Is psychiatry thinking adequately about behaviour?

摘要

Spence's cogent summary of concerns about child behaviour problems contains a fundamental confusion about behaviour and thinking disorders. To a psychiatrist, mental disorder is a conscious difference in thinking, pathological compared with the norm. Thought difference leads to behaviour problems that can threaten the patient's or others' safety. Overthe past century psychiatry explored such presentations in children, and their consequent behaviour differences, such as anxiety, depression, and (I include) autism, with varying degrees of success. In these thinking disorders the key psychiatric task is to understand thought differences and to support the child and family's associated distress. Sometimes severity of presentation necessitates psychotropic drug treatment.