University of Wolverhampton, Wolverhampton, United Kingdom.
Qual Health Res. 2012 Nov;22(11):1460-7. doi: 10.1177/1049732312450283. Epub 2012 Jun 28.
Our main aim was to examine how insight into schizophrenia is discursively represented in psychiatrists' accounts, how these accounts relate to the current psychiatric literature on insight, and their potential clinical consequences. The article is anchored in the constructionist view of discourse and is based on nine semistructured interviews with specialist psychiatrists. We discuss three dimensions of insight into schizophrenia in the data we collected: a sense of illness, criticism, and readiness to receive treatment. We argue that they are embodiments of the dominant medical perspective in the relations between patients and physicians. Whereas in the former two it is possessing and accepting psychiatric knowledge which constitutes having insight, in the latter it is unquestioning acceptance and trust in whatever treatment the doctor deems fit to administer. We conclude with a discussion of medicalization of experience of mental illness, which appears to be the preferred mode of patient narrative for psychiatrists.
我们的主要目的是探讨精神科医生的叙述中如何论述精神分裂症的洞察力，这些叙述如何与当前精神科文献中的洞察力相关，以及它们可能产生的临床后果。本文基于话语的建构主义观点，基于与 9 名专科精神科医生的 9 次半结构化访谈。我们讨论了我们收集的数据中精神分裂症洞察力的三个维度：疾病意识、批评和接受治疗的意愿。我们认为，它们体现了患者与医生之间关系中占主导地位的医学观点。在前两个维度中，拥有和接受精神病学知识构成了洞察力，而在后一个维度中，对医生认为适合治疗的任何治疗方法的无条件接受和信任则构成了洞察力。最后，我们讨论了精神疾病体验的医学化，这似乎是精神科医生首选的患者叙述模式。
