Ineichen B
Department of Public Health/Epidemiology, Charing Cross and Westminster Medical School, London, UK.
Int J Soc Psychiatry. 1991 Winter;37(4):227-32. doi: 10.1177/002076409103700401.
The concept and aetiology of schizophrenia remain controversial issues. Epidemiological studies reveal considerable variations in rates of diagnosed cases between groups. British Afro-Caribbeans show high rates. At the same time, their psychiatric experience is marked by a high level of conflict with the psychiatric services. The two debates--that surrounding the concept of schizophrenia, and that concerning the psychiatric experiences of British Afro-Caribbeans--need to be separated so that each receives appropriate consideration. Studies based on the experiences of people diagnosed as schizophrenic may confuse rather than advance the first debate if due care is not paid to the reliability of the diagnosis. The second debate has consequences for the development of psychiatric services. Further unaddressed questions referring to the mental health of ethnic minorities are suggested.
精神分裂症的概念和病因仍是颇具争议的问题。流行病学研究表明，不同群体之间确诊病例的发生率存在显著差异。英国的非裔加勒比人患病率较高。与此同时，他们在精神科就医时与精神科服务机构冲突不断。关于精神分裂症概念的争论和关于英国非裔加勒比人精神科就医经历的争论，这两者需要区分开来，以便各自得到恰当的考量。如果对诊断的可靠性缺乏应有的关注，基于被诊断为精神分裂症患者经历的研究，可能非但无法推动反而会混淆第一场争论。第二场争论对精神科服务的发展具有影响。文中还提出了一些关于少数族裔心理健康尚未得到解答的问题。
