The new emphasis on brain circuits and the newly emerging tools available to study them have electrified neuroscientists and researchers working in the lab. But they haven't yet been translated into new treatments that might relieve anxiety. The last big anti-anxiety medication was Prozac and other selective serotonin reuptake inhibitors, or SSRIs, which came out in the 1980s.
重新重视大脑回路和新工具的出现让实验室里的神经科学家和研究人员兴奋不已。但它们还没有被转化成可能减轻焦虑的新疗法。最后一种大型抗焦虑药物是百忧解(Prozac)和其他选择性血清素再吸收抑制剂(SSRIs)，于上世纪80年代问世。
"The field has been sort of stagnating for quite a while, actually," says Stefan Hofmann, a professor of psychology and director of the Psychotherapy and Emotion Research Laboratory at Boston University's Center for Anxiety and Related Disorder. "SSRIs came on the market a couple decades ago with big hype. But since then, not much else really happened and I think people are more or less desperate."
“这个领域已经停滞了很长一段时间，”波士顿大学焦虑及相关障碍研究中心心理治疗与情绪研究实验室主任、心理学教授史蒂芬·霍夫曼说。“SSRI类药物在几十年前上市时大肆宣传。但从那以后，就没发生什么事了，我想人们或多或少有些绝望。”
The awkward truth about current anxiety treatments is that they are for the most part unproven. Although 75 percent of patients who seek help for debilitating anxiety get "substantially better" during the course of treatment, medical scientists don't know to what extent these improvements are due to the treatments themselves or to the placebo effect. Drugs that are effective in tamping down anxiety tend to have many unwanted side-effects. Why 25 percent of patients fail to respond to any treatment at all is another mystery.
关于目前的焦虑症治疗，一个尴尬的事实是，它们大多未经证实。尽管75%因焦虑而寻求帮助的患者在治疗过程中“明显好转”，但医学科学家不知道这些改善在多大程度上是由于治疗本身或安慰剂效应。能有效缓解焦虑的药物往往会产生许多副作用。为什么25%的病人对任何治疗都毫无反应是另一个谜。
One problem is that mental-health clinicians don't have good ways of diagnosing and classifying mental disorders. For almost 70 years, the diagnostic bible for clinicians treating anxiety and other psychiatric disorders has been the Diagnostic and Statistical Manual of Mental Disorders (DSM), which assigns symptoms to different classifications of various conditions. As brain science has advanced, the DSM has come to be seen by many in the field as an increasingly antiquated and blunt tool that doesn't fully help define what is wrong with a patient.
一个问题是，心理健康医生没有诊断和分类精神疾病的好方法。近70年来，《精神疾病诊断与统计手册》(DSM) 一直是用于临床医生治疗焦虑和其他精神疾病的诊断圣经，它将症状按照不同的情况进行分类。随着脑科学的进步，DSM已经被该领域的许多人视为一个日益过时和生硬的工具，它并不能完全帮助确定病人的问题所在。
"The problem is, you have a list of some 30, 40 different symptoms for any given disorder, and often you have to only meet four or five of them to get a diagnosis," says BU's Hofmann, who helped revise the latest edition, the DSM-V. "You get an astounding number of possible combinations that all would be described as depression and generalized anxiety disorder. So you have this wide array of people that are assigned to the same diagnostic category. Even though they seem to have similar problems on the surface, they might have very different problems that give rise to these problems."
“问题是，对于任何一种疾病，你都有一个30到40种不同症状的列表，通常你只需要满足其中的4到5种就可以得到诊断，”波士顿大学的霍夫曼说，他帮助修订了最新版DSM-V。“你会得到数目惊人的可能组合，所有这些组合都可以被描述为抑郁和广泛性焦虑障碍。所以你有很多人被分配到相同的诊断类别。虽然表面上他们似乎有相似的问题，但他们可能致病原因不同。”
译文由可可原创，仅供学习交流使用，未经许可请勿转载。
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