21世纪中国精神卫生的瞻望

1995年9月世界卫生组织、我国卫生部等单位在北京召开了“脑十年”神经科学进展国际研讨会。会议指出脑的概念或脑学科包括神经科和精神科,“脑十年”即今后10年中要将脑的学科放在首位。这是全球性的问题,国际上许多科学家认为对世纪为“脑”的世纪。我国卫生部部长指出要落实医学模式的转变,县级以上医院须设精神科,要重视预防精神疾病,包括心身疾病[1]。这次国际会议为我国下一世纪精神卫生事业的发展提供了重要的启发和参考,据此提出以下设想。一、精神科临床工作的现代化在下一世纪,我国精神科临床工作须更迅速地改进。1．进一…     

迎接21世纪挑战的中国精神病学

２０世纪即将过去,２１世纪即将来临。值此世纪之交和中华人民共和国成立５０年之际,本刊集中发表一组文章,简要回顾和总结建国以来本学科的发展历程,并期望着在新世纪有更大、更快、更好的发展。毋庸置疑,我国的精神医学已经有了较大的发展。新中国成立时,全国的精神科病床仅千余张,精神科医生不足百人。现在,全国的精神科病床已达１０万余张,在专科工作的医生超过万名。许多精神科机构已经面目一新,建筑和设施均有很大的改观。多数医学院校均设有独立的精神科教研室;已拥有精神科博士研究生点数个、硕士研究生点１０余个,以及…     

精神医学的未来:我们在21世纪面临的挑战

20世纪初,精神医学的任务是建立精神疾病的分类和发展治疗方法.进入21世纪,精神医学领域发生了巨大变化,因此它所面临的挑战和100年之前具有很大的差别.     

21世纪我国精神医学发展前景

人类将步入21世纪,我国精神医学的发展也将进入一个新的时代。作者单位:200030　上海医科大学精神医学教研室1　生物精神医学的发展21世纪初,将完成精神疾病群体遗传学、遗传流行病学研究,精神疾病遗传学研究将从细胞水平向分子水平过渡。从分子生物学探索精神疾病的病因?..     

中国解决精神卫生老问题的新举措

由于疾病本身的影响,精神障碍患者主动寻求或接受治疗的意愿和能力受到损害。许多国家都在致力于提高此类患者的治疗率。其中,以下两个问题颇受争论。     

关于妇女精神卫生问题的讨论 妇女精神卫生的兴起和发展

一、“妇女精神卫生”专业的兴起妇女具有一些心理和生理特征,在社会和环境因素作用下,易于发生情感性障碍、摄食障碍和甲状腺疾病等,但也由于同样基础使她们得到保护,因而较少发生心血管疾病、酒精中毒和病态人格等。与生殖阶段(月经,产后,绝经)有关的精神疾病则仅见于妇女。此外,生理上的     

全球化和中国的精神卫生及其政策

中国的全球化进程是从 1978年底开始的,即在提出改革开放以后,中国进入了全球化的行列,且速度非常快.全球化会对各行各业带来诸多影响,精神卫生也不例外.现简就全球化对我国精神卫生及精神卫生政策的影响,谈点个人看法.抛砖引玉,欢迎指正.     

中国的精神卫生立法

我国的精神卫生立法工作已经走过17个年头,如今可谓"曙光初现":各方重视与支持逐步增加、精神卫生工作基础更加扎实、法律内容与立法技术更趋完善、立法进度显著加快,今年已经被列入卫生部重点立法计划.以下就我国的精神卫生立法工作作一概况介绍.     

浅谈21世纪神经精神医学的发展趋势

<正> 神经科学的历史悠久而波折,哲学和宗教主导了近两千年的启蒙阶段,19世纪后开始了快速的医学化和专业化进程,分化形成了神经病学和精神病学两个不同的医学专科,分别以脑"器质性"和"功能性"疾病为研究对象,具有各自相对独立的疾病分类体系,两者理论基础、研究方法歧见颇大。由于对精神本质的认识不同,精神病学在上世纪初期进一步分化为基于神经病理学的生物精神病学和以精神动力学为代表的诸多社会心理精神病学流派,逐步     

Mental health and social justice: a vision for the 21st century

If the American Orthopsychiatric Association is to prosper, it must follow a vision grounded in its historic concern with social justice, relevant to contemporary concerns, and pursued through the expertise of its members. Such a vision may lie in a 3-part agenda: (a) a psychologically-minded analysis of, and advocacy for, human rights: (b) attention to mental health concerns in the work of the Washington Group of international agencies; and (c) advocacy for access by disadvantaged people with mental health problems to a broad array of services and to a climate of respect.     

The Geriatric Mental State Examination in the 21st century

The Geriatric Mental State Examination (GMS) is now established as one of the most commonly used mental health assessments for older people. Its strengths lie in extensive validity studies, high inter-rater reliability, accessibility to trained raters, irrespective of professional background and its continual evolution and adaptation. Its computerisation, association with supplementary instruments and support by a diagnostic algorithm provides a comprehensive diagnostic system and syndrome profile for each subject. The instrument has been validated against most major diagnostic systems and has been used as outcome measures in intervention studies. It has been translated into numerous languages and validated as a diagnostic instrument in various cultures. Such studies have exposed weaknesses, including the over diagnoses of organic states in populations with poorly developed education. On-going studies continue to address these issues, providing a culture sensitive instrument enabling unique trans-cultural research in a relatively under-researched field.     

二十一世纪中国精神医学的思考——由《全球疾病负担研究》引发的联想

1993年,世界卫生组织、世界银行和美国哈佛大学,联合开展了一项名为《全球疾病负担研究》(Global Burden of Diseases,GBD)的研究。该研究发展了“伤残调整生命年”(Disability Adjusted Life Year, DALY)的概念,以疾病/外伤造成的DALY减少为单位(DALYs),评估社会整体的疾病负担。 传统的疾病流行状况及其严重度的研究,多数以发病率/患病率、或者病死率/死亡率为参数,用以评估疾病负担时有一定弊端。容易造成对高发病率(如上呼吸道感染)或高死亡率的疾病负担过高估     

Nociceptors for the 21st century

This review summarizes recent developments in the context of the neurochemical classification of nociceptors and explores the relationships between functionally and neurochemically defined subgroups. Although the complete picture is not yet available, several lines of intriguing evidence suggest that despite the complexity and diversity of nociceptor properties, a relatively "simple" neurochemical classification fits well with several recently identified molecular characteristics.     

Racism and mental health into the 21st century: perspectives and parameters

Definitions and theories of racism are reviewed, and the influence of racism on the American mental health system is examined, with special attention to the effects on racial and ethnic minorities of the sociopolitical climate of the 1990s. The aims of this special section are outlined and an overview is presented of the articles, which define some of the key problems of racism and mental health, describe their scope and effects, and propose approaches to remediation as we move into the 21st century.     

Neo-psychoanalysis: a paradigm for the 21st century

Freud's metapsychological assumption, splitting mind from brain, created two major and unsolved problems: the relation of the mind with the brain and with outer reality. Recently neuroscientists have focused on the first problem, often basing their work on a category error (mereological fallacy). The second problem may be avoided by considering the coevolution of mind/brain, and by recognizing a non-dualistic symbiosis. Psychodynamic science, built largely on a century of psychoanalytic progress, is proposed as a coequal partner with traditional science in the effort to better understand the theory of knowledge, a central problem of both disciplines. Group selection and downward causation contribute to the recognition of neo-psychoanalysis, a new paradigm to complement the traditional viewpoint. The new view will permit a reunion between traditional and psychodynamic science. Recent fMRI and other data are presented in support of this view.