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The Psychiatry Portal

psychiatric medication and an ECT machine, in Berlin Museum of medical history

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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Leucotome, a tool for performing leucotomies (lobotomies), circa 1942, United Kingdom
Advertisement for a leucotome, a tool for performing leucotomies (lobotomies) (UK, circa 1942)
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Benjamin Rush (January 4, 1746 [O.S. December 24, 1745] – April 19, 1813) was a Founding Father of the United States. Rush lived in the state of Pennsylvania and was a physician, writer, educator, humanitarian, as well as the founder of Dickinson College in Carlisle, Pennsylvania.

Rush signed the Declaration of Independence and attended the Continental Congress. He served as Surgeon General in the Continental army, and was blamed for criticising George Washington. Later in life, Rush became a professor of chemistry, medical theory, and clinical practice at the University of Pennsylvania.

As a leading physician, Rush had a major impact on the emerging medical profession. As an Enlightenment intellectual, he was committed to organizing all medical knowledge around explanatory theories, rather than rely on empirical methods. Rush argued that illness was the result of imbalances in the body's physical system and was caused by malfunctions in the brain. His approach prepared the way for later medical research, but Rush himself undertook none of it. He promoted public health by advocating clean environment and stressing the importance of personal and military hygiene. His study of mental disorder made him one of the founders of American psychiatry. (Full article...)

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