精神疾病诊断与统计手册dsm iv

DSM- APA

APA 1952 DiagnosticandStatisticalManualofMentalDisorders DSM1968DSM- 1974 1980 DSM1987 APA DSM-R. 1987 DSM APA DSMIV

AllenFrances H.A.Pincus NancyC.Andreasen R.L.Spitzcr 27 13 512

M.R.Liebowitz G.J.Tucker D.ShafferM.Campbell B.T.Walsh A.J.Rush J.B.W.Williams J.Gunderson J.H.Gold R.E.Hales N.C.Andrcasen C.W.Schmidt D.J.Kupfer M.A.Schuckit 50

100 60 WHO ICD10 APA HospitalandCommunityPsychiatry . 12 70 6000.2APADSM19931994 5. DSM

DicisionTree

Distressdisability..

ageneralmedicalconditionseparationdissciationdisabilitybereavement Tourett AIzheimer PCP

I I I I I II

xxx yyy

CCMD-II-RICD 1 2 3 4 312.8 5Tourett 30723 A70 B

C 18 317 IQ50 5570 318.O IQ35 4O5O 55 318.1 IQ20 25 35 40 318.2 IQ 20 25 319

Al23 6 2l23 1 l a

b C

d 2 a

b C d 3 a b C d B 31 23 C Rett 312.8 A

3 12 1 6 l 2 3 4 5 6 7 8 9 10 11 12 13 13 l4 2 1 15 13 B C 18

Tourett 30723 A

B 3

C D 18 E

CCMD-II-RICD 12930 2AIzheimer 32904X 42940 2930 A.

B.

C. D AIzheimer A l 2 a (b C d B A1 A2

C D A1 A2 l

2 B12 HIV 3 E F I 2904X

A 1 2 (a b c d B A1 A2

C

D 2940 A B C D

CCMD-II-RICD 1 2 3 4 5 30300 6 2918 7 29289 8 2920 9 30590 10 29289 11 29289 12 2920 13 29289 1429289 15 29289 16 2920 17 29289 18 2920 19PCP 29289 20 29289 21 2920

A

B

C A B C 30300 A

B C 1 1 2 3 4 5 6 D 2918 A B A 2 1 100 2 3 4 5 6 7 8 C B

D 29289 A B

C 2 l 2

3 4 5 6 7 8 9 D 2920 A B A 2 l 2 3 4 5 C D 30590 A 250 23 B 5 l 2 3 4 5 6 7 8 9 10 11 12 C B D

2920 A B A 2 l 2 3 4

5 C B

D 29289 A B

C

D 2 l 2 3 4 5 6 7 E 29289 A B

C 2 2 1 2 3 4 D 29289 A B

C 2 l 2 3 4 5 6 7 8 9

D 29289 A

B A

C 29289 A

B

C 2 l 2 3 4 5 6 7 8 9 10 11 12 13 D 2920 A B 24 4 1 2 3 4 5 6 7 8 C B

D 29289

A B

C

1 2 3 D 2920 A l 2 B A 3 l 2 3 4 5 6 7 8 9 C B

D PCP 29289 A B

C 1 2 3 4 5 6 7 8 D 29289 A B

C 1 l 2 3 4 5 6 D 2920 A B A 2 l 100 2 3 4 5 6 7 8 C B

A 2

1 2 3 4 5 2

1 B

C. 6 6 1 A A 2

D.1(2

E.

F.

295.30 A. B. 295.10 A. l 2 3 B. 295.20 2 l 2 3

4

5 295.90 A 295.60 A B. A 2

295.40 A. AD E B. 1 6

2 1 4 2 3 4 295.70 A.

A Al B. 2 C. D.

:DSM W(periodofillness

) 297.1 A.

