ABOUT THE SPEAKER
Thomas Insel - Neuroscientist and psychiatrist
The Director of the National Institute of Mental Health, Thomas Insel supports research that will help us understand, treat and even prevent mental disorders.

Why you should listen

Thomas Insel has seen many advances in the understanding of mental disorders since becoming the Director of the National Institute of Mental Health (NIMH) in 2002. During his tenure, major breakthroughs have been made in the areas of practical clinical trials, autism research and the role of genetics in mental illnesses.

Prior to his appointment at the NIMH, Insel was a professor of psychiatry at Emory University, studying the neurobiology of complex social behaviors. While there, he was the founding director of the NSF Center for Behavioral Neuroscience and director of the NIH-funded Center for Autism Research. He has published over 250 scientific articles and four books and has served on numerous academic, scientific, and professional committees and boards. He is a member of the Institute of Medicine, a fellow of the American College of Neuropsychopharmacology, and a recipient of the Outstanding Service Award from the U.S. Public Health Service and the 2010 La Fondation IPSEN Neuronal Plasticity Prize. 

More profile about the speaker
Thomas Insel | Speaker | TED.com
TEDxCaltech

Thomas Insel: Toward a new understanding of mental illness

Thomas Insel: 对精神疾病的重新认识

Filmed:
1,412,184 views

今天, 归功于“早发现”和“早治疗”,心脏病患者的死亡率比几十年前减少了63%。 Thomas Insel, 国家精神健康研究所主任,他提出一个新的见解:我们是否可以对精神疾病做同样的处理?在探讨新的研究领域之前,他阐述了一个关键的理念:让我们摒弃精神失常的说法,尝试着用大脑失常来理解这些疾病。(此片拍摄于TEDxCaltech.)
- Neuroscientist and psychiatrist
The Director of the National Institute of Mental Health, Thomas Insel supports research that will help us understand, treat and even prevent mental disorders. Full bio

Double-click the English transcript below to play the video.

