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抑郁症的异质性:一种现象学观点。

The heterogeneity of depressions: A phenomenological viewpoint.

机构信息

Department of Health Sciences, University of Florence, Florence, Italy.

Centro de Estudios de Fenomenologia y Psiquiatria, Universidad 'Diego Portales', Santiago, Chile.

出版信息

Eur Psychiatry. 2023 Apr 11;66(1):e32. doi: 10.1192/j.eurpsy.2023.21.

Abstract

What is commonly referred to as "depression" indicates a heterogeneous complex disorder that includes distinct psychopathological forms. A more accurate classification can be achieved by assessing the individual experiences of depression and tracing back each of these forms to the specific vulnerable structure from which they emerge. Each of these vulnerable forms of existence can be characterized by focusing on their values. I identify four main prototypes. Homo melancholicus is impressive for their over-normality, extreme social adjustment, and conformism; their depressive decomposition is characterized by the experience of loss. The values of homo œconomicus are utility (every action must be directed toward production) and optimization (what costs more than it produces is a dead branch to be cut); their depressive decomposition is marked by insolvency. Homo dissipans' values are excess (feeling animated by an inexhaustible drive to "pour out" of oneself, especially outside the limits of composure and reasonableness) and expenditure (an ethical attitude that gives its approval to excess and to its metamorphic and destructive power); their depressive decomposition is epitomized by inner incoherence and emptiness. The style of homo nevroticus form of existence is subjugated by the condemnation to limitation and the diktat of prohibition; their depressive decomposition is characterized by frustration and demoralization.

摘要

通常所说的“抑郁”,指的是一种异质的复杂障碍,包括不同的精神病理学形式。通过评估个体的抑郁体验,并追溯每种形式所源自的特定脆弱结构,可以实现更准确的分类。每种脆弱的存在形式都可以通过关注其价值观来加以描述。我确定了四个主要原型。忧郁的人(homo melancholicus)因其过度正常、极端的社会适应和顺从而引人注目;他们的抑郁分解以失落感为特征。经济人的价值观是效用(每一个行动都必须指向生产)和优化(花费超过产出的东西是一根死枝,必须剪掉);他们的抑郁分解以无力偿债为特征。挥霍者(homo dissipans)的价值观是过度(感觉被一种无尽的动力所驱使,要从自己身上“喷涌而出”,尤其是在镇静和理智的极限之外)和支出(一种伦理态度,对过度和其变形和破坏力量表示认可);他们的抑郁分解以内在的不连贯和空虚为特征。神经症者(homo nevroticus)的存在形式的风格被限制和禁止的命令所支配;他们的抑郁分解以挫折感和士气低落为特征。

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