新的精神病学诊断:破坏性情绪失调障碍

A. Portnova, Y. Sivolap
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摘要

2013年通过的DSM-5提出了一份最新的情感性障碍清单,它以一种全新的精神病学诊断——破坏性情绪失调障碍——为开端。破坏性情绪失调障碍被诊断为6至18岁的儿童和青少年,表现为慢性严重和持续的烦躁或愤怒,以及与原因不成比例的愤怒爆发。很明显,在出现这种诊断之前,很大一部分患有破坏性情绪失调障碍的儿童和青少年的状况被错误地认为是双相情感障碍的表现。破坏性情绪失调障碍和双相情感障碍的根本区别的标准是前者不存在躁狂或轻躁狂。破坏性情绪失调的特点是高合并症,常与对立违抗性障碍、品行障碍、注意缺陷伴多动以及焦虑合并。破坏性情绪失调障碍的病程和预后意义,以及选择最有效的药物治疗和心理治疗方法,需要大量的进一步研究。
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The new psychiatric dignosis: disruptive mood dysregulation disorder
The DSM-5, adopted in 2013, presents an updated list of affective disorders, which opens with a fundamentally new psychiatric diagnosis of a disruptive mood dysregulation disorder. Disruptive mood dysregulation disorder is diagnosed in children and adolescents aged 6 to 18 years and is manifested by chronic severe and persistent irritability or anger, as well as outbursts of anger disproportionate to the cause. It is obvious that the condition of a significant part of children and adolescents with a disruptive mood dysregulation disorder before the appearance of this diagnosis was mistakenly regarded as manifestations of bipolar disorder. The criterion of the fundamental difference between disruptive mood dysregulation disorder and bipolar disorder is the absence of manic or hypomanic in the first of them. Disruptive mood dysregulation disorder is characterized by high comorbidity and is often combined with oppositional defiant disorder, conduct disorder and attention deficit with hyperactivity, as well as anxiety. The course and prognostic significance of a disruptive mood dysregulation disorder, as well as the choice of the most effective methods of pharmacological treatment and psychotherapy require numerous further studies.
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