从医学概念到“疾病”事实——儿童“注意缺陷多动障碍”的临诊民族志

摘要/Abstract

摘要： 本文聚焦儿童精神科医生的临床诊疗，尝试在深描诊疗实践的基础上推进对医学化过程的理解。文章通过分析医生将儿童特定行为诊断为“注意缺陷多动障碍”（ADHD）并予以药物治疗的临床实践以及家长在此过程中的选择与行动，探讨精神医学领域内特定障碍被诉诸行动的具体过程。本文认为，聚焦诊疗实践既有助于探究障碍/疾病从医学概念转变为“疾病”事实的具体过程，亦有助于从微观层面理解医学化的临床发生及其作为一种社会过程的属性。

关键词: 医学化, 诊断, 精神医学, ADHD

Abstract: Diagnosis and treatment are crucial steps in the process of medicalization, in which medical labels are enacted into disease realities. This article focuses on the clinical practice of pediatric psychiatrists， and seeks to advance our understanding of medicalization by providing a “thick description” of this practice. The article analyzes the clinical practice of doctors diagnosing children with Attention Deficit Hyperactivity Disorder （ADHD） and prescribing medication. It also examines the different actions taken by parents in this process， such as cooperation， hesitation， or capitulation. The medical attributes of ADHA as a neurodevelopmental disorder is not only embedded in the interactive relationships and collaboration networks of medicine， education， and family， but also linked to the clinical practice of diagnosis and treatment. By focusing on clinical practice， the article brings the “human” and moral dimensions of medicalization to the forefront， and in so doing， presents a vivid account of how mental health categories are sometimes smoothly and sometimes haltingly incorporated into everyday life. Ultimately， the article argues that focusing on clinical practice can help us understand the mechanisms of medicalization at the micro level， and its ongoing and unfinished nature as a social process.

Key words: medicalization, diagnosis, psychiatry, ADHD

李荣荣. 从医学概念到“疾病”事实——儿童“注意缺陷多动障碍”的临诊民族志[J]. 社会杂志, 2024, 44(1): 1-31.

LI Rongrong. From Medical Labels to “Disorder” Reality: The Clinical Ethnography of Childhood Attention Deficit Hyperactivity Disorder[J]. Chinese Journal of Sociology, 2024, 44(1): 1-31.

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