Roskilde University, Denmark.
Department of Psychology, University of Copenhagen, Denmark.
Health (London). 2021 Mar;25(2):231-249. doi: 10.1177/1363459319874102. Epub 2019 Sep 9.
The increasing prevalence of mental disorders together with the uncertain validity of psychopathological diagnostics challenges psychiatry as the primary home of studying, diagnosing and treating mental health problems and developing mental healthcare. This marks an emerging paradigmatical shift towards 'alternative' mental health perspectives. With the ambition of attending authoritatively in definitory practices, contemporary scholars of psychology, sociology, anthropology and philosophy call for an interdisciplinary approach to mental health, with a predominant focus on the subject. We argue that a paradigmatical shift of mental health requires structural-historical considerations of the foundations upon which subjectivity has been and still is manifested through psychiatry. On this basis, we critically investigate fluctuating psychiatric discourses on subjectivity, normality and pathology. We conducted a genealogical analysis of 13 psychiatric sources (1938-2017) focusing on 'Psychopathy' as a fluctuating diagnosis. We elucidate how subject concepts in psychiatry develop in parallel to subject concepts in society and culture, exemplified through convincing similarities between psychopathic symptoms and neoliberal ideals. Considerations like these, offer scholars valuable bases for mental health research and debate, and also valuable insights to healthcare professionals.
精神障碍的发病率不断上升，加上精神病理学诊断的不确定性，这对精神病学作为研究、诊断和治疗精神健康问题以及发展精神卫生保健的主要学科提出了挑战。这标志着一种向“替代”精神健康观点的新兴范式转变。出于权威性地参与定义实践的愿望，心理学、社会学、人类学和哲学的当代学者呼吁采用一种跨学科的方法来研究精神健康，主要关注该主题。我们认为，精神健康的范式转变需要对精神病学通过主观性表现出来的基础进行结构历史上的考虑。在此基础上，我们批判性地研究了精神医学中关于主观性、常态和病态的不断变化的话语。我们对 13 个精神病学来源（1938-2017 年）进行了谱系分析，重点关注作为波动诊断的“精神病态”。我们阐明了精神病学中的主体概念是如何与社会和文化中的主体概念平行发展的，通过精神病态症状与新自由主义理想之间令人信服的相似性来说明这一点。诸如此类的考虑为精神健康研究和辩论提供了宝贵的基础，也为医疗保健专业人员提供了宝贵的见解。
