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身心医学方法与诊断问题

The psychosomatic approach and the problem of diagnosis.

作者信息

Lolas F

出版信息

Soc Sci Med. 1985;21(12):1355-61. doi: 10.1016/0277-9536(85)90443-5.

Abstract

This paper examines some of the characteristics and aims of the process of medical diagnosis and the problems posed by the seeming opposition between disease-centered and person-centered diagnosis. The latter was one of the basic tenets of the psychosomatic approach from its inception. Its application to medical practice, however, has been hindered by the lack of an appropriate theoretical framework which might help avoid the one-sidedness prevailing in the discourse of different medical specialties. The building up of an integrative medicine has proceeded on the basis of addition and not on the basis of organic development from a theory-derived set of principles. In order to circumvent the problems associated with such state of affairs, it is proposed that multiaxial systems of diagnosis, like the ones currently in use in psychiatry, be adopted. These should be improved and expanded in order to take into account additional dimensions and data sources not hitherto taken into consideration.

摘要

本文探讨了医学诊断过程的一些特点和目的,以及以疾病为中心的诊断与人本位诊断之间看似对立所带来的问题。后者从心身医学方法诞生之初就是其基本原则之一。然而,由于缺乏一个合适的理论框架来避免不同医学专业话语中普遍存在的片面性,其在医学实践中的应用受到了阻碍。整合医学的建立是基于叠加,而不是从一套理论衍生的原则进行有机发展。为了规避与此种情况相关的问题,建议采用多轴诊断系统,如目前精神病学中使用的那些系统。应改进和扩展这些系统,以考虑到迄今未被考虑的其他维度和数据来源。

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