00:12
So let's start开始 with some good news新闻,
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让我们从一些好消息开始吧,
00:15
and the good news新闻 has to do with what do we know
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而这些好消息与我们所了解的
00:17
based基于 on biomedical生物医药 research研究
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生物医学研究有关
00:20
that actually其实 has changed the outcomes结果
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这些生物医学研究其实已经改变了
00:23
for many许多 very serious严重 diseases疾病?
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许多重症的治愈结果。
00:26
Let's start开始 with leukemia白血病,
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让我们先来谈谈白血病,
00:28
acute急性 lymphoblastic淋巴细胞 leukemia白血病, ALL,
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急性淋巴细胞白血病,缩写ALL,
00:31
the most common共同 cancer癌症 of children孩子.
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是一种在儿童中最常见的癌症类型。
00:33
When I was a student学生,
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当我是学生时,
00:35
the mortality死亡 rate was about 95 percent百分.
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它的死亡率是 95%左右。
00:39
Today今天, some 25, 30 years年份 later后来, we're talking about
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30年后的今天,我们所谈论的(ALL) 的死亡率
00:42
a mortality死亡 rate that's reduced减少 by 85 percent百分.
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已经降低了 85%。
00:46
Six thousand children孩子 each year
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每年有6000名
00:49
who would have previously先前 died死亡 of this disease疾病 are cured治愈.
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原本会死于白血病的患儿,现今得以治愈
00:53
If you want the really big numbers数字,
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如果你想要更有说服力的数字,
00:55
look at these numbers数字 for heart disease疾病.
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让我们来看看心脏病的数据
00:57
Heart disease疾病 used to be the biggest最大 killer凶手,
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心脏病曾经是最大的杀手,
00:59
particularly尤其 for men男人 in their 40s.
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尤其是对于40 多岁的男子。
01:01
Today今天, we've我们已经 seen看到 a 63-percent-百分 reduction减少 in mortality死亡
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如今,我们可以看到
01:04
from heart disease疾病 --
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心脏病的死亡率减少了 63 %,
01:06
remarkably异常, 1.1 million百万 deaths死亡 averted避免 every一切 year.
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成就是如此显著,每年减少110万起心脏病死亡数
01:11
AIDS艾滋病, incredibly令人难以置信, has just been named命名,
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更难以置信的是,艾滋病,
01:14
in the past过去 month, a chronic慢性 disease疾病,
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在上个月里刚被定义为一种慢性疾病,
01:16
meaning含义 that a 20-year-old-岁 who becomes infected感染 with HIVHIV
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也就是说一个20岁感染艾滋病毒的人,
01:19
is expected预期 not to live生活 weeks, months个月, or a couple一对 of years年份,
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要是在十年前,人们会觉得他活不过几周
01:23
as we said only a decade ago,
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几个月,至多几年,
01:25
but is thought to live生活 decades几十年,
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但现在被认为会再活数十年,
01:28
probably大概 to die in his '60s or '70s from other causes原因 altogether.
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也许会在他六七十岁时死于其他并发症。
01:32
These are just remarkable卓越, remarkable卓越 changes变化
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对于这些"致命杀手"而言,
01:35
in the outlook外表 for some of the biggest最大 killers杀手.
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这些都是非常显著的变化。
01:38
And one in particular特定
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特别值得一提的是
01:40
that you probably大概 wouldn't不会 know about, stroke行程,
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你大概不大清楚 ---中风,
01:42
which哪一个 has been, along沿 with heart disease疾病,
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一般伴随心脏病,
01:44
one of the biggest最大 killers杀手 in this country国家,
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是本国最大健康杀手之一,
01:46
is a disease疾病 in which哪一个 now we know
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也是现在我们所知道的一种疾病
01:48
that if you can get people into the emergency room房间
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如果病人能在发病3小时之内
01:50
within three hours小时 of the onset发病,
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得到紧急医治,
01:53
some 30 percent百分 of them will be able能够 to leave离开 the hospital醫院
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大约 30%的病人能在出院时,
01:55
without any disability失能 whatsoever任何.
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不留任何残疾或后遗症。
01:58
Remarkable卓越 stories故事,
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多么非凡的成就,
02:01
good-news好消息 stories故事,
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令人振奋的故事!
02:03
all of which哪一个 boil down to understanding理解
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所有这一切都归功于
