Ethical and Epidemiological Dimensions of Labeling Psychosis Risk.
Ethical and Epidemiological Dimensions of Labeling Psychosis Risk.
复制标题
DOI：
10.1001/journalofethics.2016.18.6.msoc2-1606
复制
发表时间：
2016-06-01
影响因子：
--
通讯作者：
Corcoran, Cheryl M
中科院分区：
文献类型：
--
作者：
Corcoran, Cheryl M
在过去的二十年里，对精神分裂症前驱期的研究有所增加，前驱期是精神病首次发作之前的阶段。精神病的临床高风险状态标准已得到验证，并作为减弱的精神病综合征纳入DSM-5，需要进一步研究。这引起了激烈的辩论，因为人们担心会给那些将获得这种精神病风险标签的年轻人打上烙印。在这篇文章中，我回顾了与精神病风险标签相关的伦理问题，包括如果在观察到的精神病风险指定的预测能力较低的情况下保留风险标签，则污名化和家长式作风的潜在危害。我回顾了支持精神病风险标签不一定有害，甚至可以带来好处的数据，并制定了通过个性化风险评估和公共卫生教育减少耻辱的策略。
The past two decades have marked an increase in research on the prodromal stages of schizophrenia that precede a first episode of psychosis. Criteria for a clinical high risk (CHR) state for psychosis have been validated and included in the DSM-5 as the attenuated psychosis syndrome and as requiring further study. This was hotly debated, given the concern of stigmatizing young people who would receive this psychosis risk label. In this article, I review ethical issues related to the psychosis risk label, including the potential harm of stigma and paternalism if risk labels are withheld in the context of the observed low predictive power of the psychosis risk designation. I review data that supports that the psychosis risk label need not be harmful, and could even confer benefit, and set out strategies for reducing stigma through individualized risk assessment and public health education.