1 B. A

C. D. E.

290.8 A 1 l 2 3 4

B. 1 1 C

4 297.3 A. B. C

293.XX A. B.. C. D. : .81 .82:. A. : B 1 A 2 C

1

D. CCMD-II-RICD 1 2 3 4

5 296.2X 6 296.3X 7 I 296.0X 8 296.40 9 I 296.4X 10 I 296.6X 11 I 296.SX 12 I 296.7 13 II 296.89 14 301.I3 15293.83 16 17 18 19 20 21 22 23 24 25 26 27 300.4 2833296.6F34.0 29(3)()3() 30(30) 30 31(30) 30.1() 32(30) 30.2 33(30) 30.3 34(30) 30.4 35(30) 30.41>> 36(30) 30.42>> 37(30) 30.43>> 38(30) 30.9 39(31) 31 40(31) 31.1 41(31) 31.2 42(31) 31.3 43(31) 31.4 44(31) 31.5 45(31) 31.6 46(31) 31.7 47(31) 31.9 48(31) 31.91>>

49(32) 32 50(32) 32.1() 51(32) 32.2 52(32) 32.3 53(32) 32.4 54(32) 32.41>> 55(32) 32.42>> 56(32) 32.43>> 57(32) 32.9 58(33) 33 59(33) 33.1 60(33) 33.2 61(33) 33.9 62(39) 39 63 5 3x.xx1 64 5 3x.xx2 65 5 3x.xx3 66 5 3x.xx4 A 2 5

112 1

2 3 5

4 5

6 7

8

9

D. C.

D.

E 2

A. 1

B. 3 1 2 3 3 4 5 6

7

C. D.

E.

I A. I

B.

C

A. 4

B. 3 4

l 2 3 3 4 5 6

7

C. D E.

F.

II 296.2X A. B

C.

296.3X A. 2 2 2

B

C.

I 296.0X A. 2 B.

296.40 A. B. C.

D.A B

I 296.4X A B.

C. A B

I 296.6X A. B.C. I 296.SX A. B. C. I 296.7 A. B. C.D. I C D E. A B

II 296.89 A. B. C. D.A B

E. 301.I3 A 2

I B. 2 I A 2 C. 2 2 I

I II

D.A

E.

F. 293.83 A.

1 2 B. C.

E. A. A B. 1A 2 C.

I

D. E.

5 I

II .X1

.X2 .X3

.X4

.X5 2

.X6 2

.XO 5 I

.XI

.XZ

.X3

.X4

.X5 2

.X6 2

.XO 5 I

I II

2 II

2 l 2 3

4

5 I

II A. 1 2

B. 3 1

2 3 2 4 5 6

I II

2 2

A. B. 2 l 2 3 4

C. I

4 I II I II

A. II

B. C. 2 2 A B

D. II 12 4

2

300.4 A. 2

1 B. 2 l 2 3

4 5 6 C. 2 A B D. 2 I

2

2 I 2

E.

F. G.

H.

33 296.6F34.0

l. 2. 3. 4. 5. 6. 7. 8. 9. 1. 2. 3. 1. 2.

1. 2. 3. 4. 5. 6. 7. 8. 9. 1. 2.

(3)() 3F30-F39() ()

(30) 30F30

3 4

(1) (2) (3) (4)

(5) (6) (7) (8) (1) 1 (2)

1 (30) 30.1F30.0() 30 (30) 30.2F30.1 30

(30) 30.3F30.2 30

(30) 30.4F30.8 (1) 2 1

(2) (3) (30) 30.41F30.8>> 30.4 30.1 (30) 30.42F30.8>> 30.4 30.2 (30) 30.43F30.8>> 30.4 30.3 30.9F30.8F30.9 (31) 31F31

(31) 31.1F31.0 30.1 1 (31) 31.2F31.1 30.2 1

(31) 31.3F31.2 30.3 1

(31) 31.4F31.3 32.1 1 (31) 31.5F31.4 32.2 1

(31) 31.6F31.5 32.3 1

(31) 31.7F31.6 (1) 2

(2) 1 (31) 31.9F31.8F31.9 (31) 31.91F31.8>> 12 4 30.1 30

32.1 32 (32) 32F32

4 (1) (2) (3) (4) (5)