02:06
something about the diseases疾病 that has allowed允许 us
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我们对这些疾病的研究和认识,
02:09
to detect检测 early and intervene干预 early.
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可以让我们去“早发现”和“早治疗”。
02:12
Early detection发现, early intervention介入,
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在“早发现”和“早治疗”方面的进步,
02:15
that's the story故事 for these successes成功.
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是取得上述成果的关键。
02:18
Unfortunately不幸, the news新闻 is not all good.
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不幸的是,并非全都是好消息。
02:20
Let's talk about one other story故事
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我们来谈谈另外一个故事,
02:23
which哪一个 has to do with suicide自杀.
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与自杀有关。
02:24
Now this is, of course课程, not a disease疾病, per seSE.
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当然,就自杀本身而言,它不是一种疾病,
02:27
It's a condition条件, or it's a situation情况
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是一种状况或是一种现象,
02:30
that leads引线 to mortality死亡.
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最终导致死亡。
02:32
What you may可能 not realize实现 is just how prevalent流行 it is.
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你可能没有意识到这种现象是多么的普遍,
02:35
There are 38,000 suicides自杀 each year in the United联合的 States状态.
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在美国,每年有38000起自杀事件发生,
02:39
That means手段 one about every一切 15 minutes分钟.
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这意味着每15分钟就有一起。
02:42
Third第三 most common共同 cause原因 of death死亡 amongst其中包括 people
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在导致青少年死亡的常见原因中
02:45
between之间 the ages年龄 of 15 and 25.
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排名第三位。
02:48
It's kind of an extraordinary非凡 story故事 when you realize实现
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这是多么的令人震惊
02:50
that this is twice两次 as common共同 as homicide杀人
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自杀是谋杀数量的两倍
02:52
and actually其实 more common共同 as a source资源 of death死亡
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是更为普遍的死亡来源
02:55
than traffic交通 fatalities死亡 in this country国家.
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比本国交通事故的死亡数还要高。
02:58
Now, when we talk about suicide自杀,
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现在,当我们讨论自杀,
03:01
there is also a medical contribution贡献 here,
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不能忽视医学可能带来的改善,
03:04
because 90 percent百分 of suicides自杀
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因为 90%的自杀事件
03:06
are related有关 to a mental心理 illness疾病:
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与精神疾病有关:
03:08
depression萧条, bipolar双极 disorder紊乱, schizophrenia精神分裂症,
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如抑郁症、 躁郁症、 精神分裂症、
03:11
anorexia厌食症, borderline边缘 personality个性. There's a long list名单
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厌食症,边缘人格等等
03:14
of disorders障碍 that contribute有助于,
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(请回忆“早发现”和“早治疗”)
03:16
and as I mentioned提到 before, often经常 early in life.
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许多精神失常的症状往往出现在幼年期。
03:20
But it's not just the mortality死亡 from these disorders障碍.
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这些症状不仅对应着死亡的最终结果,
03:24
It's also morbidity发病率.
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也对应着疾病的悄然萌发。
03:25
If you look at disability失能,
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以"罹患"为例,
03:28
as measured测量 by the World世界 Health健康 Organization组织
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世界卫生组织是以
03:30
with something they call the Disability失能 Adjusted调整 Life Years年份,
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"罹患调整寿命年"为指标,
03:33
it's kind of a metric that nobody没有人 would think of
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它是一个除了经济学家
03:35
except an economist经济学家,
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不会有其他人能设计出来的指标,
03:37
except it's one way of trying to capture捕获 what is lost丢失
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用来衡量从发病到死亡所损失的健康寿命年
03:40
in terms条款 of disability失能 from medical causes原因,
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换言之,承受疾病负担的年数,
03:43
and as you can see, virtually实质上 30 percent百分
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如你所见,几乎有30 %
03:46
of all disability失能 from all medical causes原因
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因接受医疗而从此被认定为“罹患”
03:48
can be attributed由于 to mental心理 disorders障碍,
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是属于精神疾病,
03:51
neuropsychiatric神经精神 syndromes综合征.
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神经精神性综合症。
03:53
You're probably大概 thinking思维 that doesn't make any sense.
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你可能没想到精神疾病会排在第一,
03:56
I mean, cancer癌症 seems似乎 far more serious严重.
