Pediaditakis Nicholas
Department of Psychiatric Medicine, East Carolina University School of Medicine, Greenville, NC 27858, USA.
Med Hypotheses. 2006;67(2):395-400. doi: 10.1016/j.mehy.2005.09.015. Epub 2006 Apr 24.
The consideration of the collective significance of the shared characteristics and overlaps in the clinical expression and pharmacological responses of the major mental disorders (namely, schizophrenia, bipolar disorders, obsessive compulsive disorder, anxieties/phobias, borderline syndrome and possibly others) supports the following: (1) These disorders have a common, initial neurodevelopmental origin. (2) They occur probabilistically on some of "at-risk" individuals whose pre-existing, extreme, temperamental/structural variance confers vulnerability for such occurrence. (3) Lastly, each of these syndromes can be considered as a clinical expression of oscillations (i.e., a switch to a pathologically ordered phase) of the overall, common operating mode of brain function. This mode based on a particular-for-our-brain, emergent quality of complexity, normally ensures the synchrony, coordination, subtlety and robust flexibility in the expression of the components of each of the various higher faculties of the brain, namely, the faculty of: (1) mood modulation; (2) coordination of feelings, thoughts and the responses to the external world; and (3) keeping constrain and limited but appropriate input of primitive drives. The conclusions in this paper have important ramifications in rethinking the current nosological procrustean flawed classification and the neurodevelopmental origin of the major mental disorders as well as the biases shown in selecting subjects for research. It also opens opportunities in the future development of novel, effective, economical and harmless therapies that will restore and maintain the normal phase of the operating mode of brain function. For example, the patient can wear an appropriate electronic device that sends a particular type of signal to the brain which will affect remission and prevent relapses without harm. We can thus avoid the use of pharmacological agents which have limited effectiveness, severe, long-term side-effects and financial burden to the patient.
对主要精神障碍(即精神分裂症、双相情感障碍、强迫症、焦虑症/恐惧症、边缘性综合征以及可能的其他障碍)在临床症状和药理反应方面共同特征及重叠的集体意义的考量支持以下观点:(1)这些障碍有着共同的、初始的神经发育起源。(2)它们在一些“高危”个体中以概率方式发生,这些个体预先存在的极端气质/结构差异使其易患此类疾病。(3)最后,这些综合征中的每一种都可被视为脑功能整体共同运作模式振荡(即转变为病理有序阶段)的临床症状表现。这种基于对我们大脑而言特定的、涌现的复杂性特质的模式,通常确保了大脑各个高级功能组成部分表达中的同步性、协调性、微妙性和强大的灵活性,即:(1)情绪调节功能;(2)情感、思维与对外界反应的协调功能;(3)对原始驱力进行约束、限制但适度输入的功能。本文的结论对于重新思考当前分类学中普罗克汝斯忒斯式的有缺陷分类、主要精神障碍的神经发育起源以及研究对象选择中存在的偏差具有重要影响。它还为未来开发新颖、有效、经济且无害的疗法创造了机会,这些疗法将恢复并维持脑功能运作模式的正常阶段。例如,患者可以佩戴一种合适的电子设备,该设备向大脑发送特定类型的信号,从而影响病情缓解并预防复发且无危害。这样我们就可以避免使用效果有限、有严重长期副作用且给患者带来经济负担的药物。