12.1鐭ヨ瘑鍒嗗瓙The Intellectual
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浠€涔堟槸鎶戦儊鐥囷紵
鎶戦儊鐥囷紙major depressive disorder锛汳DD锛夋槸鎯呮劅鐤剧梾銆傛牴鎹父鐢ㄧ殑鐢辩編鍥界簿绁炵梾瀛﹀崗浼氬嚭鐗堢殑銆婄簿绁炵柧鐥呰瘖鏂拰缁熻鎵嬪唽銆嬬浜旂増锛圖SM5锛夌殑鏍囧噯聽[1]锛屾姂閮佺棁琛ㄧ幇涓鸿嚦灏戣繛缁袱鍛ㄣ€佸嚑涔庢瘡澶╃殑鎯呮劅浣庤惤锛堟寔缁殑鎮蹭机鎰燂級鍙?鎴栧揩鎰熺己澶憋紙瀵规棩甯告椿鍔ㄦ槑鏄惧け鍘诲叴瓒f垨涔愯叮锛夈€傚彟澶栬繕鍖呮嫭涓夊埌鍥涢」浠ヤ笅琛ㄧ幇锛氬己鐑堢殑鍐呯枤鎰熸垨鏃犲姪鎰熴€佺儲韬佹劅銆佺柌鍊︽劅銆佹敞鎰忓姏闅句互闆嗕腑銆佹劅瑙夎繜閽濆埌浠栦汉鏄庢樉鍙煡銆佽嚜鏉€鐨勬兂娉曠敋鑷宠涓恒€佺潯鐪犲洶闅炬垨杩囧銆佽鍒掑鐨勯娆擦強浣撻噸鐨勬槑鏄惧彉鍖栥€佹棤鏄庣‘鐢熺悊鍘熷洜鐨勭柤鐥涙劅绛夈€傚湪DSM5鏍囧噯澶栵紝鎶戦儊鐥囨偅鑰呭父鏈夊鐙劅銆佽〃鐜板嚭绀句細閫€缂┞燵2]銆?/p>
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鎶戦儊鐥囨槸鍏ㄧ悆鎬х殑鐤剧梾锛岀編鍥界殑娴佽鐥呭鐮旂┒鎶ュ锛?020骞翠腑鑷冲皯鏈変竴娆℃姂閮佺殑浜哄ぇ姒傚崰鎬讳汉缇ょ殑8%锛屽コ鎬т笌鐢锋€у彂鐥呮瘮渚嬬害涓?:1锛岄娆″彂鐥呯殑楂樺嘲鏈熸槸18-25宀伮燵4]銆備腑鍥借繃鍘荤殑璋冩煡琛ㄦ槑锛屽勾鍙戠梾鐜囨槸1%-4%聽[5]锛屼絾闅忕潃绀句細瀵逛簬鎶戦儊鐥囩殑璁よ瘑鍔犳繁鍜屾偅鑰呬富鍔ㄥ姹傚府鍔╋紝鎶ュ憡鐨勫彂鐥呯巼鍦ㄦ湭鏉ュ疄闄呭彲鑳芥洿楂樸€傛牴鎹娴嬶紝鎶戦儊鐥囧皢鍦?030骞村鑷存暟涓囦嚎缇庡厓鐨勫叏鐞冪ぞ浼氭垚鏈紝鏄嵄瀹虫渶楂樼殑鐤剧梾涔嬩竴聽[6]銆?/p>
2
鎶戦儊鐥囩殑鐥呭洜
濡傜粷澶у鏁扮簿绁炵柧鐥咃紝鎶戦儊鐥囩殑鐥呭洜鍖呮嫭閬椾紶鍜岀幆澧冨洜绱犮€?/p>
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棰嗗煙鏅亶璁や负鎶戦儊鐥囨槸澶氱閬椾紶鍥犵礌涓庣敓鐞嗐€佺幆澧冨洜绱犵浉浜掍綔鐢ㄥ鑷淬€傜敓鐞嗗洜绱犲寘鎷剳琛€娴佸彉鍖栥€佹縺绱犳按骞崇殑鍓х儓鍙樺寲銆佹參鎬х値鐥囥€佸叾瀹冪柧鐥咃紙濡傜檶鐥囥€佷腑椋庛€佺櫕鐥€佹參鎬х棝锛夈€佽嵂鐗╁弽搴旓紙濡傚寲鐤楋級绛壜燵10]銆傜幆澧冨洜绱犱富瑕佸寘鎷暱鏈熷簲婵€锛堟渶鍚庡皬鑺傚彟杩帮級[11]銆?/p>
3
鎶戦儊鐥囩殑鐢熺墿瀛﹀熀纭€
鎶戦儊鐥囨湰璐ㄤ笂鏄儏缁儏鎰熼殰纰嶏紝鏈夌浉褰撶殑涓昏鎰熷彈鎴愬垎锛岃嚦浠婅繕娌℃湁鍦ㄦ暣涓鍩熸櫘閬嶆帴鍙楃殑鐢熺墿鏍囪鐗┿€傚湪缇や綋姘村钩锛屾姂閮佺棁鎮h€呭懆杈硅涓儴鍒嗕績鐐庢€х粏鑳炲洜瀛愭按骞虫樉钁楀亸楂橈紝浣嗚繖绉嶅亸楂樺拰澶氱鍏跺畠鐤剧梾锛堝绮剧鍒嗚銆佺缁忛€€琛屾€х柧鐥咃級涔熺浉鍏筹紝鍥犺€屽浜庝釜浣撴按骞崇殑鎶戦儊鐥囪瘖鏂殑姝g‘搴﹀亸浣幝燵12]銆?/p>
