The Psychiatry Portal

Psychiatry is the medical specialty devoted to the diagnosis, prevention, and treatment of deleterious mental conditions. These include various matters related to mood, behaviour, cognition, perceptions, and emotions.

Initial psychiatric assessment of a person begins with creating a case history and conducting a mental status examination. Physical examinations, psychological tests, and laboratory tests may be conducted. On occasion, neuroimaging or other neurophysiological studies are performed. Mental disorders are diagnosed in accordance with diagnostic manuals such as the International Classification of Diseases (ICD), edited by the World Health Organization (WHO), and the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association (APA). The fifth edition of the DSM (DSM-5), published in May 2013, reorganized the categories of disorders and added newer information and insights consistent with current research.

Treatment may include psychotropics (psychiatric medicines) and psychotherapy, and also other modalities such as assertive community treatment, community reinforcement, substance-abuse treatment, and supported employment. Treatment may be delivered on an inpatient or outpatient basis, depending on the severity of functional impairment or risk to the individual or community. Research within psychiatry is conducted on an interdisciplinary basis with other professionals, such as epidemiologists, nurses, social workers, occupational therapists, and clinical psychologists. (Full article...)

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Self-inflicted cuts on the forearm
Self-inflicted cuts on the forearm
Self-harm (SH) or deliberate self-harm (DSH) includes self-injury (SI) and self-poisoning and is defined as the intentional, direct injuring of body tissue most often done without suicidal intentions. These terms are used in the more recent literature in an attempt to reach a more neutral terminology. The older literature, especially that which predates the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), almost exclusively refers to self-mutilation. The term self-harm is synonymous with the term self-injury.

The most common form of self-harm is skin-cutting but self-harm also covers a wide range of behaviors including, but not limited to, burning, scratching, banging or hitting body parts, interfering with wound healing (dermatillomania), hair-pulling (trichotillomania) and the ingestion of toxic substances or objects. Behaviours associated with substance abuse and eating disorders are usually not considered self-harm because the resulting tissue damage is ordinarily an unintentional side effect. However, the boundaries are not always clearly defined and in some cases behaviours that usually fall outside the boundaries of self-harm may indeed represent self-harm if performed with explicit intent to cause tissue damage. Although suicide is not the intention of self-harm, the relationship between self-harm and suicide is complex, as self-harming behaviour may be potentially life-threatening. There is also an increased risk of suicide in individuals who self-harm to the extent that self-harm is found in 40–60% of suicides. However, generalising self-harmers to be suicidal is, in the majority of cases, inaccurate. (Full article...)

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A human skull mapped according to phrenology (1883), early precursor to modern psychiatry and neuroscience, now considered a pseudoscience
image credit: public domain

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Sigmund Freud (German pronunciation: [ˈziːkmʊnt ˈfʁɔʏ̯t]; born Sigismund Schlomo Freud; 6 May 1856 – 23 September 1939) was an Austrian neurologist who became known as the founding father of psychoanalysis.

Freud qualified as a doctor of medicine at the University of Vienna in 1881, and then carried out research into cerebral palsy, aphasia and microscopic neuroanatomy at the Vienna General Hospital. He was appointed a university lecturer in neuropathology in 1885 and became an affiliated professor (professor extraordinarius) in 1902.

In creating psychoanalysis, a clinical method for treating psychopathology through dialogue between a patient and a psychoanalyst, Freud developed therapeutic techniques such as the use of free association and discovered transference, establishing its central role in the analytic process. Freud’s redefinition of sexuality to include its infantile forms led him to formulate the Oedipus complex as the central tenet of psychoanalytical theory. His analysis of dreams as wish-fulfillments provided him with models for the clinical analysis of symptom formation and the mechanisms of repression as well as for elaboration of his theory of the unconscious as an agency disruptive of conscious states of mind. Freud postulated the existence of libido, an energy with which mental processes and structures are invested and which generates erotic attachments, and a death drive, the source of repetition, hate, aggression and neurotic guilt. In his later work Freud developed a wide-ranging interpretation and critique of religion and culture.

Psychoanalysis remains influential within psychotherapy, within some areas of psychiatry, and across the humanities. As such, it continues to generate extensive and highly contested debate with regard to its therapeutic efficacy, its scientific status, and whether it advances or is detrimental to the feminist cause. (Full article...)

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