情感障碍Mood Disorder:严重忧郁发作情景Major Depressive Episode

情感障碍Mood Disorder(一)

This section is divided into three parts. 这一章节共分成三个部分:
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.
第一部分描述情感发作情景(严重忧郁发作情景,躁狂发作情景,混合发作情景,和轻度躁狂发作情景),并被放在这一章节的开始,便于用来诊断各种情感障碍.这些发作情景本身没有诊断代码,但是它们是诊断情感障碍的基础.

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碍的诊断标准(如:忧郁症,双向情感障碍,一些全身性的疾病引起的情感障碍,毒品或药物造成的情感障碍).这部分的诊断主要运用第一部分的症状描述.

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类符,以描述最近期发生的情感发作或反复发作的原因.

情感发作情景Mood Episodes

严重忧郁发作情景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.
五项或更多以下症状出现在两周时间,并表现出与发作前功能上的不同,其中至少有一项是(1)忧郁的情绪或(2)没有兴趣或不快乐.
注意:不包含明显因为一般的疾病引起或心境不协调病的妄想或幻觉.

(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).
每天大部分时间表现忧郁的情绪,几乎日日如此,可以是主观的(如:感觉悲伤或空虚)也可以是他人的观察(如泪眼)
Note: In children and adolescents, can be irritable mood.
注意:在儿童或少年,可能表现为不安的情绪.

(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)
每天的大部分时间很少做或完全停止有兴趣的或有乐趣的活动,几乎天天如此(可以是主观的,也可以是他人的观察)

(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.
显著的体重减少(在不节食的情况下)或体重增加(如:体重在一个月内有5%的变化),或几乎每天的食欲不振或食欲大增.
注意:对儿童而言,可以是体重增加达不到年龄的标准.

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

(5) psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down)
精神运动的不安或迟钝几乎每日如此(要别人可以观察到,而不仅仅是自己的感觉)

(6) fatigue or loss of energy nearly every day
几乎每天疲乏无力

(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)
感觉自己的人生毫无价值,或过分的,不合理的罪恶感(可以是错觉)几乎每日如此(不仅仅是自我责备或因为生病而负疚)

(8) diminished ability to think or concentrate , or indecisiveness, nearly every day (either by subjective account or as observed by others)
思维不能集中,难于做决策,几乎每日如此(可以是自我观察或他人的观察)

(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
死亡的反复思想(不仅是害怕死亡),反复思考自杀但缺乏一个具体的计划;自杀企图或企图的具体计划.

B. The symptoms do not meet criteria for a Mixed Episode.
症状不符合混合发作情景.

C. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
以上症状导致在社交,工作,或其他重要功能方面的显著障碍.

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).
以上症状不是由毒品或药物,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.
以上症状不是因为丧偶引起(如:失去至爱的人,症状持续超过两个月,显著的功能障碍,集中表现出自我无价值,自杀念头,精神错乱,精神运动迟钝).