van Loo Hanna M, Romeijn Jan-Willem
Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Department of Psychiatry, University Medical Center Groningen, Hanzeplein 1, PO Box 30.001, 9700 RB, Groningen, The Netherlands,
Theor Med Bioeth. 2015 Feb;36(1):41-60. doi: 10.1007/s11017-015-9321-0.
The frequent occurrence of comorbidity has brought about an extensive theoretical debate in psychiatry. Why are the rates of psychiatric comorbidity so high and what are their implications for the ontological and epistemological status of comorbid psychiatric diseases? Current explanations focus either on classification choices or on causal ties between disorders. Based on empirical and philosophical arguments, we propose a conventionalist interpretation of psychiatric comorbidity instead. We argue that a conventionalist approach fits well with research and clinical practice and resolves two problems for psychiatric diseases: experimenter's regress and arbitrariness.
共病的频繁出现引发了精神病学领域广泛的理论争论。为什么精神疾病共病率如此之高,它们对共病精神疾病的本体论和认识论地位有何影响?目前的解释要么集中在分类选择上,要么集中在疾病之间的因果关系上。基于实证和哲学论证,我们反而提出了一种关于精神疾病共病的约定论解释。我们认为,约定论方法与研究和临床实践非常契合,并解决了精神疾病的两个问题:实验者的循环论证和随意性。