that is possible since determining diagnostic significance of the signs and symptoms that emerged in our review would require different methods. This is why, in comparing our results with the DSM, we referred to not only the diagnostic criteria but also the other diagnostic and associated features described at length in the DSM. Like the authors of the DSM we were interested in providing a fuller description of the experience of depression beyond the narrow confines of diagnostic criteria. The implications of our review, one we raised in the paper, is that there is clearly a problem with focusing only on diagnostic criteria as the basis for what constitutes depression and therefore assessment, given that there are symptoms outside the diagnostic criteria that are frequently described around the world. This is actually very consistent with how the DSM was designed–as an index of disorders to simplify interpretation, while acknowledging the existence of substantial variation in the disorder experience (Kendler, 2017; Kendler, 2016). However, this is not always how it is used, and our results emphasize the