Kirmayer Laurence J
McGill University, Montreal, QC, Canada.
Lady Davis Institute, Montreal, QC, Canada.
Soc Psychiatry Psychiatr Epidemiol. 2025 Apr;60(4):771-783. doi: 10.1007/s00127-024-02772-5. Epub 2024 Sep 28.
Social psychiatry considers the ways in which mental disorders are shaped by particular social environments. This paper outlines a cultural-ecosocial approach that emphasizes the ways in which cultural meaning and practices mediate the effects of the social determinants of mental health on the mechanisms of illness, disorder, and disease.
Selective review of literature and conceptual synthesis.
"The social" in psychiatry stands for the structures and dynamics of groups of people interacting on multiple scales from the intimate sphere of couple and family to neighbourhoods, communities, societies, nations, and transnational or global networks. These interactions create social contexts, niches, forms of belonging, identities, institutions, and larger systems that influence the causes, expression, course, and outcome of mental disorders. Characterizing these systems requires theory that considers the ways in which social systems constitute dynamical systems that configure material, energetic, and informational flows that give rise to human experience. Unpacking the health consequences of these local and extended systems requires an interdisciplinary approach that considers: (1) the social psychological, psychophysiological, and sociophysiological processes that mediate the impact of the environment on body, mind, and person; (2) the interactional dynamics of social systems that give rise to structural adversity and inequity as well as resilience; and (3) the recursive effects of self-understanding, agency and subjectivity.
In the cultural-ecosocial view, "the social" is shorthand for interactional processes that constitute material and symbolic structures that provide cultural affordances, constraints, and challenges as well as resources for healing, recovery, and adaptation.
社会精神病学研究精神障碍如何受到特定社会环境的影响。本文概述了一种文化生态社会方法，该方法强调文化意义和实践在心理健康的社会决定因素对疾病、障碍和病症机制的影响中所起的中介作用。
对文献进行选择性综述并进行概念综合。
精神病学中的“社会”代表着人群在从夫妻和家庭的亲密领域到邻里、社区、社会、国家以及跨国或全球网络等多个层面上相互作用的结构和动态。这些互动创造了社会背景、生态位、归属形式、身份认同、机构以及更大的系统，它们影响着精神障碍的病因、表现、病程和结局。描述这些系统需要一种理论，该理论要考虑社会系统如何构成动态系统，这些动态系统配置物质、能量和信息流，从而产生人类体验。剖析这些局部和扩展系统对健康的影响需要一种跨学科方法，该方法要考虑：（1）介导环境对身体、心理和个人影响的社会心理、心理生理和社会生理过程；（2）社会系统中导致结构性逆境和不平等以及复原力的互动动态；（3）自我理解、能动性和主体性的递归效应。
在文化生态社会观点中，“社会”是互动过程的简称，这些互动过程构成物质和象征结构，这些结构提供文化便利条件、限制和挑战，以及用于治愈、康复和适应的资源。
