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Page Creation Date
2018.10.08

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2019.10.21

精神病 Mental illness


簡介 Introduction

精神病是一個重要的公共衛生議題,這不僅可致個人痛苦,更能造成巨大的家庭與社會成本。研究發現,精神病在社區裡並不罕見。生理、心理和社會因素,全都可以促成精神病之出現,評估和治療精神病時也應該充分考慮這些因素。一個人出現精神病,往往不會是單一原因造成的。生理因素(e.g., 基因影響和化學失衡) 和心理社會因素(e.g., 創傷、孤獨、家庭關係、貧窮) 皆可是重要成因。至於精神病的治療,生物醫學治療(e.g., 藥物治療) 和心理社會介入方法 (e.g., 認知行為治療) 皆可能有幫助。然而,誤解和污名是社區裡之障礙,可延誤為患有精神病的人提供適當評估和治療。
Mental illness is an important public health issue as it not only could lead to personal suffering, but also lead to huge family and social costs. Studies show that mental illness is not rare in the community. Biological, psychological and social factors could all contribute to the development of mental illness, and these factors should be taken into consideration when assessing and treating mental illness. Usually, there is no single cause for a person who develops a mental disorder. Biological factors (e.g., genetic influences and chemical imbalance) and psychosocial factors (e.g., trauma, loneliness, family relationship and poverty) may all play an important role. In terms of treatment for mental illness, both biomedical treatments (e.g., medications) and psychosocial interventions (e.g., cognitive-behavioral therapy) may be very helpful. However, misunderstanding and stigma are obstacles in the community which could lead to delay in providing appropriate assessment and treatment for persons with mental illness.

作者/Author: Hong Wang Fung

新聞及政府資訊 News&Government Information

PsycheTruth. (2012, 2012-08-23, January 01). Cause of Mental Health Disorders: Chemical or Trauma? Psychiatrist Colin Ross & Corrina Psychetruth.
In this video, psychiatrist Dr. Colin Ross discusses the potential biological and psychological causes of mental illness. He suggests that psychological trauma is a significant risk factor for mental health problems.
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Tsang, E. (2015, 2015-09-25, January 01). Severe shortage of Hong Kong psychiatrists “means they have just minutes to decide if patient”s condition is dangerous’. South China Morning Post.
There is a serious shortage of mental health services in Hong Kong. This newspaper article reports Hong Kong psychiatrists generally only have a few minutes to assess their patients.
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李慧筠. (2018, 2018-08-23, January 01). 精神中心落戶拗足五年 區議員:唔反對咪幫緊佢. HK01.
精神健康綜合社區中心(ICCMW)是香港精神復康的主要服務提供單位之一,在各區為社區人士提供服務。然而,有些ICCMW卻多年來未有永久會址,長期在不穩定的場所提供社區服務。箇中原因,包括居民誤解與反對、被規劃署列為「敏感設施」等等,也包括缺乏議員的支持。此報導講述一間沙田ICCMW落戶之困難。
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影視作品 Movie and TV Series

GT Entertainment, . (2014). It’s Okay, That's Love (괜찮아, 사랑이야).
This is a Korean television series about mental illness. It mainly focuses on the main character who had psychosis, who later developed a relationship with a psychiatrist.
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香港電視廣播有限公司. (2011). 仁心解碼.
此電視劇以精神病為題材,透過不同案件,講述不同角色患上精神病的故事,包括創傷後壓力症、反社會人格障礙、妄想症患者等角色。
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學術文章 Academic Papers

Clement, S. et al. (2015). What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychological Medicine, 45(1), 11–27.
This systematic review examines the impact of mental health-related stigma on help-seeking. It was found that stigma could have significant negative effect on help-seeking.
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Kessler, R. C. et al. (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 617–627.
This paper reports the 12-month prevalence, severity, and comorbidity of several DSM-IV mental disorders in the general population in the United States.
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Read, J. et al. (2009). Time to abandon the bio-bio-bio model of psychosis: Exploring the epigenetic and psychological mechanisms by which adverse life events lead to psychotic symptoms. Epidemiology and Psychiatric Sciences, 18(4), 299–310.
Biological, psychological and social factors are all important and should be considered in the assessment and treatment of mental illness. However, the authors argued that the field of mental health has been dominated by a simplistic focus on the biological aspects and the psychosocial aspects are commonly ignored. This paper discusses the findings in epigenetic studies in the context of the relationship between adverse childhood experiences and psychosis.
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Read, J. et al. (2008). Child maltreatment and psychosis: A return to a genuinely integrated bio-psycho-social model. Clinical Schizophrenia & Related Psychoses, 2(3), 235–254.
This article discusses the importance of recognizing psychosocial factors in psychosis (which is a serious mental health problem) and advocates a return to the original stress-vulnerability model, which offers the possibility of a genuine integration of biological and psychosocial research. The relationship between child maltreatment and psychosis is reviewed and trauma assessment for all mental health service users is recommended.
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Steel, Z. et al. (2014). The global prevalence of common mental disorders: A systematic review and meta-analysis 1980–2013. International Journal of Epidemiology, 43(2), 476–493.
This paper systematically reviews the global prevalence of common mental disorders.
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書籍 Books

American Psychiatric Association, . (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington: American Psychiatric Publishing. Washington, DC: Author.
This is the manual published by the American Psychiatric Association. It offers information regarding etiology, prevalence, diagnostic criteria and differential diagnosis of each officially recognized psychiatric disorder.
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Read, J. & Dillon, J. (2013). Models of madness: Psychological, social and biological approaches to psychosis. London: Routledge.
This book provides a history of madness and summarizes the research showing that many mental health problems (e.g., hallucinations) could be caused primarily by adverse life events (e.g., family violence, parental loss, bullying, poverty) and can be understood from the psychological and social perspectives. It also reviews the evidence for using psychological and social approaches to treat mental health problems and challenges the simplistic and pessimistic theories and treatments of mental disorders.
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Ross, C. A. (2007). The trauma model: A solution to the problem of comorbidity in psychiatry. Richardson, TX: Manitou Communications.
Extensive comorbidity (i.e., one psychiatric patient suffers from many different mental disorders at the same time) is common in the mental health field, but there is no model to account for this problem. This book suggests that comorbidity is the central problem in psychiatry. It presents a detailed description of the Trauma Model, which is designed to be a scientifically testable theory and is suitable for a wide range of mental health problems associated with trauma and stress. The Trauma Model predicts that there would be dose-response relationships between trauma and many mental health problems. It is suggested that the trauma model is the solution to the problem of comorbidity in the mental health field.
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World Health Organization, . (2001). The world health report 2001 - Mental health: New understanding, new hope.
This report aims to raise public and professional awareness of mental health problems and their costs. This reviews the costs of mental illness and the contributing factors. Prevention and treatment strategies are also highlighted.
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World Health Organization, . (2018). The ICD-11 Classification of Mental and Behavioral Disorders. Clinical description and diagnostic guidelines. Geneva: Author.
The ICD published by World Health Organization is another international manual for mental disorders. Yet, the ICD includes not only mental disorders but also other physical diseases.
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葉錦成. (2011). 精神醫療社會工作:信念、理論和實踐. 台北市: 心理出版社股份有限公司.
本書為精神醫療社會工作勾劃出信念、理論和實踐,配以案例說明,說明社工在支援精神病患者時之介入手法和取向。本書簡介能耐為本、復原為本等模式之同時,也講述院舍化、自助組織等議題。
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