Rosenfield Paul J
Columbia University College of Physicians and Surgeons, USA.
J Am Acad Psychoanal Dyn Psychiatry. 2007 Summer;35(2):189-201. doi: 10.1521/jaap.2007.35.2.189.
Antipsychotic medications provide tremendous relief to many individuals with schizophrenia, but can have significant costs, including adverse metabolic, neurological, and psychological effects. Prescribers and consumers of these medications often have different perceptions of the safety and utility of medications, ranging from "poison" to "cure." While much of the literature on the meaning of medication in schizophrenia discusses patients' negative perceptions of medication, poor insight, and other risk factors for nonadherence, a variety of additional factors should be considered, including both doctors' and patients' perspectives. Historical, cultural, and scientific, as well as individual factors, influence both the prescribing and taking of antipsychotic medications. The relationship between doctors and patients, as informed by these factors, plays a central role in the creation of the meanings of medications. An understanding of this relationship can help to establish more collaborative treatment relationships, beyond the dichotomy of poison or cure.
抗精神病药物为许多精神分裂症患者带来了极大的缓解，但也可能产生重大代价，包括不良的代谢、神经和心理影响。这些药物的开处方者和使用者对药物的安全性和效用往往有不同的看法，从“毒药”到“治愈方法”不一而足。虽然关于精神分裂症中药物意义的许多文献都讨论了患者对药物的负面看法、洞察力差以及其他不依从的风险因素，但还应考虑各种其他因素，包括医生和患者的观点。历史、文化、科学以及个体因素都会影响抗精神病药物的开处方和服用。受这些因素影响的医患关系在药物意义的形成中起着核心作用。理解这种关系有助于建立更具协作性的治疗关系，超越毒药或治愈方法的二分法。
