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)抑郁症是根据DSM-III进行生理学分类的。双相情感障碍和忧郁症患者的CNV测量结果有显着差异，因此CNV可能有助于抑郁症的准确分类。使用CNV指标进行的聚类分析可以发现3到4个亚类，其中一些对应于双相和忧郁抑郁。根据CNV与Maudsley个性问卷的外倾评分(皮质觉醒水平)之间的倒U关系，提示双相情感障碍患者可能是低觉醒状态，而黑质障碍患者可能是高觉醒状态。抑郁症与其他精神障碍的诊断比较(1986年)105名正常人、70名抑郁症患者、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歇斯底里患者参加了CNV研究，这些患者都是根据需求侧管理量表III被诊断出来的。抑郁症患者的CNV不能与正常人区分，但其CNV明显大于精神分裂症和歇斯底里患者。通过聚类分析，将所有患者分为两组，而不考虑其临床诊断。虽然第一组患者的CNV值在正常范围内，但几乎所有患者都以抑郁为主。第二组，症状混合，CNV波幅异常降低。结果表明，虽然抑郁症是根据DSM-III的不同标准诊断的，但它们在病理生理上是不同的，因此，心理生理学方法对精神病人的评估是有用的。此外，辨别分析还产生了一个能区分两种精神障碍的功能，即反应性-轻型型和本质性-重型。

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.