The anthropological method for diagnosing mental diseases: On the theory of time structure of Bin Kimura

Shun'ichi Noma
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Abstract

Abstract Bin Kimura (1931–2021), the Japanese anthropological psychopathologist and philosopher, attached importance to clinical impressions at psychiatric consultations in order to diagnose mental diseases precisely, and thus proposed his original theory of time structure. According to Kimura's theory of time structure, whether we live by giving weight to the past, the present, or the future can be called “time structure,” and is essentially related to the way we live with others and experience the world. We can obtain some signs for diagnosing mental diseases from the viewpoint of the time structure of each patient. “Ante‐festum” is the time structure in which one lives ahead to the future, and is typical of schizophrenic patients. “Post‐festum” is the time structure in which one is late for oneself, and is typical of patients with endogenous depression. “Intra‐festum” is the time structure in which one lives directly in the present, and is typical of patients with epilepsy or bipolar disorders. The anthropological diagnosis according to Kimura's theory of time structure could complement the operational diagnostic criteria, such as the Diagnostic and Statistical Manual of Mental Disorders and the International Classification of Diseases and Related Health Problems , in daily clinical practice. For example, Kimura's theory of time structure could exercise its ability to discriminate between endogenous and neurotic depression, and between schizophrenia and other delusional psychoses. The theory of time structure and anthropological diagnosis which Bin Kimura proposed in the late 20th century can give us many hints for assessing patients with mental diseases even today.
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精神疾病诊断的人类学方法——论木村本的时间结构理论
日本人类学精神病理学家、哲学家木村彬(1931-2021)重视精神科会诊时的临床印象,以准确诊断精神疾病,并提出了独创的时间结构理论。根据木村的时间结构理论,无论我们生活在过去、现在还是未来,都可以被称为“时间结构”,本质上与我们与他人生活和体验世界的方式有关。从每个病人的时间结构来看,我们可以获得一些诊断精神疾病的迹象。“Ante - festum”是一个人生活在未来的时间结构,是典型的精神分裂症患者。“节日后”是一个人迟到的时间结构,是内源性抑郁症患者的典型特征。“节日内”是一个人直接生活在当下的时间结构,是癫痫或双相情感障碍患者的典型特征。根据木村时间结构理论进行的人类学诊断,可以在日常临床实践中补充《精神障碍诊断与统计手册》、《国际疾病与相关健康问题分类》等操作性诊断标准。例如,木村的时间结构理论可以运用其区分内源性抑郁症和神经性抑郁症,以及区分精神分裂症和其他妄想性精神病的能力。木村本在20世纪末提出的时间结构理论和人类学诊断理论,即使在今天,对精神疾病患者的评估仍有许多启示。
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