Psychiatry
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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
- Alfred Adler Individual psychology
- Aaron Beck cognitive therapy
- Eugene Bleuler diagnostic criteria for schizophrenia
- Ian Brockington nosological pioneer
- John Cade introduced lithium
- Ugo Cerletti electroconvulsive therapy
- Edmund Chiu Huntington's chorea
- Timothy Crow biological basis of schizophrenia
- Pierre Deniker introduced chlorpromazine
- Leon Eisenberg Psychiatric anthropology
- Milton Erickson hypnosis
- Jean Etienne Esquirol descriptive psychopathology and postnatal depression
- Frantz Fanon effect of discrimination on an individual
- Daniel X Freedman
- Christopher Paul Lindsay Freeman electroconvulsive therapy
- Sigmund Freud introduced psychoanalysis
- William Glasser reality therapy & choice theory
- Max Hamilton introduced depression and anxiety scales
- David Healy influence of pharmaceuticals
- Ashoka Jahnavi-Prasad introduced sodium valproate as a safer alternative to lithium
- Pierre Janet intoduced the concept of dissociation
- Karl Jaspers phenomenologist
- Eve Johnstone brain changes in schizophrenia
- Maxwell Jones therapeautic community
- Carl Gustav Jung analytical psychology
- Seymour Kety pioneer in psychiatric genetics
- Eric R. Kandel
- Radovan Karadžić psychiatrist, politician and alleged war criminal
- Robert Evan Kendell diagnostic problems in psychiatry
- Antoni Kepinski
- Arthur Klienmen psychiatric anthropologist
- Emil Kraepelin pioneer of psychiatry
- Richard von Krafft-Ebbing
- Norman Krietman psychiatric epidemiology
- R. D. Laing antipsychiatry movement
- Sir Aubrey Lewis nosological pioneer
- Alwyn Lishman neuropsychiatrist
- Peter McGuffin psychiatric geneticist
- Adolf Meyer psychobiology
- Egas Moniz psychosurgery
- Henry Murray
- John Nemiah psychotherapist
- Ian Oswald sleep research
- Eugene Paykel life events and mental illness
- Ivan Pavlov pioneer of conditioning behavior
- Jean Piaget famous for his theory of cognitive development
- Philippe Pinel abolished all retraint in psychiatric treatment
- W. H. R. Rivers psychiatric anthropologist
- Sir Martin Roth psychiatry of old age
- Sir Michael Rutter child psychiatry
- William Sargant mind control
- Kurt Schneider diagnostic criteria
- Mogens Schou lithium therapy
- Carl Hans Heinze Sennhenn eugenicist
- Peter Sifneos
- Elliott Slater psychiatric epidemiologist
- Robert Spitzer diagnostic criteria
- Harry Stack Sullivan interpersonal psychiatry
- Thomas Szasz antipsychiatry movement
- Eng Seong Tan cross cultural psychiatry
- Fuller Torrey Humane treatment of schizophrenia
- Ming Tsuang psychiatric geneticist
- Ladislas von Meduna pharmacoconvulsions
- Julius Wagner-Jauregg malarial treatment of GPI
- Sula Wolff children under stress
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
- Dr. Alistair Crown in Bernice Rubens' novel A Solitary Grief (1991)
- Dr. Dick Diver in F. Scott Fitzgerald's novel Tender is the Night
- Dr. Igor in Paulo Coelho's novel Veronika Decides to Die
- The radio talk-show presenter Dr Frasier Crane in the sit-com Frasier
- Hannibal Lecter from Thomas Harris's books
- Dr. Laszlo Kreizler from The Alienist and The Angel of Darkness by Caleb Carr
- Dr. Tobias Funke in the sitcom Arrested Development
See also
- anti-psychiatry
- cognitive neuropsychiatry
- list of psychiatric drugs
- neuropsychiatry
- psychiatric survivors movement
- psychoanalysis
- psychopharmacology
- psychotherapy
- Important publications in Psychiatry
- Important publications in medicine
- Important publications in psychology
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