Psychophysiological Diagnosis of Depression : Determination of Diagnostic Criteria in Comparison with Other Major Mental Disorders

1. 抑郁症的精神病理分类（1985）抑郁症在DSM-III的基础上进行了生理分类。双相情感障碍和抑郁症患者的CNV测量值与其他患者有显著差异，因此认为CNV可能是一种准确分类抑郁症的辅助工具。采用CNV方法进行聚类分析可揭示3或4个亚类，其中一些与双相抑郁和忧郁性抑郁相对应。基于Maudsley人格量表的CNV与外向性评分（皮质觉醒水平）的倒u关系，我们认为双相情感障碍患者可能是低觉醒的，而忧郁症患者可能是高觉醒的。105名正常人、70名重度抑郁症患者、33名精神分裂症患者和14名躯体形式和分离性障碍癔症患者参加了CNV研究，所有患者均根据DSM-III进行诊断。抑郁症患者的CNV值不能与正常人区分，但其CNV值明显高于精神分裂症和癔症患者。不考虑临床诊断，采用聚类分析方法将全部患者分为两组。第一组患者以抑郁为主，但CNV值均在正常范围内。第二组，症状混合，CNV值异常降低。结果表明，尽管DSM-III的诊断标准不同，但抑郁症在病理生理上是异质性的，因此心理生理学方法对精神病患者的评估是有用的。此外，判别分析还诱导出一种能区分反应型-轻度型和内在型-重度两种精神障碍的功能。

1. Psychopathological Classification of Depression(1985)Depression was physiologically classified on the basis of the DSM-III. The bipolar and melancholic patients were significantly different in the CNV measures from the others so that the CNV was concluded to be a possible aid for classifying the depression with some accuracy. The cluster analysis using the CNV measures could reveal 3 or 4 subcategories, some corresponding with the bipolar and melancholic depressions. It was suggested on the basis of the inverted-U relation between the CNV and the extraversion score(cortical arousal level) of the Maudsley Personality Inventory that the bipolar patients may be hypoarousal in contrast with that the melancholiacs may be hyperarousal.2. Diagnosis of Depression Compared with Other Mental Disorders(1986)A hundred and five normals, 70 major depressive patients, 33 schizophrenics, and 14 hysterical patients with the Somatoform and Dissociative Disorders, all of whom were diagnosed according to the DSM-III, participated in the CNV study. The depressives could not be distinguished from the normals by the CNV magnitude but they had significantly larger CNV than the schizophrenic and hysterical patients. The whole patients were categorized into 2 groups by the cluster analysis regardless of their clinical diagnoses. Almost all patients of the first group were mainly depressed though their CNV magnitude ranged within the normal limits. The second group, symptomatically mixed, showed abnormally reduced CNV magnitude. The results suggest that the depression is pathophysiologically heterogeneous though they were diagnosed by the distinct criteria of the DSM-III and thus that the psychophysiological methods are usefull for evaluating the psychiatric patients. Furthermore, the discrimination analysis induced a function whichi could differentiate 2 kinds of mental disorder, reactive-mild form and intrinsic-severe form.