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关于《精神疾病诊断与统计手册》第五版的辩论:诊断与批判社会学

Debating DSM-5: diagnosis and the sociology of critique.

作者信息

Pickersgill Martyn D

出版信息

J Med Ethics. 2014 Aug;40(8):521-5. doi: 10.1136/medethics-2013-101762. Epub 2013 Dec 10.

Abstract

The development of the fifth edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders-the DSM-5-has reenergised and driven further forward critical discourse about the place and role of diagnosis in mental health. The DSM-5 has attracted considerable criticism, not least about its role in processes of medicalisation. This paper suggests the need for a sociology of psychiatric critique. Sociological analysis can help map fields of contention, and cast fresh light on the assumptions and nuances of debate around the DSM-5; it underscores the importance of diagnosis to the governance of social and clinical life, as well as the wider discourses critical commentaries connect with and are activated by. More normatively, a sociology of critique can indicate which interests and values are structuring the dialogues being articulated, and just how diverse clinical opinion regarding the DSM can actually be. This has implications for the considerations of health services and policy decision-makers who might look to such debates for guidance.

摘要

美国精神病学协会《精神疾病诊断与统计手册》第五版(即DSM-5)的编制,为有关诊断在心理健康领域的地位和作用的批判性讨论注入了新活力,并推动其进一步发展。DSM-5引发了诸多批评,尤其是关于其在医学化过程中所扮演的角色。本文提出有必要开展精神病学批判社会学研究。社会学分析有助于梳理争议领域,为围绕DSM-5的辩论中的假设和细微差别带来新的见解;它强调了诊断对于社会和临床生活治理的重要性,以及批判性评论所关联并受其激发的更广泛话语。从更规范的角度来看,批判社会学能够指出哪些利益和价值观在构建正在展开的对话,以及关于DSM的临床意见实际上究竟有多么多样。这对于那些可能指望此类辩论提供指导的卫生服务机构和政策决策者而言具有启示意义。

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