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

1.抑郁症的精神病理学分类（1985）抑郁症是根据DSM-III进行生理学分类的。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，因此得出结论，CNV可能有助于对抑郁症进行一定程度的准确性分类。使用CNV测量的聚类分析可以揭示3或4个亚类，一些对应于双相和双相抑郁症。根据CNV与Maudsley人格问卷的外倾性得分（皮层唤醒水平）之间的倒U型关系，双相情感障碍患者可能存在低唤醒，而抑郁症患者可能存在高唤醒. 105名正常人、70名重性抑郁症患者、33名精神分裂症患者和14名患有躯体形式和分离性障碍的癔症患者参加了CNV研究，所有这些患者均根据DSM-III进行诊断。抑郁症患者的CNV与正常人的CNV无明显差异，但明显大于精神分裂症和癔症患者。根据聚类分析将所有患者分为2组，不考虑其临床诊断。第一组几乎所有的患者都以抑郁为主，尽管他们的CNV幅度在正常范围内。第二组为混合型，CNV幅度异常降低。结果表明，虽然精神病患者的诊断标准与DSM-III不同，但其病理生理特征是异质的，因此心理生理学方法对精神病患者的诊断是有用的。此外，判别分析还导出了一个能区分反应性轻度和内在性重度两种精神障碍的判别函数。

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.