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精神分裂症的以患者为中心的精神病理学:以卡尔·雅斯贝尔斯对患者对疾病态度的理解为基础。

Person-centered psychopathology of schizophrenia: building on Karl Jaspers' understanding of patient's attitude toward his illness.

机构信息

DiSPUTer– G. d'Annunzio University, Chieti, Italy.

出版信息

Schizophr Bull. 2013 Mar;39(2):287-94. doi: 10.1093/schbul/sbs154. Epub 2013 Jan 11.

Abstract

In this article, building on and extending Jaspers' concept of the "patient's attitude toward his illness" we draw attention to the active role that the person, as a self-interpreting agent engaged in a world shared with other persons, has in interacting with his/her basic disorder and in the shaping of psychopathological syndromes. This person-centered approach helps us to see patients as meaning-making entities rather than passive individuals and their attempt at self-understanding as not necessarily pathological and potentially adaptive. We describe 3 contemporary resources for a person-centered psychopathology: dialectical psychopathology, contemporary approaches to the meanings-causes debate, and value-based practice. Each of these provides a theoretical framework and practical resources for understanding the diversity of schizophrenic phenotypes, including symptom presentation, course, and outcome as a consequence of the different ways people with schizophrenia seek to make sense of the basic changes in self and world experiences. A person-centered approach, in building on patients' individual values and experiences as key aspects of their self-understanding of their psychosis, supports recovery and development of self-management skills.

摘要

在本文中,我们借鉴并扩展了雅斯贝尔斯(Jaspers)的“患者对疾病的态度”概念,提请注意患者作为一个与他人共享世界的自我解释主体,在与基本障碍相互作用以及在精神病理综合征的形成中所发挥的积极作用。这种以人为本的方法帮助我们将患者视为有意义的实体,而不是被动的个体,并且将他们的自我理解尝试视为不一定是病理性的,并且具有潜在的适应性。我们描述了三种以人为本的精神病理学的当代资源:辩证精神病理学、当代意义-原因争论的方法以及基于价值的实践。这些方法中的每一种都为理解精神分裂症表型的多样性提供了理论框架和实践资源,包括症状表现、病程和结局,这是由于精神分裂症患者寻求理解自我和世界经验的基本变化的方式不同所致。以人为本的方法以患者的个体价值观和经验为其自我理解精神分裂症的关键方面,支持康复和自我管理技能的发展。

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