New Yorker 07月22日 06:54
A New Way to Think About Schizophrenia
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本文探讨了一种新的医学观点,即部分精神疾病可能并非源于传统认知,而是可治疗的自身免疫性疾病。文章以一位患有二十年精神病症的女性玛丽的惊人康复经历为切入点,揭示了在接受癌症化疗后,其精神病症状竟奇迹般消失。研究人员和医生正开始关注这一现象,初步估计约有1%-5%的思觉失调症患者可能属于此类情况,这意味着全球可能近百万人需要不同的治疗方法。文章深入分析了患者家属在面对亲人精神疾病时的情感挣扎与对“正常”的复杂感受,并引用了编辑的评论,强调了从精神疾病康复到恢复“正常”过程中,个人历史认知的转变。

💡 精神疾病或可归因于自身免疫性疾病:文章引入了“精神疾病是否为可治愈的自身免疫性疾病”这一新颖的医学视角,挑战了传统观念,为精神疾病的治疗提供了新的方向。

🌟 案例研究揭示惊人康复:通过对一位名为玛丽的女性长达二十年的精神病症,以及其在接受癌症化疗后症状奇迹般消失的案例进行深入报道,生动地展现了自身免疫性疾病治疗可能对精神疾病产生的积极影响。

📊 科学研究提供数据支持:文中引用了国家心理健康研究所的科学家观点,指出约有1%-5%的思觉失调症患者可能存在自身免疫性问题,这一比例在全球范围内可能涉及近百万人,强调了对这一新疗法进行深入研究的必要性和潜在的巨大益处。

👨‍👩‍👧‍👦 家庭成员的情感与叙事:文章细腻地描绘了患者家属(玛丽的两个女儿)在母亲患病期间所经历的艰难、她们的成长以及对“正常”母亲的复杂情感,探讨了在亲人康复后,如何面对过去与现在的认知冲突。

🔄 康复过程中的叙事转变:编辑的评论深刻指出,从疾病中康复不仅是生理上的改变,更是个人叙事和历史认知的重塑,强调了理解和接纳这一转变过程的重要性。

What if some psychiatric disorders are actually treatable autoimmune conditions? Introducing Rachel Aviv’s report on one woman’s stunning recovery from psychosis. Plus:

Stephen Colbert’s “Late Show” told the truth
The baseball coach who stood up to ICE
Fragrances of Presidents past

Letter from the Editor

When Mary was treated for cancer, the drugs also relieved her psychosis of twenty years. Her daughter Christine described her as a “psychological débutante.”Illustration by Emiliano Ponzi

Dear Reader,

For decades, a woman named Mary suffered from consuming delusions. Long-lost professional colleagues

were meddling with her life; someone was spying on her through a camera in the showerhead; her eldest daughter was conspiring against her and putting poison on her pizza. She took to barricading herself inside her house, and would spend years in and out of psychiatric inpatient care. And then, suddenly, just months after she began chemotherapy treatment for lymphoma, her symptoms of psychosis disappeared.

In this week’s issue, Rachel Aviv tells the story of Mary’s illness and astonishing recovery. Aviv, who has been writing about psychology in one way or another for The New Yorker for years, investigates a relatively new phenomenon: researchers and physicians are beginning to ask how many patients who present with what are typically considered psychiatric disorders, including schizophrenia, may actually be suffering from autoimmune conditions. One scientist at the National Institute of Mental Health tells Aviv that the figure may be between one and five per cent of schizophrenia patients. “Even one per cent ends up being almost a million people in the world who should be treated with a different kind of medicine,” he explains.

Mary’s story is inseparable from the experiences of her two daughters, Christine and Angie, whose lives were, for years, dominated by their mother’s impenetrable view of the world around her. They both speak with uncanny poise and insight about the struggles they faced in getting Mary the help she needed, the bonds they have formed, and the difficulty of reconciling the woman they know now with the person who raised them. As Angie explains, “I’m happy that my mom is normal now, that we can have a deep connection and I can share my life with her. And, at the same time, I want justice for the child who was hurt by that other mother.”

“When a person recovers from illness, it is usually seen as the end of the story,” Aviv writes. “But to become sane also represents a kind of narrative collapse, a confrontation with a personal history that is no longer recognizable.” Aviv continues the story, with intelligence, nuance, and empathy—and I’m excited to share it with you.

This week’s piece joins a rich archive of writing and reporting about psychiatry and mental illness in The New Yorker—Oliver Sacks’s years of brilliant contributions, Janet Malcolm’s classic reporting on Freud’s possible deceptions, Jerome Groopman on psychiatry’s dark past, Manvir Singh on how diagnostic labels have become identities, and much more.

As ever,

David Remnick
Editor, The New Yorker

Read the story »


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How Bad Is It?

Measles cases have hit their highest number since the disease was declared eliminated in the U.S., in 2000. In total, according to the latest figures from the C.D.C., more than thirteen hundred people have had a confirmed case of measles this year; more than ninety per cent of those people were unvaccinated or had an unknown vaccination status.

How dangerous is this resurgence of the disease?

We reached out to Dhruv Khullar, a physician and a contributing writer. “It’s needlessly, frustratingly bad,” he told us via e-mail. “Not only is the virus circulating again but we’ve had more cases than in any year since the turn of the century—and the year is only half over!” Khullar points out that measles is one of the most contagious pathogens on the planet—even more so than chicken pox or COVID. “In unvaccinated communities, every infected person might pass the virus on to fifteen or more people,” he explained. “The current outbreak, which began in West Texas, has spread to dozens of states, and three people, including two children, have died—the country’s first measles deaths in a decade.

“It’s important to state plainly: virtually every case of measles is preventable through vaccination,” he continued. “But, instead of issuing forthright endorsements of the importance of immunization, the Secretary of Health and Human Services, Robert F. Kennedy, Jr., has offered mealy-mouthed guidance, muddying the waters with talk of vitamins and cod-liver oil. This outbreak is the logical endpoint of decades of anti-vaccine propaganda.”


This Week’s Caption Contest

Mark Thompson

Submit your best caption for this cartoon. The top three will be featured in next week’s magazine.


Puzzles & Games


P.S. “kamala IS brat.” A year ago today, the British singer-songwriter Charli XCX granted her imprimatur to Kamala Harris’s sudden campaign for President. This past weekend, the pop star got married in London. It’s been quite a year.

Ian Crouch contributed to today’s edition.

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精神疾病 自身免疫性疾病 医学新视角 心理健康 康复案例
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