Professor and Director, Department of Neuroscience, University of Palermo, Buenos Aires, Argentina.
Can J Psychiatry. 2014 Aug;59(8):412-6. doi: 10.1177/070674371405900803.
Clinical psychiatric evaluations of patients have changed dramatically in recent decades. Both initial assessments and follow-up visits have become brief and superficial, focused on searching for categorical diagnostic criteria from checklists, with limited inquiry into patient-reported symptomatic status and tolerability of treatments. The virtually exclusive therapeutic task has become selecting a plausible psychotropic, usually based on expert consensus guidelines. These guidelines and practice patterns rest mainly on published monotherapy trials that may or may not be applicable to particular patients but are having a profound impact, not only on modern psychiatric practice but also on psychiatric education, research, and theory.
近年来，对患者的临床精神评估发生了巨大变化。初始评估和随访都变得简短而肤浅，侧重于从清单中寻找分类诊断标准，而对患者报告的症状状态和治疗耐受性的询问有限。几乎唯一的治疗任务是选择一种合理的精神药物，通常基于专家共识指南。这些指南和实践模式主要基于发表的单药治疗试验，这些试验可能适用于也可能不适用于特定患者，但它们对现代精神科实践、精神科教育、研究和理论产生了深远的影响。
