Blakemore C
Psychol Med. 1981 Feb;11(1):27-37. doi: 10.1017/s0033291700053253.
Psychiatry is, in a number of ways, a unique area within medicine. It is a subject of intense public interest, with a wide-ranging influence on non-medical culture; its practitioners have a perplexing variety of strategies of diagnosis and treatment, the diversity of which can be attributed to the lack of understanding of the physical basis of mental disease. It is argued here (using schizophrenia as a particular example) that the special nature of the signs and symptoms of psychiatric disorders, involving mainly behavioural disturbances, and alterations of thought and mood, have led to particular social, even political, attitudes towards the mentally ill, to the segregation of psychiatry as a medical discipline and to a view of the disease process different from that operating in other areas of medicine. The future progress of psychiatry, both in science and in society, might depend on changes of attitude among psychiatrists themselves.
精神病学在许多方面都是医学领域中的一个独特领域。它是公众高度关注的主题,对非医学文化有着广泛影响;其从业者拥有令人困惑的各种诊断和治疗策略,这种多样性可归因于对精神疾病物理基础的缺乏了解。本文(以精神分裂症为例)认为,精神疾病的症状和体征具有特殊性,主要涉及行为障碍、思维和情绪改变,这导致了对精神疾病患者的特殊社会甚至政治态度,导致精神病学作为一门医学学科被隔离,并产生了与其他医学领域不同的疾病过程观。精神病学在科学和社会方面的未来进展可能取决于精神科医生自身态度的转变。