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精神病的跨诊断维度:对精神疾病的分类学与研究的意义(英文) 被引量:5
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作者 jim van os 《上海精神医学》 CSCD 2015年第2期82-86,共5页
如果精神病是一种跨诊断的维度,精神病性症状的出现受动态变化的情境和情感因素左右,而后者又是可治疗的,那么目前精神科疾病的分类学和治疗研究的方法可能需要修改。迄今为此,无论在临床工作上还是在疾病概念上,占主导地位的方法是将... 如果精神病是一种跨诊断的维度,精神病性症状的出现受动态变化的情境和情感因素左右,而后者又是可治疗的,那么目前精神科疾病的分类学和治疗研究的方法可能需要修改。迄今为此,无论在临床工作上还是在疾病概念上,占主导地位的方法是将精神病性症状置于精神分裂症的框架中。然而,终生患病率为1%的精神分裂症只代表了部分预后不佳的精神病谱系障碍,而后者发生更多,终生患病率为3.5%。因此,精神分裂症的研究结果可能反映了预后相关的机制,而非精神病和其他症状维度之间本质上的相关性。同样,常见的非精神病性精神障碍中高达30%的个体有阈下精神病性症状,他们会被归于精神病的跨诊断维度之下,这些精神症状还会影响临床严重程度和治疗有效性。上述发现也同样提示武断区分"精神病性"与"非精神病性"的做法妨碍了临床实践和研究。精神病学诊断手册可以借鉴跨诊断维度(包括精神病的跨诊断维度)的体系。引入跨诊断维度,则既能根据原则进行分类诊断(即疾病分组的特异性),又可结合个体特有的多维度综合评分(即个体特异性)。这样的益处在于促使人们思考在精神病理学中症状之间是如何动态地交互作用的,并思考社会环境是如何影响精神病理症状的。 展开更多
关键词 精神病 分类学 尺寸 疾病 精神分裂症 临床实践 情感因素 精神障碍
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Empowerment according to Persons with Severe Mental Illness: Development of the Netherlands Empowerment List and Its Psychometric Properties
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作者 Wilma Boevink Hans Kroon +1 位作者 Philippe Delespaul jim van os 《Open Journal of Psychiatry》 2017年第1期18-30,共13页
Objectives. It is unclear whether and to what extent purportedly empowering practices in mental health care, like rehabilitation programs, recovery-supporting mental health care environments and peer-run services, con... Objectives. It is unclear whether and to what extent purportedly empowering practices in mental health care, like rehabilitation programs, recovery-supporting mental health care environments and peer-run services, contribute to the process of empowerment. Several American empowerment questionnaires have been developed in recent years, facilitating the measurement of empowerment outcomes. Given likely major transatlantic cultural differences in a value-sensitive concept such as empowerment, this article describes the development of the Netherlands Empowerment List (NEL) and its psychometric properties. Methods. Patients in Dutch mental health services provided meaning to the empowerment concept from which the NEL was derived. Based on 531 completed questionnaires, analyses in agreement with COSMIN criteria examined aspects of internal consistency, content validity, structural validity, convergent validity, discriminant validity, reproducibility and responsiveness of the NEL. Results. The NEL is a 40-item self-report questionnaire with six subscales: Social support, Professional help, Connectedness, Confidence and purpose, Self-management and Caring community. Internal consistency (Cronbach’s alpha = 0.94), aspects of validity, reproducibility (intraclass correlation = 0.79) and responsiveness were good. Correlation with existing scales was the highest for the Mental Health Confidence Scale (r = 0.78) and the lowest for the Boston Empowerment Scale (r = 0.61). Conclusion. The NEL appears to be a suitable instrument to capture the dimension of empowerment in European mental health settings. 展开更多
关键词 EMPOWERMENT PSYCHOTIC DISORDER RECOVERY
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