Schomerus Georg, Spahlholz Jenny, Speerforck Sven
Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Leipzig- AöR, Semmelweisstr. 10, 04103, Leipzig, Deutschland.
Medizinische Fakultät, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universität Leipzig, Leipzig, Deutschland.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2023 Apr;66(4):416-422. doi: 10.1007/s00103-023-03679-3. Epub 2023 Feb 28.
For many of those affected, a mental illness also means dealing with the reactions of their environment. These are shaped by culturally prevailing ideas about the cause, treatment, course, and biographical significance of the illness. This article provides an overview of the development of population attitudes towards individuals with mental illness in Germany between 1990 and 2020 with a focus on depression and schizophrenia.A look at the last 30 years shows that attitudes toward mental illness are not static; rather, they are subject to certain dynamics that can vary considerably depending on the type of mental illness. In summary, depression evokes far fewer negative emotions than is the case with schizophrenia. This gap in attitudes has widened over the last 30 years: people with depression are met with more understanding today than 30 years ago, while the stigma of schizophrenia seems to have increased. In addition to an increasing openness in dealing with mental stress, ideas of normality and concepts of mental illness seem to have also changed. Depressive states are more closely connected with people's perceptions of their own experiences today than they were ten years ago. Schizophrenia, in turn, seems to be perceived as even more unfamiliar. While the recommendation of both psychotherapy and medication increases over time, and both psychotherapists and psychiatrists are more readily recommended as a source of help, recommendation of spiritual support (pastor, priest) declines steadily since 1990. We discuss potential causes and consequences of these divergent time trends.
对于许多患者来说，精神疾病还意味着要应对周围环境的反应。这些反应受到关于该疾病的病因、治疗、病程及个人经历意义的文化主流观念的影响。本文概述了1990年至2020年间德国民众对患有精神疾病者态度的发展情况，重点关注抑郁症和精神分裂症。回顾过去30年可以发现，人们对精神疾病的态度并非一成不变；相反，它们受到某些动态因素的影响，这些因素会因精神疾病的类型而有很大差异。总体而言，抑郁症引发的负面情绪远少于精神分裂症。在过去30年里，这种态度上的差距不断扩大：如今，抑郁症患者比30年前得到了更多理解，而精神分裂症的污名化似乎有所增加。除了在应对精神压力方面越来越开放外，正常观念和精神疾病概念似乎也发生了变化。如今，抑郁状态与人们对自身经历的认知比十年前联系更为紧密。而精神分裂症则似乎被认为更加陌生。虽然心理治疗和药物治疗的推荐率都随着时间的推移而增加，心理治疗师和精神科医生作为帮助来源也更常被推荐，但自1990年以来，对精神支持（牧师、神父）的推荐率却稳步下降。我们讨论了这些不同时间趋势的潜在原因和后果。