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你或许觉得癌症更严重,
03:58
Heart disease疾病 seems似乎 far more serious严重.
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还有心脏病!
04:01
But you can see actually其实 they are further进一步 down this list名单,
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但你可以看到在这张图表上它们排在精神疾病之后,
04:04
and that's because we're talking here about disability失能.
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这是因为我们在说罹患(而不是死亡率)。
04:07
What drives驱动器 the disability失能 for these disorders障碍
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是什么引起了这些精神障碍
04:09
like schizophrenia精神分裂症 and bipolar双极 and depression萧条?
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表现出精神分裂,,躁郁和抑郁的症状?
04:13
Why are they number one here?
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为什么他们排在第一位?
04:16
Well, there are probably大概 three reasons原因.
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这里大概有三个原因:
04:18
One is that they're highly高度 prevalent流行.
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首先是这些疾病非常普遍。
04:20
About one in five people will suffer遭受 from one of these disorders障碍
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约有1/5的人在有生之年
04:23
in the course课程 of their lifetime一生.
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会患上此类疾病。
04:26
A second第二, of course课程, is that, for some people,
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其次,对一部分患上此病的人来说,
04:28
these become成为 truly disabling禁用,
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成为永久性残疾,
04:29
and it's about four to five percent百分, perhaps也许 one in 20.
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大约 4% 至5%,也就是20人中就有1个。
04:33
But what really drives驱动器 these numbers数字, this high morbidity发病率,
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但真正导致这么高的发病率,
04:37
and to some extent程度 the high mortality死亡,
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换言之,这么高的死亡率,
04:39
is the fact事实 that these start开始 very early in life.
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是因为发病时间早。
04:43
Fifty五十 percent百分 will have onset发病 by age年龄 14,
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50%的病人从14岁起患病,
04:46
75 percent百分 by age年龄 24,
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75 %的病人从24岁起患病,
04:49
a picture图片 that is very different不同 than what one would see
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与传统的疾病观念不同
04:53
if you're talking about cancer癌症 or heart disease疾病,
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如果你在谈论癌症、心脏病
04:55
diabetes糖尿病, hypertension高血压 -- most of the major重大的 illnesses疾病
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糖尿病、 高血压 — — 这些疾病
04:59
that we think about as being存在 sources来源 of morbidity发病率 and mortality死亡.
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被认为是发病率和死亡的来源。
05:03
These are, indeed确实, the chronic慢性 disorders障碍 of young年轻 people.
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而精神疾病,却是折磨年轻人的慢性病。
05:09
Now, I started开始 by telling告诉 you that there were some good-news好消息 stories故事.
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在演讲开始时,我告诉你们一些好的消息。
05:12
This is obviously明显 not one of them.
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它们显然不在其中。
05:13
This is the part部分 of it that is perhaps也许 most difficult,
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这也许是最难攻克的那部分,
05:16
and in a sense this is a kind of confession自白书 for me.
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并且,在某种意义上说是我的告白。
05:19
My job工作 is to actually其实 make sure that we make progress进展
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我的工作就是要为精神疾病的研究
05:24
on all of these disorders障碍.
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带来实质的进展。
05:26
I work for the federal联邦 government政府.
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我为联邦政府工作,
05:28
Actually其实, I work for you. You pay工资 my salary薪水.
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实际上,是为你们工作,是你们付我薪水。
05:30
And maybe at this point, when you know what I do,
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此时你已经知道我是做什么的,
05:33
or maybe what I've failed失败 to do,
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也知道了我在工作上没有取得成果,
05:35
you'll你会 think that I probably大概 ought应该 to be fired解雇,
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如果你觉得我应该被解雇,
05:37
and I could certainly当然 understand理解 that.
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我会完全理解。
05:39
But what I want to suggest建议, and the reason原因 I'm here
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但我想要说的,和我在这里的原因
05:41
is to tell you that I think we're about to be
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就是想告诉你,我们将要进入一个
05:45
in a very different不同 world世界 as we think about these illnesses疾病.
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认识精神疾病的全新领域。
05:49
What I've been talking to you about so far is mental心理 disorders障碍,
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到目前为止,我所说的被称为精神失常,
05:52
diseases疾病 of the mind心神.
