WHO の健康定義に代わる新しい健康概念の意義について

1 1 WHO WHO definition of Health (a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity) (harmful overtreatment) WHO 1 WHO 1948 (Machteld Huber) WHO (the ability to adapt and self manage in the face of social, physical, and emotional challenges) BMJ How should we define health?

2 2011 ,116-125,2012 BMJ 2) 21 2 16 WHO 1948 1998 WHO 70 (Machteld Huber) WHO 2 WHO WHO WHO WHO 3 DSM- 2013 DSM Allen J.

3 Frances 1942 - DSM- DSM- Saving Normal: An Insider's Revolt Against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the medicalization of Ordinary Life, 2013 DSM-5 2013 Disruptive Mood Dysregulation Disorder DMDD DSM- 3 4 5 WHO

4 6 WHO 7 WHO 1948 1948 4 WHO .. WHO WHO WHO WHO (the ability to adapt and self manage in the face of social, physical, and emotional challenges) self manage adapt (cope) , (self manage)

5 WHO (resilience) (sense of wellbeing (capacity) E A resilience resilire 5 8 9 (cope) 3 WHO 10 Aaron Antonovsky, 1923-1994) (salutogenesis) 11 WHO 1986 ( )

6 2005 (the process of enabling people to increase control over their health and its determinants, and thereby improve their health) 2003 WHO 12 (sense of coherence: SOC) 6 (SOC) (comprehensibility) (manageability) (meaningfulness) self manage SOC (sense of wellbeing) (capacity) (resilience) (salutogenesis)

7 13 14 ( ) 15 (formulation) WHO WHO definition of Health (definition) 7 (formulation) (definition) (a concept or conceptual framework) (Herbert George Blumer,1900-1987) (interaction) (conception) 16 (operational definition) (operational procedure) (a general concept) (operational definitions) allostasis (protective response) (restore an (adapted) equilibrium) (physiological coping strategy) (illness)

8 ( SOC) (A strengthened capability to adapt and to manage yourself) (subjective wellbeing) (a positive interaction between mind and body) 8 (illness) .. ( ) QOL QOL 2014 1 (medical futility) Encyclopedia of Bioethics.

9 3d. 1713-1721,2003. , 29-32 2007. 2 Machteld Huber et al., How should we define health? In: BMJ 2011, 343(4163):235-237. BMJ HAL -HN01 25 181 -185 2014 9 3 DSM-5 ( ), ( ) 2013 4 11 2013 , 1-24 5 ( ) 2010 6 ( ) 2004 7 692 2014 , 78-96 8 2009 9 2014 22 G8 ( ) 2012 5 10 10 Schipperges, Heinrich, Der Garten der Gesundheit.

10 Medizin im Mittelalter. 1985. 1988 . 164 11 2008 12 2003 21 13 14 2008 2007 15 EOL 16 Blumer H. Symbolic interactionism: perspective and method. Prentice Hall, 1969. 1991 215