抑郁体验的拓扑图。辩证法

IF 4.9 2区 医学 Q1 CLINICAL NEUROLOGY Journal of affective disorders Pub Date : 2024-10-21 DOI:10.1016/j.jad.2024.10.064
Guilherme Messas, Francesca Brencio
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引用次数: 0

摘要

本文旨在对抑郁体验的本体论性质进行临床描述和哲学阐释,试图解决与当代诊断范式有关的问题,以及影响临床决策的以价值观为基础的做法。这一贡献的核心思想是,可以通过承认每种抑郁形式的本体论存在质的差异来理解各种抑郁体验。我们认为,作为一种疾病的忧郁症与那些作为人类生存特征的忧郁特质之间存在着根本的区别:前者表明了人类整体体验的质变,构成了精神病理学体验,而后者则描述了一种本身并不病态的不相称的生存方式。此外,我们认为,忧郁症(医学意义上的)是精神改变的一个独特的统一体,不应与以抑郁症为名的各种体验混为一谈,后者的多样性可被理解为个人发展的障碍。正是在这种情况下,人类学比例失调的主要因素影响了前反思性和超越性结构的作用,将自我和世界一分为二,形成了三重地形图:1.抑郁是自我和世界之间的过度对称;2.抑郁是自我和世界之间的比例失调(自我受损);3.抑郁是世界超越性价值的贫乏。
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Topography of depressive experiences. A dialectic approach.

This article aims to offer clinical descriptions and philosophical interpretations of the ontological nature of depressive experiences trying to address issues related to the contemporary diagnostic paradigm and values-based practices which shape clinical decisions. At the core of this contribution there is the idea that the variety of depressive experiences might be understood acknowledging the qualitative difference in the ontology underlying each form of depression. We argue that there is a fundamental difference between melancholia as a disease and those melancholic traits which characterizes human existence as such: while the former indicates a qualitative alteration of the global human experience, constituting psychopathological experience, the latter describes a style of disproportion of existence not pathological per se at all. Moreover, we defend the hypothesis that melancholia (in a medical sense) is a distinct unity of mental alteration, and should not be conflated with the multivarious kind of experiences merged under the name of depression, the variety of which may be understood as disorders of the personal development. It is in this context that the leading element of anthropological disproportions impact the role of pre-reflective and transcendental structures, polarizing the self and the world in a three-way topography: 1. depression as an excessive symmetric proportion between self and world; 2. depression as a disproportion between the self and the world (detriment of the self); 3. depressions as impoverishment of the transcendental value of the world.

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来源期刊
Journal of affective disorders
Journal of affective disorders 医学-精神病学
CiteScore
10.90
自引率
6.10%
发文量
1319
审稿时长
9.3 weeks
期刊介绍: The Journal of Affective Disorders publishes papers concerned with affective disorders in the widest sense: depression, mania, mood spectrum, emotions and personality, anxiety and stress. It is interdisciplinary and aims to bring together different approaches for a diverse readership. Top quality papers will be accepted dealing with any aspect of affective disorders, including neuroimaging, cognitive neurosciences, genetics, molecular biology, experimental and clinical neurosciences, pharmacology, neuroimmunoendocrinology, intervention and treatment trials.
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