情感障礙Mood Disorder:嚴重憂鬱發作情景Major Depressive Episode

情感障礙Mood Disorder(一)

This section is divided into three parts. 這一章節共分成三個部分:
The first part describes mood episodes (Major Depressive Episode, Manic Episode, Mixed Episode, and Hypomanic Episode) that have been included separately at the beginning of this section for convenience in diagnosing the various Mood Disorders. These episodes do not have their own diagnostic codes and cannot be diagnosed as separate entities; however, they serve as the building blocks for the disorder diagnoses.
第一部分描述情感發作情景(嚴重憂鬱發作情景,躁狂發作情景,混合發作情景,和輕度躁狂發作情景),並被放在這一章節的開始,便於用來診斷各種情感障礙.這些發作情景本身沒有診斷代碼,但是它們是診斷情感障礙的基礎.

The second part contains criteria sets for the Mood Disorders (e.g., Depressive Disorders, Bipolar Disorders, Mood Disorder Due to a general Medical Condition, Substance-Induced Mood Disorder). The criteria sets for most of the Mood Disorders require the presence or absence of the mood episodes described in the first part of the section.
第二部分包含情感障礙的診斷標準(如:憂鬱症,雙向情感障礙,一些全身性的疾病引起的情感障礙,毒品或藥物造成的情感障礙).這部分的診斷主要運用第一部分的症狀描述.

The third part includes the specifiers that describe either the most recent mood episode or the course of recurrent episodes.
第三部分包含一些分類符,以描述最近期發生的情感發作或反複發作的原因.

情感發作情景Mood Episodes

嚴重憂鬱發作情景Major Depressive Episode

A. Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.

Note: Do not include symptoms that are clearly due to a general medical condition, or mood-incongruent delusions or hallucinations.
五項或更多以下症狀出現在兩周時間,並表現出與發作前功能上的不同,其中至少有一項是(1)憂鬱的情緒或(2)沒有興趣或不快樂.
注意:不包含明顯因為一般的疾病引起或心境不協調病的妄想或幻覺.

(1) depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty)or observation made by others (e.g., appears tearful).
每天大部分時間表現憂鬱的情緒,幾乎日日如此,可以是主觀的(如:感覺悲傷或空虛)也可以是他人的觀察(如淚眼)
Note: In children and adolescents, can be irritable mood.
注意:在兒童或少年,可能表現為不安的情緒.

(2) markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation made by others)
每天的大部分時間很少做或完全停止有興趣的或有樂趣的活動,幾乎天天如此(可以是主觀的,也可以是他人的觀察)

(3)significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day.

Note: In children, consider failure to make expected weight gains.
顯著的體重減少(在不節食的情況下)或體重增加(如:體重在一個月內有5%的變化),或幾乎每天的食欲不振或食欲大增.
注意:對兒童而言,可以是體重增加達不到年齡的標準.

(4) Insomnia or hypersonic nearly every day
失眠或嗜睡幾乎每日如此.

(5) psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down)
精神運動的不安或遲鈍幾乎每日如此(要別人可以觀察到,而不僅僅是自己的感覺)

(6) fatigue or loss of energy nearly every day
幾乎每天疲乏無力

(7) feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick)
感覺自己的人生毫無價值,或過分的,不合理的罪惡感(可以是錯覺)幾乎每日如此(不僅僅是自我責備或因為生病而負疚)

(8) diminished ability to think or concentrate , or indecisiveness, nearly every day (either by subjective account or as observed by others)
思維不能集中,難於做決策,幾乎每日如此(可以是自我觀察或他人的觀察)

(9) recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide
死亡的反複思想(不僅是害怕死亡),反複思考自殺但缺乏一個具體的計劃;自殺企圖或企圖的具體計劃.

B. The symptoms do not meet criteria for a Mixed Episode.
症狀不符合混合發作情景.

C. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
以上症狀導致在社交,工作,或其他重要功能方麵的顯著障礙.

D. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hypothyroidism).
以上症狀不是由毒品或藥物,或一般疾病引起.

E. The symptoms are not better accounted for by Bereavement, I.e., after the loss of a loved one, the symptoms persist for longer than 2 months or are characterized by marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation.
以上症狀不是因為喪偶引起(如:失去至愛的人,症狀持續超過兩個月,顯著的功能障礙,集中表現出自我無價值,自殺念頭,精神錯亂,精神運動遲鈍).