Epidemiology of depressive disorders in the community.
Epidemiology of depressive disorders in the community.
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社区抑郁症的流行病学。
DOI：
10.1016/0165-0327(82)90029-5
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发表时间：
1982
影响因子：
6.6
通讯作者：
P. Bebbington
中科院分区：
文献类型：
--
作者：
J. Wing;P. Bebbington
最近关于情感障碍流行病学的评论家公正地指出，评论几乎与实证研究一样多（Boyd 和 Weissman 1982）。这种情况在精神病学文献中并不陌生。 Mishler 和 Scotch (1963) 20 年前对跨文化精神病学也做过类似的评论。它反映了对常见问题的概念方法的混乱、由于这种混乱而产生的相互矛盾的经验数据的混乱，以及寻找更清晰视角的无数次失败的尝试。就情感障碍而言，医院实践中的精神科医生很早就认识到并试图解释一种严重抑郁症或“忧郁症”，但他们的表述很少是直截了当的。例如，格里辛格主要因拥护“单一精神病”的概念和“精神疾病是脑疾病”的说法而被人们铭记，他充分意识到宿主、主体和环境之间相互作用的复杂性。他指出，忧郁症可以因其严重程度、持续时间、独立发展和其他特定症状的存在而与正常情绪反应区分开来，并且因为可能根本没有心理社会诱因（Griesinger 1861）。另一方面，他认识到，每个人的情绪反应的严重程度各不相同，有些人对特定形式的逆境高度敏感，无论是来自突然的灾难，还是雅斯贝尔斯（Jaspers，1963）所说的“命运的固定性之一”，例如“随着年龄的增长而浪费希望”。 Kraepelin（1913，1921）通过假设一种名为“躁狂抑郁性精神病”的遗传性疾病实体，大大简化了问题，但代价是对所包含内容的假定同质性（例如Leonhard 1971，1979）和所排除内容的假定独立性（例如Lewis 1934）的持久争议。目前对情感障碍的研究中出现的所有问题——正常与异常、特质与状态、分类与维度、原发性与继发性、单相与双相、内源性与外源性、神经质或反应性——都得到了有能力的精神病学家的长期集中关注，但基本上仍未得到解决。事实上，根据最近对样本的研究，它们被提出了更加困难的形式。
The most recent commentators on the epidemiology of affective disorders have justly pointed out that there have been almost as many reviews as empirical studies (Boyd and Weissman 1982). This situation is not unfamiliar in the psychiatric literature; Mishler and Scotch (1963) made a similar comment about transcultural psychiatry 20 years ago. It reflects a confusion of conceptual approaches to common problems, a welter of conflicting empirical data resulting from this confusion, and numerous unsuccessful attempts to find a clearer perspective. In the case of the affective disorders, psychiatrists in hospital practice have long recognized, and tried to explain, a condition of severe depression or ‘melancholia’, but their formulations have rarely been straightforward. Griesinger, for example, who is chiefly remembered for his espousal of the concept of ‘unitary psychosis’ and of the statement ‘mental illness is cerebral illness’, was fully aware of the complexity of the interactions between host, agent and environment. He pointed out that melancholia can be distinguished from normal emotional reactions by reason of its severity, duration, independent development and the presence of other specific symptoms, and because there may be no psychosocial precipitants at all (Griesinger 1861). On the other hand, he recognized that individuals vary in the severity of their emotional reactions, some being highly sensitive to particular forms of adversity, whether arising from a sudden catastrophe or from what Jaspers (1963) called ‘one of the fixities of fate’, such as ‘the wasting of hope with increasing age’. Kraepelin (1913, 1921) simplified matters considerably by postulating an inherited disease entity called ‘Manic-Depressive Psychosis’ but only at the expense of enduring controversy about the supposed homogeneity of what had been included (eg Leonhard 1971, 1979) and the supposed independence of what had been left out (eg Lewis 1934). All the problems arising in current research into the affective disorders-normal versus abnormal, trait versus state, categorical versus dimensional, primary versus secondary, unipolar versus bipolar, endogenous versus exogenous or neurotic or reactive-have been given long and concentrated attention by capable psychiatrists, but have remained substantially unresolved. Indeed, they have been posed in even more difficult form in the light of recent studies of samples of the
影响因子：
--
作者：
Boyd,JH;Weissman,MM
通讯作者：
Weissman,MM