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是神志上的疾病。
05:54
That's actually其实 becoming变得 a rather unpopular不得人心 term术语 these days,
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如今,精神病已经让人"谈虎色变"
05:58
and people feel that, for whatever随你 reason原因,
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顾及到病人的感受或其他原因,
06:00
it's politically政治上 better to use the term术语 behavioral行为的 disorders障碍
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便采用"行为障碍"这一委婉说法
06:03
and to talk about these as disorders障碍 of behavior行为.
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和对不正常行为的的讨论。
06:07
Fair公平 enough足够. They are disorders障碍 of behavior行为,
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倒也讲得过去,疾病的表现形式是行为失常,
06:09
and they are disorders障碍 of the mind心神.
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也是精神失常。
06:11
But what I want to suggest建议 to you
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但是今天我要告诉诸位
06:14
is that both of those terms条款,
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正是这两种说法,
06:15
which哪一个 have been in play for a century世纪 or more,
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主导医界长达一个多世纪,
06:18
are actually其实 now impediments障碍 to progress进展,
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正在阻碍精神疾病的研究进展,
06:21
that what we need conceptually概念 to make progress进展 here
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若要从理念上突破精神疾病研究
06:26
is to rethink反思 these disorders障碍 as brain disorders障碍.
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则需要重新命名为大脑失常。
06:31
Now, for some of you, you're going to say,
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现在,你们中的一些人会说:
06:33
"Oh my goodness善良, here we go again.
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“哦, 我的天啊,又来了,
06:35
We're going to hear about a biochemical生化 imbalance失调
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我们将要听到关于生化失衡,
06:38
or we're going to hear about drugs毒品
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或者药品知识,
06:39
or we're going to hear about some very simplistic简单化 notion概念
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或是一些非常简单的概念,
06:44
that will take our subjective主观 experience经验
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(这些概念)只是凭借我们主观的经验,
06:47
and turn it into molecules分子, or maybe into some sort分类 of
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把他们想象成生化分子,以某种
06:53
very flat平面, unidimensional一维 understanding理解
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极其简单的定向思维来解释
06:56
of what it is to have depression萧条 or schizophrenia精神分裂症.
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造成抑郁症或精神分裂症的原因。
07:00
When we talk about the brain, it is anything but
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当我们谈论大脑时,
07:05
unidimensional一维 or simplistic简单化 or reductionistic还原论.
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绝非一维和简化。
07:08
It depends依靠, of course课程, on what scale规模
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当然,这取决于以什么尺度
07:11
or what scope范围 you want to think about,
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或什么范畴来谈此事,
07:13
but this is an organ器官 of surreal超现实主义 complexity复杂,
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它是一个极其复杂的器官,
07:20
and we are just beginning开始 to understand理解
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我们对它的了解才刚刚起步
07:23
how to even study研究 it, whether是否 you're thinking思维 about
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还谈不上研究它,无论是对
07:25
the 100 billion十亿 neurons神经元 that are in the cortex皮质
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大脑皮层上1000 亿的神经元,
07:28
or the 100 trillion synapses突触
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还是连结各个“ 交通枢纽”的
07:30
that make up all the connections连接.
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100 兆的神经突触,
07:32
We have just begun开始 to try to figure数字 out
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我们刚刚开始,试图找出答案:
07:36
how do we take this very complex复杂 machine
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我们如何运用大脑这个能够
07:40
that does extraordinary非凡 kinds of information信息 processing处理
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处埋惊人信息的非凡机器,
07:42
and use our own拥有 minds头脑 to understand理解
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同时使用我们自己的头脑来解释
07:45
this very complex复杂 brain that supports支持 our own拥有 minds头脑.
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这个非凡的大脑是如何支配我们的行为。
07:49
It's actually其实 a kind of cruel残忍 trick of evolution演化
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听上去十分跷舌,又很滑稽的理论,
07:51
that we simply只是 don't have a brain
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好象我们的大脑发育
07:55
that seems似乎 to be wired有线 well enough足够 to understand理解 itself本身.
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不够健全,连自己都不了解自己~
07:58
In a sense, it actually其实 makes品牌 you feel that
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从某种意义上讲,大脑有时让你感觉到,
08:00
