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诊断精神疾病的人类学方法:论木村彬的时间结构理论。

The anthropological method for diagnosing mental diseases: On the theory of time structure of Bin Kimura.

作者信息

Noma Shun'ichi

机构信息

Noma-Kokoro Clinic Kyoto Japan.

出版信息

PCN Rep. 2023 Nov 6;2(4):e150. doi: 10.1002/pcn5.150. eCollection 2023 Dec.

Abstract

Bin Kimura (1931-2021), the Japanese anthropological psychopathologist and philosopher, attached importance to clinical impressions at psychiatric consultations in order to diagnose mental diseases precisely, and thus proposed his original theory of time structure. According to Kimura's theory of time structure, whether we live by giving weight to the past, the present, or the future can be called "time structure," and is essentially related to the way we live with others and experience the world. We can obtain some signs for diagnosing mental diseases from the viewpoint of the time structure of each patient. "Ante-festum" is the time structure in which one lives ahead to the future, and is typical of schizophrenic patients. "Post-festum" is the time structure in which one is late for oneself, and is typical of patients with endogenous depression. "Intra-festum" is the time structure in which one lives directly in the present, and is typical of patients with epilepsy or bipolar disorders. The anthropological diagnosis according to Kimura's theory of time structure could complement the operational diagnostic criteria, such as the and the , in daily clinical practice. For example, Kimura's theory of time structure could exercise its ability to discriminate between endogenous and neurotic depression, and between schizophrenia and other delusional psychoses. The theory of time structure and anthropological diagnosis which Bin Kimura proposed in the late 20th century can give us many hints for assessing patients with mental diseases even today.

摘要

木村彬(1931 - 2021),日本人类文化学精神病理学家兼哲学家,为了精确诊断精神疾病,他重视精神科会诊时的临床印象,进而提出了其独创的时间结构理论。根据木村的时间结构理论,我们生活中重视过去、现在还是未来可被称作“时间结构”,它本质上与我们和他人相处以及体验世界的方式相关。从每位患者的时间结构角度,我们能够获得一些用于诊断精神疾病的迹象。“超前时间结构”是一种生活重心置于未来的时间结构,是精神分裂症患者的典型特征。“滞后时间结构”是一种自身滞后于自身的时间结构,是内源性抑郁症患者的典型特征。“当下时间结构”是一种直接活在当下的时间结构,是癫痫或双相情感障碍患者的典型特征。在日常临床实践中,依据木村时间结构理论的人类文化学诊断能够补充操作性诊断标准,比如[此处原文缺失具体标准名称]和[此处原文缺失具体标准名称]。例如,木村的时间结构理论能够发挥其区分内源性抑郁症和神经症性抑郁症,以及精神分裂症和其他妄想性精神病的能力。木村彬在20世纪后期提出的时间结构理论和人类文化学诊断,即便在今天也能为我们评估精神疾病患者提供诸多启示。

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