Department of Psychiatry, Trinity College Dublin, Trinity Centre for Health Sciences, Tallaght University Hospital, Tallaght, Dublin, Ireland.
Australas Psychiatry. 2022 Apr;30(2):171-173. doi: 10.1177/10398562211048141. Epub 2021 Nov 27.
To provide an overview of specific aspects of historical and possible future trajectories of psychiatry.
Psychiatric treatments alleviate suffering, promote physical health, and are associated with increased longevity. As the biological underpinnings of mental illnesses are slowly uncovered, they generally cease to be primarily part of psychiatry (e.g. epilepsy, anti-NMDA receptor encephalitis). If this process continues, the biological basis of all symptom-based 'mental illnesses' might be described, and psychiatry absorbed into neurology and other disciplines. This will be a positive development if it provides better treatment for mental illness and psychiatric symptoms in other conditions, which is psychiatry's sole concern. Psychiatry's own survival as a distinct discipline is irrelevant if other disciplines can do the job better, possibly in collaboration. Given the tiny impact of neuroscience on psychiatry to date, the disappearance of psychiatry is unlikely to occur anytime soon, if ever. It is possible that human psychological functioning and psychiatric suffering are sufficiently complex and changeable as to defy complete, fine-grained, neuroscientific explanation. This would leave a role for psychiatry indefinitely, treating the immensely disabling, biologically unexplained clusters of symptoms that we currently call 'mental illnesses', increasingly in collaboration with, or absorbed within, other disciplines in medicine.
概述精神病学的历史和可能的未来轨迹的特定方面。
精神科治疗可以减轻痛苦，促进身体健康，并与延长寿命有关。随着精神疾病生物学基础的逐步揭示，它们通常不再主要属于精神病学的范畴（例如癫痫、抗 NMDA 受体脑炎）。如果这一过程继续下去，所有基于症状的“精神疾病”的生物学基础都可能被描述出来，精神病学也可能被吸收到神经病学和其他学科中。如果这能为其他情况下的精神疾病和精神症状提供更好的治疗，那么这将是一个积极的发展，而精神病学作为一个独特学科的生存则无关紧要，如果其他学科能够更好地完成这项工作，可能会进行合作。鉴于神经科学迄今为止对精神病学的影响微乎其微，精神病学不太可能很快消失，如果会的话。人类的心理功能和精神痛苦可能是如此复杂和多变，以至于无法用完整的、细微的神经科学解释来解释。这将为精神病学留下一个无限期的角色，治疗我们目前称为“精神疾病”的那些严重致残、生物学上无法解释的症状群，越来越多地与医学中的其他学科合作，或被其吸收。