(6) (7) (8) (9) (1) 2 (2)

2 (32) 32.1F32.0() 32 (32) 32.2F32.1 32

(32) 32.3F32.2 32

(32) 32.4F33 (1) 2 1

(2) (3) (32) 32.41F33.0>> 32.4 32.1 (32) 32.42F33.2>> 32.4 32.2 (32) 32.43F33.3>> 32.4 32.3 (32) 32.9F32.8F32.9F33.8F33.9 (33) 33F34 (33) 33.1F34.0

2 2

(1)

(2) (33) 33.2F34.1 2 2 2

(1)

(2)

(3) (33) 33.9F34.8F34.9 (39) 39F38F39 5 3x.xx1F38 5 3x.xx2F38

5 3x.xx3F38 2 5 3x.xx4F38 1 2 CCMD-II-RICD 1 2 3 300.01 4 300.21

5 300.22 6 300.29 7 300.23 8 300.3 9 309.81 10 308.3 11 300.02 12 300.81 13 300.11 14 300.7 15F41 16F41.0 17F41.1 18F41.2 19F41.3 20F41.8 21F41.9 22F40 23F40.0 24F401 25F40.2 26F40.8 27F40.9 281. 292.Liebowitz

303. 314. 325.

30021 4 10

l 2 3 4 5 6 7 8 9 10

11 12 13

300.21 300.22 A.

B.

C.

300.01 A. l 2 I 1 1 a b C B. C.

D.

seParation dissociation 300.21 A.300.01 A E. C.D. 300.01 C D 300.22 A. B.

C.

D. A 300.29 A.

B.

C D. E.

F. 18 6 G.

300.23 A

B.

C. D. E

F. 18 6

G.

H. A 300.3 A. 4 1

2 B. C 1

D

E. 3

4

1

2

309.81 A. 1

2

B. 1 1

2 3

4

5 C. 2

3 1 2 3 4. 5 6 7

D. 2 1 2 3 4 5 E.BC D 1 F. 3 3 6 308.3 A. 1

2 B. 3 1 2 3

4 5 C. I

D.

E.

F.

G. 2 4 4 H.

I II 300.02 A. 6

B. C. 6 3 6

1 1 2 3 4 5 6 D. I

E. 300.81 A. 30

B. l4 4

22 2 31 1

41

C.12 1B

2

D. 300.11 A.

B.

C D.

E.

F.

300.7 A. B. C. A

D.

E. 6 F.

F41

F41.0

F40.- 1 a (b C

F41.1

a b C

F32.F40.F41.0F42.

F48.0 F41.2

F43.2

F34.1 F41.3 F41.1

F40F49 F42.F44.F45.0F45.1F45.2F43.2

F41.8 F41.9 NOS F40

F45.2 F40. F40.2

67

F40.

F40.0

a

b

c

F410 F4000 F40.01 F401

a

b C

F40.2

a

b C -

F45.2F22.0F45.2F22.0

F40.8 F40.9 NOS NOS 300.7 A

B.

C. A. B C.

CCMD-II-RICD 1 300.12 2 300.13 3 300.14 4 300.12 A

B.

C. 300.13 A.

B. C.

D.

300.14 A. 2

B. 2 C. D.

300.6 A. B. C.

D.

CCMD-II-RICD

1 302.4 2 302.81 3 302.89 4 302.2 5 302.83 6 302.84 7 302.3 8 302.82 9 302.4 A. 6

B.

302.81 A. 6

B.

C.

302.89 A. 6

B.

302.2 A. 6 13

B.

C. 16 A 5 12 13 302.83 A. 6

B.

302.84 A. 6

B.

302.3 A. 6

B.

302.82 A. 6

B.

A.

1. 4 (1) 2 3 4 5 2.

B. 1.

2.

C. D. CCMD-II-RICD 1 307.1 2 307.51 3

4 307.46 550 650.0 307.1307.5F50.0 750.l307.5F50.2 850.2307.5F50.5 950.8307.5F50.8 1050.9307.5F50.9 11F50 12FO.0 13F50.1 14F50.2 15F503 16F50. 17FO.5 18F50.8 19F50.9 307.1 A.

