Jakovljevic Miro
University Hospital Centre Zagreb, Department of Psychiatry, Kišpatićeva 12, 10000 Zagreb, Croatia,
Psychiatr Danub. 2015 Sep;27 Suppl 1:S28-33.
Modern psychopharmacotherapy is currently in contention both outside and within the field of psychiatry. Conventional psychopharmacology paradigms focusing just on a disease perspective, biological narrative and a "one fits all" treatment are often regarded as inadequate and disjunctive. A significant proportion of psychiatric patients achieve no improvement or only partial improvement in their symptoms, while many of them suffer adverse and even toxic effects of medications. Psychopharmacotherapy as a sole form of treatment may carry the wrong message that patients don't have to change their life style and don't have to learn any new skills, they just have to receive their medication on time because the only problem is in brain chemistry. Evidence-based psychopharmacotherapy and person-centered narrative psychopharmacotherapy are not competitors but a complementuary duality, as intimately connected as brain and soul. Narrative preserves individuality, distinctivenesss and therapeutic context, whereas quantitative methods and evidence-based guidelines offer a solid foundation for what is reliably and generally correct. The purpose of person-centered psychopharmacotherapy is to empower the patients to control their disease, to re-author their problematic life story, to obtain full personal recovery and to regain control over their life.
现代心理药物治疗目前在精神病学领域内外都存在争议。传统的心理药理学范式仅仅关注疾病视角、生物学描述以及“一刀切”的治疗方法，常被认为是不充分且脱节的。相当一部分精神科患者症状没有改善或仅部分改善，而他们中的许多人还遭受药物的不良甚至毒性作用。作为唯一治疗形式的心理药物治疗可能传递错误信息，即患者不必改变生活方式，不必学习任何新技能，只需按时服药，因为唯一的问题在于大脑化学。循证心理药物治疗和以患者为中心的叙事心理药物治疗并非相互竞争，而是互补的二元性，就如同大脑与灵魂般紧密相连。叙事保留了个体性、独特性和治疗背景，而定量方法和循证指南为可靠且普遍正确的内容提供了坚实基础。以患者为中心的心理药物治疗的目的是使患者能够控制自己的疾病，重新书写他们有问题的人生故事，实现完全的个人康复并重新掌控自己的生活。
