【整理/观察者网 冯雪】 "我们每天都在清扫看得见的垃圾，却对那些在心里腐烂的精神痛苦视而不见。" 一天凌晨4点，当北京安定医院精神科医生姜涛连续抢救两位自杀未遂的青少年后，发出上述感叹。 从医30多年来，姜医生见过形形色色的病例，每个患者背后都有一段隐秘的心路历程。他们需要被看 见，更需要被理解。于是，就有了这本《安定此心：我当精神科医生的12000天》，记录下人性幽微之 处的种种黑暗与痛苦。 姜医生解释，虽然精神疾病本质上与心脏病等无异，只不过，这次生病的是大脑，但缺乏像诊断心脏病 时需要的客观数据或影像。特别是对于心境障碍类的诊断，依据更多的是临床症状。目前，医学界也在 努力发现这背后的"生物学标记"，比如说血液中跟免疫相关的指标，然而，像抑郁症等心境障碍，受到 影响的因素很多，生物学标记的特异性不明显；所以，目前还不能作为临床上的诊断参考。 除了上述提到的精神分裂症，"神经衰弱"也曾是困扰中国人的一种精神疾病，虽然现在已经很少使用这 个名词了。姜医生提到，如今临床上说到的广泛性焦虑障碍、睡眠障碍、躯体化障碍等等，当时都被装 进神经衰弱这个"口袋"里。 出版社供图 姜涛 中信 你的情绪，身体都记得 姜医 ...

作为一名精神科医生，我每天都在跟形形色色的患者打交道。他们坐在同一张就诊椅上，诉说着不同却 又相似的故事。这些故事如同一面面镜子，映照出精神疾病的狡猾和残酷，也映照出人性的复杂、脆弱 和坚韧。 它们起初只散落在一个个病历里。10年前，我就曾想过将其整理出来，但苦于时间和精力不足，一直未 真正提上日程。下定决心也许是在某个瞬间。某天，我站在住院部走廊，看见窗外清洁工开始清扫街 道。那一刻我突然意识到：我们每天都在清扫看得见的垃圾，却对那些在心里腐烂的精神痛苦视而不 见。精神疾病从来不是一个遥远而抽象的概念，它藏在那些说不出口的日常细节里。 曾有一位20岁出头的小伙子来门诊。他过去最爱在篮球场上奔跑，现在却连门都不愿意出；以前能一顿 饭吃掉两碗拉面，如今闻到饭香却毫无胃口。他睡不好，记不住事，心里发闷，整个人像被抽掉了力 气。最让人心疼的是，他低声说："您不知道，我做了好久的心理建设，才有勇气走进这里……" 这些说不清的"低落"，其实都化成实实在在的身体感受：失眠、心慌、体重下降、对什么都提不起 劲……这些不是矫情，而是非常具象的痛苦。它们需要被看见，更需要被理解。 可惜，我们太容易把"不一样"当作"危险"，把精 ...

姜涛/文 作为一名精神科医生，我每天都在跟形形色色的患者打交道。他们坐在同一张就诊椅上，诉说着不同却又相似的 故事。这些故事如同一面面镜子，映照出精神疾病的狡猾和残酷，也映照出人性的复杂、脆弱和坚韧。 它们起初只散落在一个个病历里。10年前，我就曾想过将其整理出来，但苦于时间和精力不足，一直未真正提上 日程。下定决心也许是在某个瞬间。一天凌晨的4点，我在连续抢救了两位自杀未遂的青少年后，站在住院部走 廊，看见窗外清洁工开始清扫街道。那一刻我突然意识到：我们每天都在清扫看得见的垃圾，却对那些在心里腐 烂的精神痛苦视而不见。精神疾病从来不是一个遥远而抽象的概念，它藏在那些说不出口的日常细节里。 曾有一位20岁出头的小伙子来门诊。他过去最爱在篮球场上奔跑，现在却连门都不愿意出；以前能一顿饭吃掉两 碗拉面，如今闻到饭香却毫无胃口。他睡不好，记不住事，心里发闷，整个人像被抽掉了力气。最让人心疼的 是，他低声说："您不知道，我做了好久的心理建设，才有勇气走进这里……" 这些说不清的"低落"，其实都化成实实在在的身体感受：失眠、心慌、体重下降、对什么都提不起劲……这些不 是矫情，而是非常具象的痛苦。它们需要被看见，更需要被 ...

