用生物心理社会医学模式指导疾病的诊治

惊恐障碍作为一种精神科疾病,由于伴有明显的躯体化症状,使大多患者首诊于综合医院非精神科,极易引起该病的误诊误治,同时也浪费了大量的卫生资源.针对这一情况,本期"临床决策研究"栏目中熊新英撰写的"从惊恐障碍看生物心理社会医学模式的必要性和紧迫性",对于惊恐障碍就诊于综合医院误诊率高的原因及高误诊率导致的后果进行了分析,并提出了相应的对策.     

客观全面地认识和治疗疾病

本期"临床决策研究"栏目由杨宁等撰写的"客观认识心脏介入治疗"对目前心脏介入治疗进行了客观评价和反思,认为目前由于医疗卫生体制不完善,医疗机构过分追求经济效益等因素的影响,使心脏介入治疗技术出现了偏差,文章指出心脏介入治疗的应用,应该严格把握适应证,社会效益与经济效益相结合,在配备好的硬件设施的同时,更要重视软件的培养,作者强调应用心脏介入治疗技术治疗心脏疾病,必须将自然科学和社会科学结合起来,用最恰当、最合适的诊治方案为患者去除病痛."     

疾病的认知及医疗的反思

近年来,医务人员为了降低医疗风险,加强自我保护,采取了越来越多的防御性医疗措施,进而导致了医患关系的进一步恶化,已经引起各方面的高度关注.本期"临床决策研究"栏目中,黄培撰写的"防御性医疗动因及干预策略"对防御性医疗的概念、特点、产生原因及干预策略进行了全面的论述.     

The Milwaukee Inventory for Subtypes of Trichotillomania-Adult Version (MIST-A): Development of an Instrument for the Assessment of “Focused” and “Automatic” Hair Pulling

This article describes the development of the Milwaukee Inventory for Subtypes of Trichotillomania-Adult Version (MIST-A), which was designed to assess “automatic” and “focused” pulling subtypes of trichotillomania (TTM). Participants reporting symptoms of TTM (n = 1,697) completed an internet survey; participants were later randomly assigned to either Exploratory (n = 848) or Confirmatory (n = 849) Analyses. Exploratory Analyses examined the development and psychometric properties of the MIST-A. Results of an exploratory factor analysis revealed a two-factor solution. Factor 1 (“focused” pulling scale) and 2 (“automatic” pulling scale) consisted of ten and five items respectively, with both scales demonstrating adequate internal consistency and good construct and discriminant validity. Subsequent confirmatory factor analysis demonstrated support for the scale’s underlying factor structure. The MIST-A provides researchers with a reliable and valid assessment of “automatic” and “focused” pulling, although replication using a clinically ascertained sample is necessary.

Two models of unawareness: comparing the object-based and the subjective-state-space approaches

This article attempts to motivate a new approach to anti-realism (or nominalism) in the philosophy of mathematics. I will explore the strongest challenges to anti-realism, based on sympathetic interpretations of our intuitions that appear to support realism. I will argue that the current anti-realistic philosophies have not yet met these challenges, and that is why they cannot convince realists. Then, I will introduce a research project for a new, truly naturalistic, and completely scientific approach to philosophy of mathematics. It belongs to anti-realism, but can meet those challenges and can perhaps convince some realists, at least those who are also naturalists.     

<医学与哲学>杂志20年

《医学与哲学》杂志创刊于 1980年 ,至今已走过了 2 0年的历程。从创刊至 2 0 0 0年第 9期 ,《医学与哲学》杂志共出版了 2 32期 ,发表论文 4 811篇 (不包括通讯、摘要、读者来信等 )。累计 2 10 0万字。在编辑出版《医学与哲学》杂志的 2 0年中 ,编辑人员始终坚持和遵循“开阔眼界 ,启迪思维 ,提供方法 ,促进发展”的办刊宗旨 ,以及“关注热点 ,挑战现实”的办刊思路 ,对涉及我国乃至世界范围内的医疗卫生及其相关领域、学科、知识和技术等进行了范围广泛、思路多向、层次不同的研究和讨论。但集中起来 ,我刊主要从 7个方面展开研究和讨论…     

Books received

Publications Received

Books received