Chris Van Es

精神病学的概念性过失

发自纽约——美国精神病学协会最近针对其官方诊断手册《精神障碍诊断与统计手册》(人称“精神病学圣经”)提出了修改意见,而这对精神病的诊断来说可能弊大于利。这本手册详细规定了所有精神障碍的诊断症状,并有效地定义了心理正常和不正常之间的区别,且手册不但通行于美国,更影响到全世界大部分地区。

手册即将推出第五版,而对新版所列的诊断条件进行订正则是一项不容有失的工作。如果将精神正常与障碍之间的界限定得太宽的话,就会有许多人被误诊并接受无谓甚至有潜在危害的治疗。事实上,在这本手册的前几版中就不乏这类因诊断条件过于宽泛而导致的错误。

而倘若把界限定得太窄的话,患者就可能得不到所需的治疗。虽然精神病学家总是倾向于定义那些需要救治的潜在患者,而不是从那些症状中剔除某些一般性行为异常或者焦虑行为,但对于一个尊重个人差异性,而且认为医生有道德责任将正常的痛苦和行为异常与精神障碍区分开的社会来说,这却是非常重要的。

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