Core Viewpoint - GLP-1 class drugs, including semaglutide and tirzepatide, show potential in treating not only type 2 diabetes and obesity but also various neurological and psychiatric disorders, supported by emerging clinical data [1][2][6]. Group 1: Mechanism and Applications - GLP-1 drugs activate GLP-1 receptors to enhance insulin secretion, suppress glucagon secretion, slow gastric emptying, and reduce appetite, leading to weight loss [1]. - These drugs have been approved for treating type 2 diabetes, obesity, cardiovascular diseases, kidney diseases, and metabolic liver diseases [1]. - Recent studies indicate that GLP-1 drugs may have therapeutic benefits for neurodegenerative diseases, substance use disorders, and other neurological conditions [2][3][6]. Group 2: Clinical Evidence and Safety - A review of clinical evidence highlights the potential of GLP-1 drugs in treating Parkinson's disease and Alzheimer's disease, with a focus on their neuroprotective properties [6][7]. - There is increasing evidence that GLP-1 drugs may reduce addictive behaviors in individuals with substance use disorders [6]. - Most patients with neuropsychiatric disorders using GLP-1 drugs have shown acceptable safety profiles, although large-scale confirmatory trials are still lacking [6][13]. Group 3: Future Research Directions - The role of GLP-1 drugs in neurological conditions will continue to evolve as new clinical trial data emerges, providing clearer evidence of their potential uses and limitations [13]. - Despite enthusiasm for GLP-1 drugs in treating central nervous system diseases, no large-scale trials have yet confirmed their efficacy and safety in these areas [13].

Core Viewpoint - The article addresses common misconceptions about mental health and treatment, emphasizing the importance of understanding mental disorders and the role of both medication and therapy in treatment [2][3][4][5][6][7][8][9][10][11][12][13][14][15]. Group 1: Misconceptions about Psychological Treatment - Misconception 1: Psychological therapy is merely chatting; it is a structured, goal-oriented process requiring professional techniques [3]. - Misconception 2: Medication alone suffices for mental illness; combined treatment with therapy is more effective for conditions like depression and anxiety [4]. - Misconception 3: Psychiatric medications are addictive and impair cognitive function; most psychiatric drugs are non-addictive and help restore cognitive balance [5][6]. Group 2: Misunderstandings about Mental Disorders - Misconception 4: Obsessive-Compulsive Disorder (OCD) is just a preference for cleanliness; it involves uncontrollable thoughts and behaviors that significantly disrupt daily life [7]. - Misconception 5: Anxiety disorders are just normal stress; they are persistent and can severely impact daily functioning [8]. - Misconception 6: All individuals with mental illness are violent; most mental disorders do not correlate with violent behavior [9]. Group 3: Stigmas and Awareness - Misconception 7: Simple encouragement can help those in mental distress; genuine understanding and professional help are necessary for effective support [10][11]. - Misconception 8: Children do not experience mental health issues; they can face various psychological problems that are often overlooked [12][13]. - Misconception 9: Memory loss and depression in the elderly are normal aging signs; these symptoms can indicate serious health issues that require medical attention [14][15].

Core Insights - The study led by scientists from Leipzig University demonstrates that mutations in the GRIN2A gene can cause mental disorders, marking it as the first known single gene responsible for such conditions [1][1][1] Summary by Categories Research Findings - The research published in the journal Molecular Psychiatry analyzed data from 121 individuals with genetic variations in the GRIN2A gene [1] - Certain variants of the GRIN2A gene are associated not only with schizophrenia but also with other mental disorders [1] - Notably, some individuals affected by mental disorders only exhibit psychiatric symptoms, while GRIN2A mutations are typically linked to epilepsy or intellectual disabilities [1] Implications - The GRIN2A gene plays a crucial role in regulating the electrical excitability of nerve cells, with specific variants leading to reduced NMDA receptor activity, which is essential for brain signaling [1]

Core Viewpoint - The article addresses common misconceptions about psychiatry and mental health, emphasizing that mental disorders are a broad category encompassing various conditions beyond just schizophrenia, and that seeking help is a normal and necessary step towards recovery [2][3][4][5][6][7][8][9][10][11][12] Misconceptions about Mental Health - Misconception 1: Mental illness is synonymous with schizophrenia, while in reality, it includes a wide range of disorders such as depression, anxiety, and insomnia, with schizophrenia being a rare condition at a lifetime prevalence of only 0.6% in China [3] - Misconception 2: Mental illness is a sign of personal weakness; however, it is caused by a combination of biological, psychological, and social factors, and is linked to brain function abnormalities [4] - Misconception 3: Seeking psychiatric help is shameful; in fact, millions globally seek mental health services, and it is becoming a common health management choice [5][6] - Misconception 4: Only those who have experienced significant trauma develop mental illness; many patients have no history of major stressors, as biological factors often play a more significant role [7] - Misconception 5: Only introverted individuals suffer from depression; in reality, various factors contribute to mental illness, and both introverted and extroverted individuals can be affected [8] - Misconception 6: Depression is merely feeling sad; clinically, it is a serious disorder characterized by persistent low mood and can lead to severe consequences if untreated [9] - Misconception 7: Psychologists and psychiatrists are the same; they have different training and roles, with psychiatrists being medical doctors who can prescribe medication [10][11] - Misconception 8: Psychiatrists only prescribe medication; their role includes comprehensive diagnosis, treatment planning, and the potential for psychological therapy [12]

