Cooksey E C, Brown P
Brown University, University of Sociology, Providence, RI 02912, USA.
Int J Health Serv. 1998;28(3):525-54. doi: 10.2190/1C4D-B7XT-BLLY-WH4X.
Through a critical examination of the psychiatric profession's heavy reliance on the Diagnostic and Statistical Manual of Mental Disorders, the authors explore the central role of diagnosis in the theory and practice of psychiatry. The set of beliefs that have guided the psychiatric profession since the creation of DSM-III are viewed as being tied to the new extension of the biopsychiatric medical model. From a sociological perspective, the authors address the issue of psychiatric nosology with reference to practice styles and professional dominance, and consider the impact of DSM's intrinsic social biases both within and outside psychiatry's traditionally drawn boundaries. They conclude that working soley within the confines of a medical framework of diagnosis, with little attention to the wider social and cultural contexts that should surround diagnostic practice, psychiatry will be unable to understand and explain the changing needs of its clientele.
通过对精神病学专业严重依赖《精神疾病诊断与统计手册》的批判性审视，作者探讨了诊断在精神病学理论与实践中的核心作用。自《精神疾病诊断与统计手册》第三版问世以来指导精神病学专业的一系列信念，被视为与生物精神病学医学模式的新扩展相关联。从社会学角度出发，作者参照实践方式和专业主导地位来探讨精神病学分类学问题，并考虑《精神疾病诊断与统计手册》内在的社会偏见在精神病学传统划定界限内外所产生的影响。他们得出结论，仅在医学诊断框架的范围内开展工作，而很少关注诊断实践应有的更广泛的社会和文化背景，精神病学将无法理解和解释其服务对象不断变化的需求。