85 85

B. C.

D. 3

307.51 A. 1 2

2

B.

C. 3 2 D. E. A.

B.

307.46 A. B. C. D.

E.

F.

50 50.0 307.1307.5F50.0

25 105 Quetelet

Quetelet2 Quetelet 17.5. 50.l 307.5F50.2

50.2 307.5F50.5

80

50.8 307.5F50.8 50.9 307.5F50.9 F50

NOSR63.0 R63.3 F98.2 F98.3 FO.0

a

a 15

Quetelets 175

C

d

e

R63.0 F50.8 F50.1 F50.0

F50.2

a

C

NOS a b C F503 F50.2

F50.

F38.F41.2 F48.9 ICD10 E66.

E66.1 ICD10

F30F39 F4049 F50.8 E66.

E66.- NOSR63.2 FO.5 F44.

F45.2 NOSRll F50.8 F50.9 CCMD-II-RICD 1 347 2F51 3F51.0 4F.1 5F.2 6F51.3 751. 8F51. 9F51.8 10F.9 347 A. 3

B. l 2REM

C.

F51 a

b

KleineLevin

G47.8 ICD10 G47.G47.4G47.2G47.3G25.3F98.0R33.8 ICD10

ICD10 F51.0

ICD1062.0

a b C d

F43.0F43.2

F.1

.F31.3F31.4F31.5F33.F32.

a

(b

d

G47.4

F.2

G47.2G47.2 a

b 1

F51.3

F51.4

3 4

a

b

C d

e

F44.l

51.

F51.3

a

110

C

d

F51.

REM REM

a

b

F51.8 F.9 321.39 A B C. D. E. CCMD-II-RICD

141.1 2F43 3F43.0 4F43.1 5F43.2 6F43.8 7F439 41.1 A. 3 B. 1 2 C. I I II D. E 6 6 6 F43

ICD10 X

F43.0

F44.2 23 F44.0

: a

b

2448 3 F60.

F43.1

6

F620 6

6

F620

F43.2

F33 F4323

1F4321 6 ICD10 Z

6 ICD10 H2634 2719 2733 F4322F4323F4324 F4325 6 F4321 a b C

2 F93O 5 F4320 1 F4321 2 F4322 F412F413

F4323

F412F413

F4324 F4325 F4328 F43.8 F439 CCMD-II-RICD 1 2 301.0 3 301.20 4 301.22 5 301.7 6 301.83 7 301.50 8 301.81 9 301.82 10 301.6 11 301.4 1260 1360.0301.0F60.0 1460.l301.2F60.1 1560.2301.7F60.2 1660.3301.3F60.3 1760.5301.4F60.5 1860.8301.8F60.8 1960.9301.9F60.9 20 21 22F60.0 23F60.1 24F60.2 25F60.3 26F60.4 27F60.5 28F606 29F607 30F608

31F609 32 33F610 34F611 35(6) 6

36(60) 60 37(60) 60.1 38(60) 60.2 39(60) 60.3 40(60) 60.4 41(60) 60.5 42(60) 60.6 43(60) 60.7 44(60) 60.8 45(60) 60.9 46(61) 61 47(61) 61.1 48(61) 61.2 49(61) 61.3 50(61) 61.4 51(61) 61.4 52(61) 61.9 53(62)62 54(62)62.1 55(62)62.11>> 56(62)62.19>> 57(62)62.2 58(62)62.21>> 59(62)62.211>>>> 60(62)62.22>> 61(62)62.23>> 62(62)62.24>> 63(62)62.25>> 64(62)62.26>> 65(62)62.29 66(62)62.3 67(62)62.31>> 68(62)62.32>> 69(62)62.39>> A.

l

2 3 4 B. C.

D. E. F.

301.0 A.

4 1 2 3 4 5 6 7 B.

301.20 A.

4 1 2 3 4 5 6 7 B.

