Lieberman J A, Rush A J
Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill 27599-7160, USA.
Am J Psychiatry. 1996 Nov;153(11):1388-97. doi: 10.1176/ajp.153.11.1388.
The authors evaluate the forces that are changing psychiatric practice and propose options for redefining the clinical and educational goals of psychiatry within medicine.
An overview of current external and internal forces shaping psychiatry is provided. These forces are both social, political, and economic (external) and scientific and technological (internal).
The convergence of these forces leads to recommendations for redefining psychiatric practice and education. If psychiatry fails to redefine itself on the basis of its scientific foundations, political and economic forces may lead to an untenable redefinition that could threaten the field.
The redefinition process may lead to altered roles and somewhat different knowledge bases for psychiatry. The profession must choose whether to be reactive or proactive given this challenge.
作者评估正在改变精神病学实践的各种力量，并提出在医学领域内重新界定精神病学临床及教育目标的若干选项。
概述当前塑造精神病学的外部和内部力量。这些力量包括社会、政治和经济方面（外部）以及科学技术方面（内部）。
这些力量的汇聚产生了重新界定精神病学实践与教育的建议。如果精神病学未能基于其科学基础进行自我重新界定，政治和经济力量可能导致一种难以维系的重新界定，从而可能威胁到该领域。
重新界定过程可能导致精神病学的角色改变以及知识基础略有不同。面对这一挑战，该行业必须选择是被动应对还是积极主动。
