Selective Serotonin Reuptake Inhibitor and Serotonin-Noradrenaline Reuptake Inhibitor Withdrawal Changes DSM Presentation of Mental Disorders: Results from the Diagnostic Clinical Interview for Drug Withdrawal.

IF 16.3 1区 医学 Q1 PSYCHIATRY Psychotherapy and Psychosomatics Pub Date : 2024-01-01 Epub Date: 2024-07-23 DOI:10.1159/000540031
Fiammetta Cosci, Virginie-Anne Chouinard, Guy Chouinard
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Abstract

Introduction: Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) may cause withdrawal at dose decrease, discontinuation, or switch. Current diagnostic methods (e.g., DSM) do not take such phenomenon into account. Using a new nosographic classification of withdrawal syndromes due to SSRI/SNRI decrease or discontinuation [by Psychother Psychosom. 2015;84(2):63-71], we explored whether DSM is adequate to identify DSM disorders when withdrawal occurs.

Methods: Seventy-five self-referred patients with a diagnosis of withdrawal syndrome due to discontinuation of SSRI/SNRI, diagnosed via the Diagnostic Clinical Interview for Drug Withdrawal 1 - New Symptoms of Selective Serotonin Reuptake Inhibitors or Serotonin-Norepinephrine Reuptake Inhibitors (DID-W1), and at least one DSM-5 diagnosis were analyzed.

Results: In 58 cases (77.3%), the DSM-5 diagnosis of current mental disorder was not confirmed when the DID-W1 diagnosis of current withdrawal syndrome was established. In 13 cases (17.3%), the DSM-5 diagnosis of past mental disorder was not confirmed when criteria for DID-W1 diagnosis of lifetime withdrawal syndrome were met. In 3 patients (4%), the DSM-5 diagnoses of current and past mental disorders were not confirmed when the DID-W1 diagnoses of current and lifetime withdrawal syndromes were taken into account. The DSM-5 diagnoses most frequently mis-formulated were current panic disorder (50.7%, n = 38) and past major depressive episode (18.7%, n = 14).

Conclusion: DSM needs to be complemented by clinimetric tools, such as the DID-W1, to detect withdrawal syndromes induced by SSRI/SNRI discontinuation, decrease, or switch, following long-term use.

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选择性5-羟色胺再摄取抑制剂和5-羟色胺-去甲肾上腺素再摄取抑制剂戒断改变DSM精神障碍的表述:戒毒诊断临床访谈的结果。
简介:选择性血清素再摄取抑制剂(SSRIs)和血清素-去甲肾上腺素再摄取抑制剂(SNRIs)可能会在减少剂量、停药或换药时导致戒断。目前的诊断方法(如 DSM)没有考虑到这种现象。通过对SSRI/SNRI减量或停药导致的戒断综合征进行新的命名分类[by Psychother Psychosom. 2015;84(2):63-71],我们探讨了当发生戒断时,DSM是否足以识别DSM疾病:分析了75例因停用SSRI/SNRI而被诊断为戒断综合征的自荐患者,这些患者通过药物戒断诊断临床访谈1--选择性羟色胺再摄取抑制剂或羟色胺-去甲肾上腺素再摄取抑制剂的新症状(DID-W1)进行诊断,并至少有一项DSM-5诊断:在 58 个病例(77.3%)中,当 DID-W1 确诊为当前戒断综合征时,DSM-5 的当前精神障碍诊断并未得到确认。13例患者(17.3%)在符合DID-W1终生戒断综合征诊断标准的情况下,DSM-5对其过去精神障碍的诊断未得到证实。3名患者(4%)在考虑了DID-W1对当前和终生戒断综合征的诊断后,DSM-5对当前和过去精神障碍的诊断均未得到确认。最常被误诊的DSM-5诊断是当前惊恐障碍(50.7%,n = 38)和既往重度抑郁发作(18.7%,n = 14):结论:DSM需要辅以临床测量工具,如DID-W1,以检测长期使用SSRI/SNRI后因停用、减少或转换而诱发的戒断综合征。
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来源期刊
Psychotherapy and Psychosomatics
Psychotherapy and Psychosomatics 医学-精神病学
CiteScore
29.40
自引率
6.10%
发文量
46
期刊介绍: Psychotherapy and Psychosomatics is a reputable journal that has been published since 1953. Over the years, it has gained recognition for its independence, originality, and methodological rigor. The journal has been at the forefront of research in psychosomatic medicine, psychotherapy research, and psychopharmacology, and has contributed to the development of new lines of research in these areas. It is now ranked among the world's most cited journals in the field. As the official journal of the International College of Psychosomatic Medicine and the World Federation for Psychotherapy, Psychotherapy and Psychosomatics serves as a platform for discussing current and controversial issues and showcasing innovations in assessment and treatment. It offers a unique forum for cutting-edge thinking at the intersection of medical and behavioral sciences, catering to both practicing clinicians and researchers. The journal is indexed in various databases and platforms such as PubMed, MEDLINE, Web of Science, Science Citation Index, Social Sciences Citation Index, Science Citation Index Expanded, BIOSIS Previews, Google Scholar, Academic Search, and Health Research Premium Collection, among others.
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