Jouvent R, Dubal S
CNRS, URA 1957, Hôpital de la Salpêtrière, Paris.
Encephale. 1997 Jun;23 Spec No 3:9-14.
Clinical research may be seen in the context of the more general problem of an exchange of knowledge between psychopathology and neurosciences. While this interaction is not contested by the specialists in either field, we cannot, nonetheless, ignore the question of their various levels of congruence. More generally, we are increasingly aware of a need for enhanced formalization of the models derived from the two disciplines with a view to setting up transpositions or even cross fertilizations. The two communities, that of psychiatrists and that of neurobiologists, while they fascinate each other, have rarely been able to produce joint findings. The psychopathologist expects a positive validation of his clinical concepts from the neurobiologist, while the neurobiologist, who has frequently not resisted the etiological temptation, wants the clinician to give him pointers to enable him to refine his own experimental models. What is required, however, is that both the psychopathologist and the neurobiologist reduce their expectations and agree to move outside of their respective disciplinary autarkies. This would avoid two traps: that of the homological temptation which leads both to graft an experimental model onto clinical entities without checking the levels of congruence or non-congruence, making do with a simple behavioral similarity; the second error consists in using the complexity of the clinical picture as an unavoidable obstacle to any coming-together of the two disciplines. These two traps have not always been avoided, in particular in the context of the use of cognitive paradigms in nosographic clinical models.
临床研究可以放在精神病理学和神经科学之间知识交流这个更普遍的问题背景下来看待。虽然这两个领域的专家都认可这种互动,但我们仍然不能忽视它们在不同层面上的一致性问题。更普遍地说,我们越来越意识到需要加强源自这两个学科的模型的形式化,以便进行转换甚至交叉融合。精神病学家群体和神经生物学家群体虽然相互吸引,但很少能够得出共同的研究结果。精神病理学家期望神经生物学家对他的临床概念进行积极验证,而神经生物学家由于经常抵制不住病因学的诱惑,希望临床医生给他一些提示,以便他能够完善自己的实验模型。然而,需要的是精神病理学家和神经生物学家都降低他们的期望,并同意走出各自学科的自给自足状态。这将避免两个陷阱:一是同源性诱惑,即导致在不检查一致性或不一致性水平的情况下,将实验模型嫁接到临床实体上,仅仅满足于简单的行为相似性;第二个错误在于将临床症状的复杂性视为这两个学科融合的不可避免的障碍。这些陷阱并非总是能被避免,特别是在疾病分类临床模型中使用认知范式的情况下。