301.22 A.

5

. 1 2

3 4 5 6 7 8 9

B

301.7 A. 15 3 1 2 3 4 5 6 7

B. I8 C. I5. D. 301.83

5 l 5

2

3 4

5 5 6

7 8 9 301.50 5

1 2 3 4 5 6 7 8 301.81

5 l

2 3

4 5 6 7 8 9 301.82

4 l 2 3 4 5 6 7 301.6

5 1 2 3 4

5 6 7 8 301.4

4 l

2

3 4

5 6 7 8 60

1.

2. 3. 1. 2. 18 60.0 301.0F60.0

1.

2. 3. 4. 5. 6. 7.

60.l 301.2F60.1

1.

2.

3.

4. 5. 6. 7.

60.2 301.7F60.2 18 1. 2. 3. 4. 5. 6. 7. 8.

9. 10. 11. 12. 18 1.

2.

3.

4. 5. 6. 7. 8.

9. 10. 60.3 301.3F60.3

1. 2. 3. 4. 5.

6. 7. 60.4301.5F60.4 1. 2. 3. 4. 5.

6.

7. 8. 60.5 301.4F60.5 1. 2.

3. 4. 5. 6. 7.

60.8 301.8F60.8

60.9 301.9F60.9

03

16 17

a

b c d e

f

F60.0 a b c

d e f g

F22.- F20.- F60.1 a b C d e f g h

i AspergerF84.5 F22.0 F845 F20.- F21 F60.2 a b C d e f

F91.- F60.3 F60.3

F60.30

F60.2 F60.31

F60.4 a (b C d e f

F60.5 a b C d e f g

h - -F42.-

F606 a (b C d e f a (b C d e f F608 F60.0-F60.7 haltlose

F609 NOs NOs F60

F60 F608

F610 F60.

F611 F60.- F62-

Z73.1 6) 6F60-F69 (60) 60F60

1 (1)

(2) (3) (4) ()

18 2 (60) 60.1F60.0 (1) (2) 3

(60) 60.2F60.1

(1) (2)

3

) (60) 60.3F60.2

18 18 (1) 3

1 (2) 18 3 2 (11) (12) (60) 60.4F60.30 (1) (2) 3

(60) 60.5F60.4 (1) (2) 3 (60) 60.6F60.5 2

70% (1) (2)

3 (60) 60.7F60.6

(1) (2) 3

(60) 60.8F60.7 (1) (2) 3 (60) 60.9F60.8F60.9 (61) 61F63

CCMD-3 4

(61) 61.1F63.0

(1) (2) (3)

(4) 1 3 (61) 61.2F63.1

(1) (2) (3) (61) 61.3F63.2

(1) (2) (3)

(4) 1 3 (61) 61.4F63.3

(1) (2) (3) (61) 61.9F63.8F63.9 (62) 62F64F65F66

62.1F64 (1)

1 1

(2) 6 (1)

1

1

(2) 6 (62) 62.11F64.0>>

(1)

(2) 2 (3) (62) 62.19F64.8F64.9>> (62) 62.2F65 (62) 62.21F65.0>>

(1)

(2) 6 (62) 62.211F65.1>>>>

(1) (2) (3) 6 (62) 62.22F65.2>>

(1)

(2) (3) 6 (62) 62.23F65.3>>

(1) (2) (3) (62) 62.24F65.8>>

(1) (2) (3) (4) 6 ) 62.25F65.5>>

(1)

1 (2)- (3) 6 (62) 62.26F65.6>> -

(62) 62.29F65.8F65.9 (62) 62.3F66

CCMD-3

(62) 62.31F66.x1>> (1) (2)

(3)

(62) 62.32F66.x2>>

(1) (2)

(3) (62) 62.39F66.8F66.9>> CCMD-II-RICD 1 2 3 A. A1

B. C. A. l 2 3 B. A C.

A. 5

5l234 1 l 2 3 4 5 6 7 8 9 10 11 B.

C.

D. AB C 2