Yamamoto J
UCLA Neuropsychiatric Institute, Division of Social and Community Psychiatry, Los Angeles, California 90024-1759, USA.
Psychiatry Clin Neurosci. 1998 Dec;52 Suppl:S233-5. doi: 10.1111/j.1440-1819.1998.tb03230.x.
Ever since Freud created psychoanalysis over 100 years ago, it has been popular, especially in the USA. However, biological psychiatry is now at the forefront and the emphasis is on neurosciences and pharmacotherapy. Still, the question remains, what place is there for psychotherapy in psychiatric practice? We need to be aware of the need for psychotherapy for some patients. This has been scientifically demonstrated in the study of patients with moderate and severe major depression. It has been convincingly shown that there is a place for interpersonal therapy and for cognitive behavioral therapy. Moderately depressed patients may benefit from a regimen of psychotherapy. In contrast, those with severe depression also need antidepressant medication. Because people in the Pacific Rim countries are heterogeneous, their requirements may be diverse. Asian populations need emphasis on the family as a part of the treatment team. Biological and cultural issues also enter the picture. Using the example of the flushing response, 25% of Koreans versus 50% of the Han Chinese and Japanese have the flushing response. Confucius' teachings have influenced Chinese, Koreans and Japanese for over 2000 years. The need for therapy and education is great. One solution is in primary and secondary prevention with cognitive behavioral classes such as the depression prevention course.
自100多年前弗洛伊德创立精神分析以来，它一直很受欢迎，尤其是在美国。然而，如今生物精神病学处于前沿，重点在于神经科学和药物治疗。尽管如此，问题依然存在，心理治疗在精神病学实践中处于什么地位呢？我们需要意识到一些患者对心理治疗的需求。这在对中度和重度重度抑郁症患者的研究中已得到科学证明。已经令人信服地表明，人际治疗和认知行为治疗有其存在的空间。中度抑郁的患者可能会从心理治疗方案中受益。相比之下，重度抑郁症患者也需要抗抑郁药物。由于环太平洋地区国家的人群具有多样性，他们的需求可能各不相同。亚洲人群需要强调家庭作为治疗团队的一部分。生物和文化问题也会涉及其中。以脸红反应为例，25%的韩国人有脸红反应，而汉族中国人和日本人的这一比例为50%。孔子的教义已经影响中国、韩国和日本两千多年了。治疗和教育的需求很大。一种解决办法是通过认知行为课程进行一级和二级预防，比如抑郁症预防课程。
