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Are somatoform disorders changing with time? The case of neurasthenia in China.

机译:躯体形式障碍是否随时间变化?中国的神经衰弱病例。

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摘要

OBJECTIVE: To examine how sociocultural factors shape the professional classification and transformation of neurasthenia (shenjing shuairuo in the Chinese language) in China. METHODS: We review the relevant literature as well as cite our own research experience on the topic. RESULTS: We identify three main periods of transformation, namely, the prereform period (before 1980) in which neurasthenia encompassed a wide range of anxiety and mood disorders; the reform period (1980s-1995) when the Diagnostic and Statistical Manual of Mental Disorders-III (DSM-III) and Kleinman's study in Hunan steadily shaped the Chinese conceptualization of nonpsychotic mental disorders; and the postreform period (after 1995) when neurasthenia has become a rarely used category of subsyndromal depression among Chinese psychiatrists. CONCLUSIONS: The dramatic transformation of neurasthenia in China speaks to the global power of the DSM system of classification, on the one hand, and the latter's failure to engage cultures in the local system of psychiatric practice, on the other. The Chinese story of neurasthenia and the social context in which the disease category is contested, marginalized, and reconstituted as the popular Western disease of depression among Chinese psychiatrists attest to the socially constructed nature of psychiatric classification. The public health implications of this transformation remain unclear.
机译:目的:探讨社会文化因素如何影响中国神经衰弱的专业分类和转变。方法:我们回顾了相关文献,并引用了我们在该主题上的研究经验。结果:我们确定了三个主要的转变时期,即重塑前时期(1980年之前),其中神经衰弱涵盖了广泛的焦虑和情绪障碍。改革时期(1980年代至1995年),当时《 III型精神疾病诊断和统计手册》(DSM-III)和Kleinman在湖南的研究稳步塑造了中国对非精神病性精神障碍的概念化;以及改革后时期(1995年之后),当时神经衰弱已成为中国精神科医生中很少使用的综合征下抑郁症的类别。结论:神经衰弱在中国的巨大转变,一方面说明了DSM分类系统的全球力量,另一方面也说明了DSM无法将文化纳入当地的精神病学实践体系。中国神经衰弱的故事和社会背景,其中疾病类别被争夺,边缘化和重新构成,因为在中国精神病医生中流行的西方抑郁症证明了精神病分类的社会建构性质。这种转变对公共卫生的影响仍不清楚。

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