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[健康与疾病的概念]

[The concept of health and disease].

作者信息

Ruíz R H

出版信息

Acta Psiquiatr Psicol Am Lat. 1976 Dec;22(4):267-76.

PMID:1015339
Abstract
  1. The author reviews some current concepts concerning the definitions and uses of the concepts of health and illness. Starting from the definitions in Psychiatry, "normality" is considered from the statistic, the normative and the clinical standpoints, and as a part of a continuum stretching from health to illness. Several approaches are analyzed, among which Wittaker's, who sets forth the following indicators of normality: a) self-knowledge; b) self-esteem; c) self-security; d) capacity for giving and receiving affection; e) satisfaction of corporal needs; f) productivity and capacity for happiness; g) lack of tensions and of hipersensitivity. 2. The concept of illness as an operative concept is also analyzed, leading to the following statements: a) it is inexistent in non-biological sciences; b) it appears in social sciences only through extrapolation; c) in medicine it means the breacking of homeosthasis; d) in psychology and dynamic psychiatry it means the abnormal stressing of normal mechanisms, common to all persons. 3. The concept of health as equilibrium is also analyzed, with the following precisions: a) equilibrium is defined within a system as affecting the whole of it, and implying transformation and self-regulation; b) homeosthasis is a case of equilibrium for steady complex systems; c) adaptation is the maintenance of equilibrium when there are exchanges with the evironment. 4. Finally, those concepts are applied to mental illness and its limits, and the following criteria are set forth: a) amount of anguish; b) depression related to its motives, intensity, persistence and frequency; c) regression to previous development stages; d) use of defense mechanisms in an inadequate or stereotyped way.
摘要
  1. 作者回顾了一些当前关于健康与疾病概念的定义及应用的观点。从精神病学的定义出发,“正常”从统计学、规范学和临床角度进行考量,并被视为从健康到疾病这一连续体的一部分。分析了几种方法,其中包括维特克的方法,他提出了以下正常指标:a)自我认知;b)自尊;c)自我安全感;d)给予和接受关爱的能力;e)身体需求的满足;f)生产力和幸福感;g)无紧张感和过度敏感。2. 还分析了疾病作为一个操作性概念,得出以下结论:a)在非生物科学中不存在;b)在社会科学中仅通过推断出现;c)在医学中它意味着体内平衡的打破;d)在心理学和动力精神病学中它意味着对所有人共有的正常机制的异常强调。3. 也分析了健康作为平衡的概念,并作了如下说明:a)平衡在一个系统内被定义为影响整个系统,并意味着转变和自我调节;b)体内平衡是稳定复杂系统平衡的一种情况;c)适应是在与环境进行交换时对平衡的维持。4. 最后,将这些概念应用于精神疾病及其界限,并提出了以下标准:a)痛苦程度;b)与其动机、强度、持续性和频率相关的抑郁;c)倒退到先前的发展阶段;d)以不适当或刻板的方式使用防御机制。

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