Psychiatry

Psychiatry is a branch of medicine that studies and treats mental and emotional disorders (see mental illness). While any physician may prescribe the medications used to treat various forms of mental illness, psychiatrists are more extensively trained in differential diagnosis of mental illness and keep up to date on the newest treatment modalities for mental illness. The term alienist is an old term for a psychiatrist, and the term shrink (from head shrinker) is a (sometimes offensive) slang term for a psychotherapist.

Note that psychiatry is practiced by psychiatrists, psychology by psychologists. Psychiatrists are medical doctors and may prescribe drugs. Psychology is the broader study of behaviour and thought processes not just in the context of mental health. Clinical psychologists specialize in mental health and have extensive training in therapy and psychological testing. They do not usually prescribe drugs.

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Mind versus brain

Psychiatric illnesses were for some time characterised as disorders of function of the mind rather than the brain, although the distinction is not always obvious. In the current state of knowledge this distinction does not always hold true, as many psychiatric conditions have physical etiologies.

For a long period of history, neurology and psychiatry were a single discipline, and following their division the steady advance in understanding of the basic functioning of neurons and the brain is bringing areas of the two disciplines back together.

Psychiatry was at first a pragmatic discipline that was part of general medicine, combining medicine and practical psychology. The work of Emil Kraepelin laid the foundations of scientific psychiatry, but was derailed by the psychoanalytic theories of Sigmund Freud. For many years, Freudian theories dominated psychiatric thinking.

The discovery of lithium carbonate as a treatment for bipolar disorder, followed by the development of fields such as molecular biology and tools such as brain imaging has led to psychiatry re-discovering its origins in physical and observational medicine without losing sight of its humane dimension.

Anti-psychiatry

For more on this topic see the main anti-psychiatry article

Unlike most other areas of medicine, there is a politicised anti-psychiatry movement opposed to the practices of, and in some cases the existence of, psychiatry. Some opponents of psychiatry state that selective financing by large multinational drug companies of both high ranking professional psychiatrists, research and educational material has led the practice of psychiatry to be subversively, and in some cases inhumanely, misled.

Some common criticisms of the field include the notion that no cause of mental illness has ever been found. There are a number of people trained in the field who have stated that physical tests cannot distinquish between a normal person and a mentally ill person. In lieu of scientifically defined clinical pathologies, critics contend, psychiatrists rely upon a notion of mental illness often referred to as the chemical imbalance theory.

There are also criticisms based on what is perceived as political motivations on the part of psychiatrists as opposed to objective scientific criteria. An example often cited is the removal of homosexuality from the list of mental illnesses in the DSM. Thus, some critics contend a mental illness label such as schizophrenia has no etiology and is only a matter of opinion. If the addition or removal of mental illnesses from the DSM is politically based, then the DSM can not be held by all as an objective standard. However, it is possible to argue that even if the removal or addition of psychiatric conditions to/from the DSM has been politically motivated, the initial inclusion or exclusion may have been a result of politics, creating something of an equalization effect. Morever, many would hold it logically fallacious to argue all DSM diagnoses are categorically invalid simply because one or some may be politically motivated or otherwise invalid.

Also, some people criticize the psychiatric profession for treatments that transition into and out of usage. An example is electroconvulsive therapy (ECT), which the psychiatric profession considered a barbarous practice during the 1970s and 1980s, only to be revived recently as a treatment for depression.

A few prominent critics of psychology and mental illness in general include Thomas Szasz, the author of "The Myth of Mental Illness", who founded an organization in 1969 together with the Church of Scientology (though soon afterwards he disavowed further association with them) called the Citizens Commission on Human Rights (CCHR), Peter Breggin, the author of Prozac Backlash, as well as other books criticizing the use of psychiatric drugs, Elliott Valenstein, Douglas C. Smith, Bruce Levine, and David Keirsey.

Practice of psychiatry

In the United States, psychiatrists are board certified as specialists in their field. Physicians wishing to become board certified psychiatrists will practice as residents for four years, learning the specialty before taking the psychiatry boards. In other countries, similar rules usually apply.

Famous figures in psychiatry

Psychiatrists

Others:

  • Kay Redfield Jamison - a psychologist who, whilst not a psychiatrist herself, is professor of psychiatry at Johns Hopkins University School of Medicine and a MacArthur Fellow.

Psychiatrists in fiction

See also

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