No More Normal: Mental Health in an Age of Over-Diagnosis

解析心理健康診斷光譜，我們不須過度診斷

面對可診斷的心理症狀、候診名單，以及藥物使用量前所未有的增長，我們已進入過度診斷時代。然而，我們的心理健康真的比以往幾代人更糟嗎？英國精神科醫師桑特斯以其多年臨床經驗，帶領讀者了解何謂憂鬱症、創傷、神經多樣性等，呼籲善用「社會處方」，提升個人應變日常心理挑戰的能力，將醫療能量投注在最需要治療的患者身上。

低落的情緒何時會轉變為抑鬱症？
當一個令人痛苦的經歷發生，何時會被認定為創傷？
當一組症狀出現，要到什麼程度才代表的確有潛在疾病？

隨著心理健康的討論從私人診療間走向公共領域，對於「正常」的概念正在發生變化。面對可診斷的心理症狀、等待治療名單以及藥物使用前所未有的增長，我們其實已進入過度診斷時代。

然而，我們的心理健康真的比以往幾代人更糟嗎？在這本勇敢、引人入勝且至關重要的新書中，神經精神病學顧問醫生阿拉斯泰爾·桑特斯(Dr. Alastair Santhouse)主張，這種過度診斷的風潮帶來的後果非常巨大。桑特斯醫生憑藉他數十年的臨床經驗，深入探討了我們當前的困境，並提出了解決方案——我們應該收斂這種過度診斷行為，專注於對核心嚴重心理健康問題進行有效治療，減少對更多常見的日常心理挑戰進行醫療。

At what point does a low mood tip over into depression? When does a distressing experience qualify as trauma? When does a cluster of symptoms indicate an underlying condition? As the conversation around mental health has moved from the consulting room to the public arena, so the concept of normal is shifting. Today, we are seeing an unprecedented rise in diagnosable conditions, in waiting lists, in diagnoses, and in medication.

Yet, are we really less psychologically healthy than previous generations? In this brave, engrossing and vitally important new book, consultant neuropsychiatrist Dr Alastair Santhouse argues that the consequences of the new climate of diagnosis are immense. Drawing on his decades of clinical experience, Dr Santhouse explores our current malaise and proposes a solution - that we pull back from this diagnostic expansion, focus on the effective treatment of a core group of severe mental health problems, and de-medicalise a vast range of other normal human experiences.