Insel T R, Scolnick E M
National Institute of Mental Health/NIH, Rm. 8235, 6001 Executive Boulevard, Bethesda, MD 20892, USA.
Mol Psychiatry. 2006 Jan;11(1):11-7. doi: 10.1038/sj.mp.4001777.
Mental disorders cause more disability than any other class of medical illness in Americans between ages 15 and 44 years. The suicide rate is higher than the annual mortality from homicide, AIDS, and most forms of cancer. In contrast to nearly all communicable and most non-communicable diseases, there is little evidence that the morbidity and mortality from mental disorders have changed in the past several decades. Mental health advocates, including psychiatric researchers, have pointed to stigma as one of the reasons for the lack of progress with mental illnesses relative to other medical illnesses. This review considers how the expectations and goals of the research community have contributed to this relative lack of progress. In contrast to researchers in cancer and heart disease who have sought cures and preventions, biological psychiatrists in both academia and industry have set their sights on incremental and marketable advances, such as drugs with fewer adverse effects. This essay argues for approaches that can lead to cures and strategies for prevention of schizophrenia and mood disorders.
在15至44岁的美国人中，精神障碍导致的残疾比任何其他类别的医学疾病都要多。自杀率高于凶杀、艾滋病以及大多数癌症形式的年死亡率。与几乎所有传染病和大多数非传染病形成对比的是，几乎没有证据表明精神障碍的发病率和死亡率在过去几十年里有所变化。包括精神病学研究人员在内的心理健康倡导者指出，耻辱感是精神疾病相对于其他医学疾病而言缺乏进展的原因之一。本综述探讨了研究界的期望和目标是如何导致这种相对缺乏进展的情况的。与寻求治愈和预防方法的癌症和心脏病研究人员不同，学术界和产业界的生物精神病学家将目光投向了渐进式且具有市场价值的进展，比如副作用更少的药物。本文主张采用能够实现治愈的方法以及预防精神分裂症和情绪障碍的策略。
