INTRODUCTION Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) may cause withdrawal at dose decrease, discontinuation, or switch. Current diagnostic methods (e.g., DSM) do not take such phenomenon into account. Using a new nosographic classification of withdrawal syndromes due to SSRI/SNRI decrease or discontinuation [by Psychother Psychosom. 2015;84(2):63-71], we explored whether DSM is adequate to identify DSM disorders when withdrawal occurs. METHODS Seventy-five self-referred patients with a diagnosis of withdrawal syndrome due to discontinuation of SSRI/SNRI, diagnosed via the Diagnostic Clinical Interview for Drug Withdrawal 1 - New Symptoms of Selective Serotonin Reuptake Inhibitors or Serotonin-Norepinephrine Reuptake Inhibitors (DID-W1), and at least one DSM-5 diagnosis were analyzed. RESULTS In 58 cases (77.3%), the DSM-5 diagnosis of current mental disorder was not confirmed when the DID-W1 diagnosis of current withdrawal syndrome was established. In 13 cases (17.3%), the DSM-5 diagnosis of past mental disorder was not confirmed when criteria for DID-W1 diagnosis of lifetime withdrawal syndrome were met. In 3 patients (4%), the DSM-5 diagnoses of current and past mental disorders were not confirmed when the DID-W1 diagnoses of current and lifetime withdrawal syndromes were taken into account. The DSM-5 diagnoses most frequently mis-formulated were current panic disorder (50.7%, n = 38) and past major depressive episode (18.7%, n = 14). CONCLUSION DSM needs to be complemented by clinimetric tools, such as the DID-W1, to detect withdrawal syndromes induced by SSRI/SNRI discontinuation, decrease, or switch, following long-term use.

中文翻译：

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选择性 5-羟色胺再摄取抑制剂 和 5-羟色胺-去甲肾上腺素再摄取抑制剂 戒断改变 DSM 精神障碍的表现：药物戒断诊断性临床访谈的结果。


引言 选择性血清素再摄取抑制剂 （SSRIs） 和血清素-去甲肾上腺素再摄取抑制剂 （SNRIs） 可能导致剂量减少、停药或转换时停药。目前的诊断方法（例如 DSM）没有考虑这种现象。使用由 SSRI/SNRI 减少或停药引起的戒断综合征的新 snoological 分类 [由 Psychother Psychosom. 2015;84（2）：63-71]，我们探讨了 DSM 是否足以在发生戒断时识别 DSM 障碍。方法 75 例自我转诊的患者因停用 SSRI/SNRI 而被诊断为戒断综合征，通过药物戒断诊断临床访谈 1 - 选择性血清素再摄取抑制剂或血清素-去甲肾上腺素再摄取抑制剂 （DID-W1） 的新症状，以及至少一项 DSM-5 诊断。结果 在 58 例 （77.3%） 病例中，当确立当前戒断综合征的 DID-W1 诊断时，未确认当前精神障碍的 DSM-5 诊断。在 13 例 （17.3%） 中，当满足终生戒断综合征的 DID-W1 诊断标准时，未确认既往精神障碍的 DSM-5 诊断。在 3 例患者 （4%） 中，当考虑当前和终生戒断综合征的 DID-W1 诊断时，未确认当前和过去精神障碍的 DSM-5 诊断。最常被错误表述的 DSM-5 诊断是当前的惊恐障碍 （50.7%，n = 38） 和过去的重度抑郁发作 （18.7%，n = 14）。结论DSM 需要辅以 DID-W1 等临床工具，以检测长期使用 SSRI/SNRI 停药、减少或转换引起的戒断综合征。