when you're in the safe安全 zone of studying研究 behavior行为 or cognition认识,
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在研究已知的行为或认知
08:03
something you can observe,
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尤其是对你可以观察到的东西时,
08:04
that in a way feels感觉 more simplistic简单化 and reductionistic还原论
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它是简单直观的,
08:07
than trying to engage从事 this very complex复杂, mysterious神秘 organ器官
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而不是让人费解 ,神秘的器官,
08:12
that we're beginning开始 to try to understand理解.
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使我们刚刚萌生兴趣。
08:15
Now, already已经 in the case案件 of the brain disorders障碍
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现在,对于“大脑失常”
08:18
that I've been talking to you about,
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正如我前面所说的
08:20
depression萧条, obsessive强迫症 compulsive强迫 disorder紊乱,
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抑郁症,强迫症,
08:22
post-traumatic创伤后 stress强调 disorder紊乱,
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创伤后应激障碍,
08:25
while we don't have an in-depth深入 understanding理解
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虽然我们还不甚了解大脑是
08:27
of how they are abnormally异常 processed处理
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如何失灵,
08:31
or what the brain is doing in these illnesses疾病,
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或病发后做何处理,
08:33
we have been able能够 to already已经 identify鉴定
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但我们已经能够辨别出脑部神经
08:36
some of the connectionalconnectional differences分歧, or some of the ways方法
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在连接上的差异
08:39
in which哪一个 the circuitry电路 is different不同
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或者脑部神经路线异样
08:41
for people who have these disorders障碍.
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这些神志错乱病人的通常症状。
08:43
We call this the human人的 connectome连接组,
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我们把这称之为脑部神经连接组,
08:45
and you can think about the connectome连接组
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你可以把它想象成
08:47
sort分类 of as the wiring接线 diagram of the brain.
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大脑的线路连接图,
08:49
You'll你会 hear more about this in a few少数 minutes分钟.
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下面会多次提到的。
08:51
The important重要 piece here is that as you begin开始 to look
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重要一点是,当提及这些病人,
08:54
at people who have these disorders障碍, the one in five of us
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每五个健康人中就有一个,
08:58
who struggle斗争 in some way,
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不同程度的患有精神疾病,
09:00
you find that there's a lot of variation变异
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你可以发现大脑出现变异情况
09:02
in the way that the brain is wired有线,
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是多么的纷繁复杂
09:06
but there are some predictable可预测 patterns模式, and those patterns模式
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但我们还是了解到一些可预测的模式,
09:08
are risk风险 factors因素 for developing发展 one of these disorders障碍.
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可以预测到发病倾向。
09:12
It's a little different不同 than the way we think about brain disorders障碍
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我所说的大脑失常与平时常见的稍有不同,
09:15
like Huntington's亨廷顿 or Parkinson's帕金森氏 or Alzheimer's老年痴呆症 disease疾病
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像亨廷顿氏症或帕金森症或老年痴呆症等,
09:18
where you have a bombed-out被炸毁的 part部分 of your cortex皮质.
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是部分大脑皮层缺损。
09:20
Here we're talking about traffic交通 jams果酱, or sometimes有时 detours少走弯路,
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而这里我们谈论是交通堵塞,或是绕道而行,
09:23
or sometimes有时 problems问题 with just the way that things are connected连接的
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或只是连接方式出了问题,
09:26
and the way that the brain functions功能.
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或大脑功能性障碍。
09:27
You could, if you want, compare比较 this to,
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你可以这样,如果一定要比较的话,
09:31
on the one hand, a myocardial心肌 infarction梗塞, a heart attack攻击,
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那就想象心肌梗塞、突发性心脏病,
09:34
where you have dead tissue组织 in the heart,
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是由于心脏中坏死组织所致,
09:35
versus an arrhythmia心律失常, where the organ器官 simply只是 isn't functioning功能
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还有心律失常、心脏运行不正常,
09:39
because of the communication通讯 problems问题 within it.
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是由于其内部的输导功能出了问题。
09:41
Either one would kill you; in only one of them
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任何一种病症都会导致死亡,
09:43
will you find a major重大的 lesion病变.
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但只有一项是主要病变。
09:46