Core Viewpoint - The article aims to clarify common misconceptions about psychiatry and mental health, emphasizing that mental illnesses are complex medical conditions rather than personal weaknesses or character flaws [2][3][4]. Misconceptions about Mental Health - Misconception 1: Mental illness is synonymous with schizophrenia. In reality, schizophrenia is just one of many mental disorders, with more prevalent conditions being depression, anxiety, and insomnia. A 2019 epidemiological survey indicated that the lifetime prevalence of various mental disorders in China (excluding Alzheimer's disease) is 16.6%, with anxiety disorders at 7.6% and depression at 6.8% [3]. - Misconception 2: Mental illness reflects a lack of character strength. Mental disorders arise from a combination of biological, psychological, and social factors, and are closely linked to brain function abnormalities. For instance, depression is associated with serotonin dysfunction, while schizophrenia relates to dopamine imbalance [4]. - Misconception 3: Seeking psychiatric help is shameful. This stigma often stems from misconceptions equating mental illness with insanity. Mental health issues exist on a spectrum, and seeking help is a step towards recovery [5]. - Misconception 4: Only those who have experienced significant trauma develop mental illnesses. The causes of mental disorders are complex, involving both biological and environmental factors. Many patients do not have a history of major trauma before their illness [8]. - Misconception 5: Only introverted or reclusive individuals suffer from depression. Depression results from multiple factors, and personality traits are just one aspect. Extroverted individuals can also experience mental health issues due to emotional exhaustion from maintaining a façade of positivity [9]. - Misconception 6: Depression is merely feeling sad or being overly sensitive. Clinically, depression (or depressive disorder) is characterized by persistent low mood and can lead to severe symptoms, including suicidal thoughts [11]. - Misconception 7: Psychologists and psychiatrists are the same. Psychiatrists are medical professionals who can diagnose and prescribe medication, while psychologists focus on emotional and behavioral issues without prescribing medication [12][13]. - Misconception 8: Psychiatrists only prescribe medication. Their role includes accurate diagnosis, treatment planning, and potentially providing psychotherapy, making them comprehensive mental health care providers [14].

Core Insights - The article emphasizes the importance of mental health and the increasing visibility of psychological issues in society, highlighting the role of the national psychological assistance hotline "12356" which has served nearly 500,000 people since its launch [1][3]. Group 1: Mental Health Awareness - Mental health is described as a continuum, with psychological disorders being an extreme state; it encompasses cognitive, emotional, behavioral, and social adaptation aspects [3]. - Common psychological issues can be categorized into general psychological distress, common mental disorders, and severe mental disorders, indicating that nearly everyone may experience psychological distress at some point in life [3][4]. Group 2: Importance of Early Intervention - Persistent negative emotions lasting over two weeks that significantly impact daily life signal a need for professional help, as many patients delay seeking treatment due to stigma [4][6]. - There are currently 4.7 million certified individuals with mental disorders in China, highlighting the scale of the issue [4]. Group 3: Community and Government Role - De-stigmatization is crucial for improving public mental health literacy and increasing treatment rates for mental health patients, requiring collaborative efforts from individuals, schools, society, and government [6]. - The "Child and Mental Health Service Year" action plan (2025-2027) aims to enhance the mental health service system, improve grassroots service levels, and extend psychological health services to communities [6].

Core Insights - The article discusses the challenges faced by individuals with mental health disorders and their families, emphasizing the need for better understanding and support within society [1][22][23]. Group 1: Understanding Mental Health - The perception of mental health and psychiatric disorders is often influenced by media portrayals, leading to misconceptions about the environment and individuals within psychiatric care [1][2]. - There exists a stress-sensitivity model in clinical psychiatry that explains the varying susceptibility of individuals to mental health disorders based on personal stress thresholds [4][5]. Group 2: Impact of Mental Health Disorders - Mental health disorders not only affect the patients but also have significant repercussions on their families and caregivers, leading to emotional and social challenges [14][21]. - A case study of a bipolar disorder patient illustrates how external stressors, such as family tragedies, can trigger relapses, highlighting the complex interplay between mental health and life events [7][8][12]. Group 3: Community and Family Support - The article emphasizes the importance of family support in the recovery process of individuals with mental health disorders, noting that caregivers often face significant burdens and emotional distress [50][62]. - A national survey revealed that a majority of caregivers are female and have been providing care for over five years, indicating a long-term commitment that often leads to their own mental health challenges [52][53][59]. Group 4: Community Resources and Training - There is a notable lack of community resources and trained social workers to support individuals with mental health issues, particularly in rural areas [71][72]. - Training programs for social workers and community helpers are essential to bridge the gap in mental health services, ensuring that caregivers and patients receive adequate support [74][75]. Group 5: Involvement of Individuals with Lived Experience - The article advocates for the inclusion of individuals with lived experiences of mental health disorders in the development of mental health services, emphasizing their unique insights into the challenges faced [78][80]. - Initiatives that encourage peer support and community involvement are crucial for creating a more inclusive and understanding environment for those affected by mental health issues [83][84].