Allodi F, Dukszta J
Can Psychiatr Assoc J. 1978 Oct;23(6):361-71. doi: 10.1177/070674377802300603.
Reportedly, the People's Republic of China has made great progress in health care services, particularly at preventive, primary and community levels. Information on their psychiatric services is still scarce. A group of 12 health professionals visited the country for three weeks in July 1977. This paper provides a description and an analysis of the network of mental health services using a sample of one mental hospital, six general hospitals and a number of health units in cities, factories and communes. The basic principles of policy and administration are those of a collective socialism with strong central guidelines and considerable local administrative initiative. Admissions to the mental hospital in Shanghai reveal that 83% are young acute schizophrenic cases and very few are neurotic or non-psychotic. This distribution stands in great contrast with admissions to mental hospitals in the West, as is the case in Canada, where schizophrenics represent only 12% of all first admissions to mental hospitals and non-psychotic or minor conditions amount to two-thirds. An impressionistic survey of Chinese traditional medicine rooms in general hospitals revealed that a good proportion of their cases (60-70%) are diagnosed as suffering from minor organic or vague organic conditions without evidence of organic pathology and which in the West would be considered as neurotic or psychosomatic conditions. Outside the institutions, in the communes of the rural and urban areas behavioural, interpersonal and family problems are not defined specifically as mental health problems, but handled within the moral and political ideology prevalent in the country. None of the general hospitals visited had a psychiatric unit, but every patient in every hospital or health unit in the cities and countryside received a combination of traditional Chinese medicine (herbal preparations, acupuncture and moxibustion) besides the Western or modern type of treatment. Officially mental illness is not considered a major problem and it is given very low priority in medical school curricula or in the planning of health services. It is concluded that psychiatric services in China are concerned primarily with cases of psychosis and severe neurosis, that neuroses are viewed as general health problems, and personality and behaviour disorders are considered social or community matters.
据报道，中华人民共和国在医疗保健服务方面取得了巨大进展，尤其是在预防、初级和社区层面。关于其精神科服务的信息仍然很少。1977年7月，一组12名卫生专业人员访问了该国三周。本文通过对一家精神病院、六家综合医院以及城市、工厂和公社的一些卫生单位进行抽样，对精神卫生服务网络进行了描述和分析。政策和行政管理的基本原则是集体社会主义，有强有力的中央指导方针和相当大的地方行政自主权。上海精神病院的入院情况显示，83%是年轻的急性精神分裂症患者，神经症患者或非精神病患者很少。这种分布与西方精神病院的入院情况形成了鲜明对比，例如在加拿大，精神分裂症患者仅占所有首次入院精神病患者的12%，而非精神病或轻度疾病占三分之二。对综合医院中医科室的印象式调查显示，相当一部分病例（60%-70%）被诊断为患有轻度器质性或不明原因的器质性疾病，但没有器质性病变的证据，在西方这些病例会被视为神经症或心身疾病。在机构之外，在农村和城市公社，行为、人际和家庭问题没有被明确界定为精神卫生问题，而是在该国普遍的道德和政治意识形态范围内处理。所访问的综合医院中没有一家设有精神科，但城乡每个医院或卫生单位的每个患者除了接受西医或现代治疗外，还接受了中药（草药制剂、针灸和艾灸）治疗。官方认为精神疾病不是一个主要问题，在医学院课程或卫生服务规划中给予的优先级很低。结论是，中国的精神科服务主要关注精神病和严重神经症病例，神经症被视为一般健康问题，人格和行为障碍被视为社会或社区问题。
