ICD-11(精神科):谁诊断得好治疗得好?

V. Mendelevich
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摘要

本文分析了大量俄罗斯精神病学家反对引入新的国际精神和行为障碍分类(ICD-11)的原因。有一种观点认为,世界精神病学从ICD-9到ICD-10治疗效果的提高与临床现象向综合征(精神病学)评估的过渡没有太大关系,而是因为现代精神药理学药物的广泛使用和循证医学原则的引入,这在国内精神病学中也受到批评。有人认为,精神病学诊断和治疗的两个重要方面实际上是相互独立的,关于拒绝或接受新分类(ICD-11)的整个争议与治疗的有效性无关。
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ICD-11 (psychiatric section): who diagnoses better treats better?
The article analyzes the reasons for the opposition of a significant number of Russian psychiatrists to the introduction of a new international classification of mental and behavioral disorders (ICD-11). An opinion is expressed that the increase in the effectiveness of therapy from ICD-9 to ICD-10 in world psychiatry is associated not so much with the transition to syndromic (anosological) assessment of clinical phenomena, but because of the widespread use of modern psychopharmacological drugs and the introduction of evidence-based medicine principles, which in domestic psychiatry are also criticized. It is argued that two important aspects of psychiatry diagnosis and therapy are practically independent of each other, and the entire dispute about rejection or acceptance of the new classification (ICD-11) has nothing to do with the effectiveness of therapy.
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