As we think about this, probably大概 it's better to actually其实 go
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除了想象,最好还是举个实例,
09:49
a little deeper更深 into one particular特定 disorder紊乱, and that would be schizophrenia精神分裂症,
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个例分析, 是精神分裂症。
09:52
because I think that's a good case案件
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我觉得这是个非常好的例子,
09:54
for helping帮助 to understand理解 why thinking思维 of this as a brain disorder紊乱 matters事项.
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揭示进行大脑失常研究的深远意义。
09:58
These are scans扫描 from Judy朱迪 Rapoport拉波鲍特 and her colleagues同事
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国家精神健康研究所茱蒂和她的同事们
10:02
at the National国民 Institute研究所 of Mental心理 Health健康
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提供了这些研究扫描图,
10:04
in which哪一个 they studied研究 children孩子 with very early onset发病 schizophrenia精神分裂症,
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他们研究了存在精神分裂症迹象的儿童,
10:07
and you can see already已经 in the top最佳
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你已经能看到在顶部,
10:09
there's areas that are red or orange橙子, yellow黄色,
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那些红色、橙色、黄色的区域,
10:11
are places地方 where there's less gray灰色 matter,
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取代了应有的灰质,
10:14
and as they followed其次 them over five years年份,
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随后追踪了五年多,
10:15
comparing比较 them to age年龄 match比赛 controls控制,
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再进行年龄匹配对照,
10:17
you can see that, particularly尤其 in areas like
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你可以看到,特别是在
10:19
the dorsolateral背侧 prefrontal前额叶 cortex皮质
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延髓背外侧前额叶皮层
10:21
or the superior优越 temporal gyrus, there's a profound深刻 loss失利 of gray灰色 matter.
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或上级颞回,(这些孩子的)大脑灰质严重缺损。
10:26
And it's important重要, if you try to model模型 this,
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这些非常重要,如果通过建模进行量化,
10:27
you can think about normal正常 development发展
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你可以理解在正常发育中
10:29
as a loss失利 of cortical皮质 mass, loss失利 of cortical皮质 gray灰色 matter,
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大脑皮层质量是会减少,或是灰质轻微损失,
10:33
and what's happening事件 in schizophrenia精神分裂症 is that you overshoot超调 that mark标记,
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但精神分裂症患者的这些损失量超标,
10:36
and at some point, when you overshoot超调,
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在某些时候,
10:38
you cross交叉 a threshold, and it's that threshold
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正是超过这个标准值,
10:41
where we say, this is a person who has this disease疾病,
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我们说这个人患有精神分裂症,
10:44
because they have the behavioral行为的 symptoms症状
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此时他的行为异常,多数呈现出
10:47
of hallucinations幻觉 and delusions妄想.
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幻觉和妄想,
10:49
That's something we can observe.
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这些我们肉眼所能观察到的异常行为,
10:50
But look at this closely密切 and you can see that actually其实 they've他们已经 crossed越过 a different不同 threshold.
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但仔细看看这个图,你会发现其实他们跨过了不同的标准值,
10:56
They've他们已经 crossed越过 a brain threshold much earlier,
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而且出现得很早,
10:59
that perhaps也许 not at age年龄 22 or 20,
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并不是在(行为失常的)22岁或20岁,
11:02
but even by age年龄 15 or 16 you can begin开始 to see
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其实在15岁或16岁已经出现明显迹象,
11:05
the trajectory弹道 for development发展 is quite相当 different不同
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发展轨迹大不相同,
11:07
at the level水平 of the brain, not at the level水平 of behavior行为.
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这是从大脑发育来说的,而不是指(后期的)行为方式,
11:11
Why does this matter? Well first because,
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为什么这件事情非常重要呢? 首先,
11:13
for brain disorders障碍, behavior行为 is the last thing to change更改.
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对于大脑紊乱,行为异常是最后的症状,
11:16
We know that for Alzheimer's老年痴呆症, for Parkinson's帕金森氏, for Huntington's亨廷顿.
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我们知道,对于老年痴呆症,帕金森症和亨廷顿氏症,
11:19
There are changes变化 in the brain a decade or more
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患者的大脑在十年前或更早,
11:21
before you see the first signs迹象 of a behavioral行为的 change更改.
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无任何迹象时已经发生了变化。
11:26
The tools工具 that we have now allow允许 us to detect检测
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我们现有的仪器已经可以很早检测出
11:29
these brain changes变化 much earlier, long before the symptoms症状 emerge出现.
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这些变化,远远早于症状的出现。
