Department of Psychiatry, Island Medical Program, University of British Columbia, Vancouver, Canada,
Health Care Anal. 2014 Jun;22(2):105-13. doi: 10.1007/s10728-012-0235-y.
This article aims to clarify the notion of a psychiatric disability. The article uses conceptual analysis, examining and applying established definitions of (general) disability to psychiatric disabilities. This analysis reveals that disability as inability to perform according to expectations or norms is related to impairment as deviation from the (statistical) norm, while disability as inability to achieve (personal) goals is related to impairment as deviation from the (personal) ideal. These two views of impairment and disability are distinct from the self-organization view of impairment as disrupted self-creation or disrupted self-repair and of disability as disrupted whole person self-compensation (in relation to an impairment). All these three views of disability pertain to psychiatric disability. Although there is nothing necessarily psychiatric about psychiatric disability other than the psychiatric impairment related to it, the life course and life circumstances typical of many people with (severe) psychiatric disorders may lead to disability and may thus confer some (psychiatric) specificity on this disability. This analysis may facilitate research on specific psychiatric disabilities and a broader scope for psychiatric rehabilitation.
本文旨在澄清精神残疾的概念。本文使用概念分析，通过检验和应用（一般）残疾的既定定义来分析精神残疾。这一分析表明，残疾作为无法按照期望或规范行事，与偏离（统计）规范的损伤有关，而残疾作为无法实现（个人）目标，与偏离（个人）理想的损伤有关。这两种损伤和残疾的观点与损伤的自我组织观点（即自我创造或自我修复的中断）以及残疾的自我补偿整体中断（相对于损伤）的观点不同。所有这些残疾观点都适用于精神残疾。尽管除了与之相关的精神损伤外，精神残疾并无其他必然的精神特质，但许多（严重）精神障碍患者的生活轨迹和生活环境可能导致残疾，从而使这种残疾具有一定的（精神）特殊性。这种分析可能有助于研究特定的精神残疾，并为精神康复提供更广泛的范围。
