<br>彭罗斯效应及其因毒品战争而加速：未翻译的神经科学和未经治疗的成瘾和精神疾病的危机。,Translational Psychiatry

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彭罗斯效应及其因毒品战争而加速：未翻译的神经科学和未经治疗的成瘾和精神疾病的危机。
Translational Psychiatry ( IF 5.8 ) Pub Date : 2019-11-28 , DOI: 10.1038/s41398-019-0661-9
Gregory G Grecco _{1,

2} , R Andrew Chambers _{3,

4}

Affiliation

1939 年，英国精神病学家莱昂内尔·彭罗斯（Lionel Penrose）描述了心理健康治疗基础设施与刑事监禁之间的反比关系。这种关系后来被称为“彭罗斯效应”，已被证明可以很好地预测现代趋势，这些趋势表现为相互组成部分，被称为“去机构化”和“大规模监禁”。在这篇评论中，我们考虑了第三个动态——通过“毒品战争”将成瘾定罪，虽然彭罗斯没有预料到，但可能在过去 30 年中放大了彭罗斯效应，造成了毁灭性的社会、经济和医疗保健后果。我们讨论了彭罗斯效应和毒品战争的协同作用如何被精神疾病等脑部疾病和成瘾之间的基本神经生物学联系介导并反映出来。这种双重诊断的神经科学，也是 Penrose 没有预料到的，仍然没有被充分转化为改进临床培训、实践或研究，以治疗各种精神疾病-成瘾合并症的患者。这种翻译的失败，以及行为医疗保健的持续碎片化和崩溃，加剧了未经治疗的精神疾病和成瘾的流行，同时推动了不可持续的政府投资，用于大规模监禁和高成本的医疗保健，这些医疗保健只从未经治疗的成瘾导致的伤害和多器官疾病中获利。通过果断行动将心理健康和成瘾培训、护理和研究相结合，扭转行为医疗保健的碎片化和衰落，这可能是结束对精神疾病和成瘾的刑事定罪的关键，并将医疗保健系统的重点重新集中在以尽可能低的成本保持人口健康上。

"点击查看英文标题和摘要"

The Penrose Effect and its acceleration by the war on drugs: a crisis of untranslated neuroscience and untreated addiction and mental illness.

In 1939, British psychiatrist Lionel Penrose described an inverse relationship between mental health treatment infrastructure and criminal incarcerations. This relationship, later termed the 'Penrose Effect', has proven remarkably predictive of modern trends which have manifested as reciprocal components, referred to as 'deinstitutionalization' and 'mass incarceration'. In this review, we consider how a third dynamic-the criminalization of addiction via the 'War on Drugs', although unanticipated by Penrose, has likely amplified the Penrose Effect over the last 30 years, with devastating social, economic, and healthcare consequences. We discuss how synergy been the Penrose Effect and the War on Drugs has been mediated by, and reflects, a fundamental neurobiological connection between the brain diseases of mental illness and addiction. This neuroscience of dual diagnosis, also not anticipated by Penrose, is still not being adequately translated into improving clinical training, practice, or research, to treat patients across the mental illness-addictions comorbidity spectrum. This failure in translation, and the ongoing fragmentation and collapse of behavioral healthcare, has worsened the epidemic of untreated mental illness and addictions, while driving unsustainable government investment into mass incarceration and high-cost medical care that profits too exclusively on injuries and multi-organ diseases resulting from untreated addictions. Reversing the fragmentation and decline of behavioral healthcare with decisive action to co-integrate mental health and addiction training, care, and research-may be key to ending criminalization of mental illness and addiction, and refocusing the healthcare system on keeping the population healthy at the lowest possible cost.

更新日期：2019-11-29

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