11:34
But most important重要, go back to where we started开始.
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但最重要的是,回到我们开始讲述的
11:37
The good-news好消息 stories故事 in medicine医学
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医学中的良好实践:
11:40
are early detection发现, early intervention介入.
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“早发现”, “早治疗”。
11:43
If we waited等待 until直到 the heart attack攻击,
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如果我们一直等到心脏病发作再治疗,
11:47
we would be sacrificing牺牲 1.1 million百万 lives生活
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每年将会有110万人
11:51
every一切 year in this country国家 to heart disease疾病.
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死于心脏疾病。
11:53
That is precisely恰恰 what we do today今天
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这正是我们今天的状况,
11:56
when we decide决定 that everybody每个人 with one of these brain disorders障碍,
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当我们发现某人有精神疾病,
12:00
brain circuit电路 disorders障碍, has a behavioral行为的 disorder紊乱.
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脑残或行为障碍等,
12:03
We wait until直到 the behavior行为 becomes manifest表现.
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直到他们的异常行为显而易见时才釆取措施。
12:06
That's not early detection发现. That's not early intervention介入.
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这不是“早发现”,也无法“早治疗”。
12:11
Now to be clear明确, we're not quite相当 ready准备 to do this.
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确实,攻克精神疾病的时机尚未成熟,
12:13
We don't have all the facts事实. We don't actually其实 even know
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我们还不淸楚所有病因,我们甚至
12:16
what the tools工具 will be,
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没有有效的检测仪器,
12:19
nor也不 what to precisely恰恰 look for in every一切 case案件 to be able能够
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也不知道去检测什么,
12:23
to get there before the behavior行为 emerges出现 as different不同.
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能够在行为异常出现前阻止病变。
12:27
But this tells告诉 us how we need to think about it,
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但目前的研究成果已经
12:30
and where we need to go.
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为我们指明方向。
12:31
Are we going to be there soon不久?
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我们会达到彼岸吗?
12:33
I think that this is something that will happen发生
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我的答案是肯定的,
12:35
over the course课程 of the next下一个 few少数 years年份, but I'd like to finish
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在接下来的几年里,
12:38
with a quote引用 about trying to predict预测 how this will happen发生
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我想用这段话结束并预测研究的进展,
12:41
by somebody who's谁是 thought a lot about changes变化
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它是由一个想用观念和技术
12:43
in concepts概念 and changes变化 in technology技术.
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改变世界的狂人所说的:
12:45
"We always overestimate估计过高 the change更改 that will occur发生
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“我们总是高估今后
12:48
in the next下一个 two years年份 and underestimate低估
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两年的变化,但是低估
12:50
the change更改 that will occur发生 in the next下一个 10." -- Bill法案 Gates盖茨.
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未来十年的变化”— — 比尔 · 盖茨
12:54
Thanks谢谢 very much.
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非常感谢。
12:55
(Applause掌声)
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(掌声)
Translated by bin xue
Reviewed by Zheqing Fang

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ABOUT THE SPEAKER
Thomas Insel - Neuroscientist and psychiatrist
The Director of the National Institute of Mental Health, Thomas Insel supports research that will help us understand, treat and even prevent mental disorders.

Why you should listen

Thomas Insel has seen many advances in the understanding of mental disorders since becoming the Director of the National Institute of Mental Health (NIMH) in 2002. During his tenure, major breakthroughs have been made in the areas of practical clinical trials, autism research and the role of genetics in mental illnesses.

Prior to his appointment at the NIMH, Insel was a professor of psychiatry at Emory University, studying the neurobiology of complex social behaviors. While there, he was the founding director of the NSF Center for Behavioral Neuroscience and director of the NIH-funded Center for Autism Research. He has published over 250 scientific articles and four books and has served on numerous academic, scientific, and professional committees and boards. He is a member of the Institute of Medicine, a fellow of the American College of Neuropsychopharmacology, and a recipient of the Outstanding Service Award from the U.S. Public Health Service and the 2010 La Fondation IPSEN Neuronal Plasticity Prize. 

More profile about the speaker
Thomas Insel | Speaker | TED.com