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鍏跺畠褰卞搷杈冨ぇ鐨勭悊璁哄寘鎷缁忓彲濉戞€у拰绁炵粡鍏冩柊鐢熺殑鍋囪銆丠PA杞磋繃搴︽縺娲荤殑鍋囪绛壜燵9]锛岄兘鏈変竴瀹氱殑璇存湇鍔涗絾鍚屾椂涔熸湁灞€闄愭€с€傛瘮濡傦紝鍓嶄竴鍋囪鍜岄儴鍒嗘姉鎶戦儊鑽鍔犵缁忓彲濉戞€у拰绁炵粡鍏冩柊鐢熺殑瀹為獙鏁版嵁鐩哥锛屼絾鏄拰闈掑皯骞达紙姝ゆ椂绁炵粡鍙鎬у己锛夋姂閮佺棁楂樺彂鐨勪复搴婅瀵熶笉澶竴鑷淬€侶PA杞磋繃搴︽縺娲荤殑鐞嗚鍜岄暱鏈熷簲婵€瀵艰嚧鎶戦儊鐨勫姩鐗╂ā鍨嬪強鎴戜滑鐨勭ぞ浼氱洿瑙夌浉绗︼紝浣嗘槸鍜岄儴鍒嗘姉鎶戦儊鑽墿婵€娲籋PA杞寸殑瑙傚療鍙堜笉澶竴鑷淬€傝繃鍘?0澶氬勾鏉ワ紝涓村簥瑙傚療鍒版參鎬х値鐥囦笌鎶戦儊鐩稿叧锛屽苟鐢辨鎺ㄥ姩鏈夊叧鑴戝唴鍏嶇柅缁嗚優锛堝皬鑳惰川缁嗚優锛夎繃搴︽縺娲诲拰鎶戦儊鐨勫叧绯荤殑鐮旂┒聽[14]銆備笉杩囷紝鎶楁姂閮佽嵂鐗╃殑鎶楃値鐥囨晥鏋滃苟闈炴渶浣筹紝寰堝鎶楃値鐥囪嵂鐗╀篃娌℃湁鎶楁姂閮佹晥鏋滐紝鍥犳灏忚兌璐ㄧ粏鑳炰笌鎶戦儊鍙戠敓鐨勫噯纭満鍒惰繕闇€瑕佽繘涓€姝ョ爺绌躲€?/p>
鍦ㄧ缁忕幆璺柟闈紝鐮旂┒杈冨鐨勮剳鍖哄寘鎷笌鎯呯华鎰熷彈鐩稿叧鐨勫唴渚у墠棰濆彾銆佸墠鎵e甫鍥炪€佹潖浠佹牳銆佽吂渚ф捣椹紝涓庡璧忓鐞嗙浉鍏崇殑涓紳鑳屾牳銆佷腑鑴戣吂渚ц鐩栧尯銆佸渚у兊鏍哥瓑聽[15]銆傝緝澶氫汉鎺ュ彈鐨勮鐐硅涓猴紝鎶戦儊鐥囩殑鍙戠敓涓庡璧忕浉鍏崇幆璺殑澶辨椿鍙婁笌搴旀縺鐩稿叧鐜矾鐨勮繃婵€娲荤浉鍏陈燵16]銆傝繖浜涚爺绌跺ぇ澶氭湁鍔ㄧ墿瀹為獙缁撴灉鏀寔锛屼笉杩囩敱浜庢姂閮佺棁鐨勫姩鐗╂ā鍨嬬殑灞€闄愭€э紝鍏蜂綋鍒颁汉鑴戞槸鍚︽垚绔嬩粛鏈変簤璁猴紝鑰屼笖杩欎簺鍔ㄧ墿鐨勭粨鏋滀篃澶у娌℃湁瑙i噴绁炵粡鐜矾娲绘€у彉鍖栫殑鍏蜂綋鏈哄埗銆?/p>
鎬讳綋鑰岃█锛屾姂閮佺棁鐨勭敓鐗╁鍩虹鍦ㄨ繃鍘诲嚑鍗佸勾闂村彇寰椾簡涓嶅皯杩涘睍銆傚洜涓烘姂閮佺棁鏄竴绉嶆瀬绔鏉傜殑绮剧闅滅锛岃繕闇€瑕佹洿澶氱殑鍩虹鐮旂┒鏉ラ槓杩板彂鐥呮満鍒跺強鎻愬嚭鏇村畬缇庢不鐤楁柟妗堛€?/p>
4
鎶戦儊鐥囩殑娌荤枟
鎶戦儊鐥囩殑娌荤枟鍖呮嫭鑽墿銆佺墿鐞嗗埡婵€锛堢數銆佺鍒烘縺锛夈€佽鐭ヨ涓虹枟娉曠瓑聽[17]銆?/p>
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鐗瑰埆璇存槑锛?/strong>
a)聽鏈汉鎵嶇枏瀛︽祬锛屾鐭枃涔冧竴瀹朵箣瑷€锛屽繀鏈変笉瓒冲拰閿欒涔嬪锛岃瘹鎭虫帴鍙楁壒璇勬寚姝o紱
b)聽鏈汉鍋氬熀纭€鐮旂┒锛屼笉鏄复搴婂尰鐢燂紝鍥犳鏈枃涓嶅彲鏇夸唬鍖荤敓鐨勪笓涓氳瘖鏂拰寤鸿锛?/p>
c)聽鏈汉瑷€璁轰笉浠h〃浠讳綍鏈烘瀯銆?/p>
聽鍙傝€冩枃鐚細锛堜笂涓嬫粦鍔ㄥ彲娴忚锛?/p>
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