Psychiatry

Psychiatry is the medical specialty devoted to diagnosing, preventing, and treating mental disorders. These include various maladaptations related to mood, behavior, cognition, and perceptions. See glossary of psychiatry. Psychiatry is the medical specialty devoted to diagnosing, preventing, and treating mental disorders. These include various maladaptations related to mood, behavior, cognition, and perceptions. See glossary of psychiatry. Psychiatric assessment of a person typically begins with a case history and mental status examination. Physical examinations and psychological tests may be conducted. Neuroimaging or other neurophysiological techniques may also be used. Mental disorders are often diagnosed under clinical concepts listed in diagnostic manuals. The International Statistical Classification of Diseases and Related Health Problems (ICD) is edited and used by the World Health Organization (WHO). The widely used Diagnostic and Statistical Manual of Mental Disorders (DSM) is published by the American Psychiatric Association (APA). The fifth edition of the DSM (DSM-5) was published in 2013. It included more up-to-date research and re-organized the larger categories of various diseases. Nowadays, psychiatric treatment usually involves a combination of psychiatric medication and psychotherapy. Modern practice also includes a wide variety of other modalities. These include assertive community treatment, community reinforcement, and supported employment. Treatment depends on the severity of functional impairment or other aspects of the disorder. It may be delivered on an inpatient or outpatient basis. An inpatient may be treated in a psychiatric hospital. Research and treatment within psychiatry as a whole are conducted on an interdisciplinary basis (e.g., with epidemiologists, mental health counselors, nurses, psychologists, public health specialists, radiologists or social workers). The term 'psychiatry' was first coined by the German physician Johann Christian Reil in 1808 and literally means the 'medical treatment of the soul' (psych- 'soul' from Ancient Greek psykhē 'soul'; -iatry 'medical treatment' from Gk. iātrikos 'medical' from iāsthai 'to heal'). A medical doctor specializing in psychiatry is a psychiatrist. (For a historical overview, see Timeline of psychiatry.) Psychiatry is the field of medicine focused specifically on the mind, aiming to study, prevent, and treat mental disorders in humans. It has been described as an intermediary between the world from a social context and the world from the perspective of those who are mentally ill. People who specialize in psychiatry often differ from most other mental health professionals and physicians in that they must be familiar with both the social and biological sciences. The discipline studies the operations of different organs and body systems as classified by the patient's subjective experiences and the objective physiology of the patient. Psychiatry treats mental disorders, which are conventionally divided into three very general categories: mental illnesses, severe learning disabilities, and personality disorders. While the focus of psychiatry has changed little over time, the diagnostic and treatment processes have evolved dramatically and continue to do so. Since the late 20th century the field of psychiatry has continued to become more biological and less conceptually isolated from other medical fields. Though the medical specialty of psychiatry uses research in the field of neuroscience, psychology, medicine, biology, biochemistry, and pharmacology, it has generally been considered a middle ground between neurology and psychology. Because psychiatry and neurology are deeply intertwined medical specialties, all certification for both specialties and for their subspecialties is offered by a single board, the American Board of Psychiatry and Neurology, one of the member boards of the American Board of Medical Specialties. Unlike other physicians and neurologists, psychiatrists specialize in the doctor–patient relationship and are trained to varying extents in the use of psychotherapy and other therapeutic communication techniques. Psychiatrists also differ from psychologists in that they are physicians and have post-graduate training called residency (usually 4 to 5 years) in psychiatry; the quality and thoroughness of their graduate medical training is identical to that of all other physicians. Psychiatrists can therefore counsel patients, prescribe medication, order laboratory tests, order neuroimaging, and conduct physical examinations. The World Psychiatric Association issues an ethical code to govern the conduct of psychiatrists (like other purveyors of professional ethics). The psychiatric code of ethics, first set forth through the Declaration of Hawaii in 1977 has been expanded through a 1983 Vienna update and in the broader Madrid Declaration in 1996. The code was further revised during the organization's general assemblies in 1999, 2002, 2005, and 2011. The World Psychiatric Association code covers such matters as: confidentiality, the death penalty, ethnic or cultural discrimination, euthanasia, genetics, the human dignity of incapacitated patients, media relations, organ transplantation, patient assessment, research ethics, sex selection, torture, and up-to-date knowledge. The ethical aspects described are increasingly being incorporated into the specialist curricula and psychiatric training.