Eisenberg L
N Engl J Med. 1977 Apr 21;296(16):903-10. doi: 10.1056/NEJM197704212961604.
The very legitimacy of psychiatry as a medical speciality has been challenged by social-labelling theory: the hypothesis that psychiatric disorders are artifacts that result from assigning diagnostic labels to minor deviations in behavior and thus generating expectations that condemn the person to a career of patienthood. Close examination of the evidence demonstrats that, through improper care care retard recovery, psychiatric illness exists before the name assigned to it, and independently of theories about its genesis. In this respect, psychiatric illness does not differ from other medical problems. All human diseases reflect the outcome of an interaction between biology and social organization, with culture in a mediating role. Whatever the proximate cause of disease -- viral, genetic, metabolic or neoplastic -- the way in which society is organized affects prevalence, cause and outcome. The physician's task is to intervene to minimize distress and preserve adaptive capacity, when cure is not possible.
该理论认为精神疾病是一种人为产物,是由于给行为上的微小偏差贴上诊断标签,从而产生一种预期,使患者注定要经历漫长的患病生涯。对证据的仔细审查表明,由于不恰当的治疗会延缓康复,精神疾病在被赋予名称之前就已存在,且独立于有关其成因的理论。在这方面,精神疾病与其他医学问题并无不同。所有人类疾病都反映了生物学与社会组织之间相互作用的结果,文化在其中起中介作用。无论疾病的直接原因是病毒、基因、代谢还是肿瘤,社会的组织方式都会影响疾病的患病率、病因和结果。当无法治愈时,医生的任务是进行干预,以尽量减少痛苦并保持适应能力。