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History Of Psychiatry And Medical Psychology: W...

The starting point of this study is the current uncertainty in German-speaking medical psychology about its actual and very own natural area of expertise. The current study ventures to advance the hypothesis that part of this uncertainty is due to the fact that during the scientific area in its history (approx. 1850-1960) medical psychology abandoned its historical core competence as it emerged and developed during the age of enlightenment (end of 17(th)-18(th) centuries). To make this change clear, different examples of the 2 opposing conceptualisations of medical psychology are discussed, of course in a selected and maybe even provocative way. The change in concept also led to the fact that the interrelationships with and differentiation from its neighbouring disciplines are not clear and sharp either, since at times 2 or more disciplines declare themselves competent for one and the same thing. This is exemplified on the manifold overlappings with clinical psychology. Given the lack of resources now and in the future, this lack of a clear definition of competence might lead to continued uncertainty as well as to conflicts over distribution. On the other hand though, the look into the history of the subject reveals that at all times it has been a matter of individual approach or attitude as to what was regarded as core area of interest and competence of medical psychology and how far it overlapped with neighbouring disciplines. From the point of view of the history of psychiatry and on the basis of carefully selected historic material, this paper presents the core of 2 different concepts of medical psychology to elaborate this hypothesis.

History of Psychiatry and Medical Psychology: W...

"The main audience for this new book is educators who want to be good scholars of intellectual history; the remaining readers are those who just want to deeply understand how present concepts of the mind were invented. This book, written ill a language of a high but approachable erudition, could serve as a knowledgeable guide to all of them in their journeys to a different level of understanding about how psychiatry actually works and thinks as a discipline. ... I enthusiastically recommend History of Psychiatry and Medical Psychology-it is refreshingly self-aware, an enjoyable read, and could provide hours of material for seminars with students to remind them of Santayana's mordant warning that those who cannot remember the past are condemned to repeat it." (Antolin C. Trinidad, MD, George Washington University, Washington, DC, JAMA, February 18, 2009-Vo1. 301, No. 7)

The push for pharmaceutical innovation paid off. A new class of antidepressants called SSRIs ("selective serotonin reuptake inhibitors") were better tolerated and medically safer than prior antidepressants. The first of these, Prozac, was released in 1987. Shortly thereafter, new anti-psychotics were released: "atypical neuroleptics" such as Risperdal and Zyprexa. Heavily promoted and with apparent advantages over their predecessors, these medications were widely prescribed by psychiatrists, and later by primary care physicians and other generalists. Psychiatry was increasingly seen as a mainstream medical specialty (to the relief of APA leadership), and public research money strongly shifted toward neuroscience and pharmaceutical research. The National Institute of Mental Health (NIMH) declared the 1990s the Decade of the Brain "to enhance public awareness of the benefits to be derived from brain research." DSM-IV was published in 1994, further elaborating criterion-based psychiatric diagnosis. Biological psychiatry appeared to have triumphed.

The release of DSM-5 in 2013 garnered much controversy. Dr. Allen Frances, chair of the APA task force that oversaw the prior edition, criticized the new effort for its medical/biological bias, and for expanding the scope of psychiatric disorders in ways that shrink the range of normality. Thousands of mental health clinicians and researchers signed petitions opposing the new edition for similar reasons. The NIMH declared it would no longer use DSM diagnoses in its research because DSM definitions were products of expert consensus, not experimental data. Like psychoanalysis before it, the new dominant paradigm, psychiatry as a "neurobiological" specialty, had also overreached.

Healing the rift between biological psychiatry and psychotherapy was foreshadowed in the 1970s by George L. Engel's biopsychosocial medical model and by Eric R. Kandel's laboratory work on the cellular basis of behavior. (Kandel's classic 2001 paper is well worth reading.) Even at the height of the medicalization of psychiatry in the 1980s and '90s, it was recognized that unconscious dynamics affect the doctor-patient relationship, and that interpersonal factors strongly influence whether patients feel helped with treatment. It is time again to acknowledge that many outpatients, probably most, seek treatment not for discrete symptoms but for diffuse dissatisfaction, stormy relationships, unwitting self-sabotage, dissociative reactions, and other misery that cannot readily be reduced to DSM diagnostic criteria. The convenient fiction that people's feelings can be distilled into a "problem list" is not so convenient after all.

The future of psychiatry can be neither "brainless" nor "mindless." History points to many conditions once thought to be "mental" (general paresis, cretinism, senility, seizures, etc.) that are now known to be medical. Brain research is essential, as more such examples are sure to come. It is equally clear that we are nowhere near analyzing and treating human psychology at the neural level. That may be possible someday, but for now, any such claims are absurdly premature. The distinction between medical and psychological will likely become less sharp in the years ahead, as certain genetic or other biological differences will be linked to psychological vulnerabilities.

Clinical psychology is different from psychiatry. Although practitioners in both fields are experts in mental health, clinical psychologists treat mental disorders primarily through psychotherapy. Currently, only six US states, Louisiana, New Mexico, Illinois, Iowa, Idaho, and Colorado allow clinical psychologists with advanced specialty training to prescribe psychotropic medications. Psychiatrists are medical doctors who specialize in the treatment of mental disorders via a variety of methods, e.g., diagnostic assessment, brief psychotherapy, psychoactive medications, and medical procedures such as electroconvulsive therapy (ECT) or transcranial magnetic stimulation (TMS). Additionally, psychiatrists are legally authorized to prescribe psychotropic medications in all states of the U.S. and in all provinces of Canada.[5] In education, clinical psychologists attend a graduate institution and have a Doctor of Philosophy (Ph.D.) or a Doctor of Psychology (Psy.D.) degree, while psychiatrists completed their studies at a medical school and hold a medical degree (M.D.) or an osteopathic degree (D.O.), with the latter only available in the United States.

During the 5th century BCE, mental disorders, especially those with psychotic traits, were considered supernatural in origin,[4] a view which existed throughout ancient Greece and Rome.[4] The beginning of psychiatry as a medical specialty is dated to the middle of the nineteenth century,[5] although one may trace its germination to the late eighteenth century.

At the turn of the century, England and France combined had only a few hundred individuals in asylums.[39] By the late 1890s and early 1900s, this number had risen to the hundreds of thousands. However, the idea that mental illness could be ameliorated through institutionalization was soon disappointed.[40] Psychiatrists were pressured by an ever-increasing patient population.[40] The average number of patients in asylums kept on growing.[40] Asylums were quickly becoming almost indistinguishable from custodial institutions,[41] and the reputation of psychiatry in the medical world had hit an extreme low.[42]

Psychiatry, like most medical specialties, has a continuing, significant need for research into its diseases, classifications and treatments.[75] Psychiatry adopts biology's fundamental belief that disease and health are different elements of an individual's adaptation to an environment.[76] But psychiatry also recognizes that the environment of the human species is complex and includes physical, cultural, and interpersonal elements.[76] In addition to external factors, the human brain must contain and organize an individual's hopes, fears, desires, fantasies and feelings.[76] Psychiatry's difficult task is to bridge the understanding of these factors so that they can be studied both clinically and physiologically.[76]

Psychiatrists are medical doctors and can order or perform a variety of medical and/or psychological tests. These tests, combined with conversations about symptoms and medical and family history, allow psychiatrists to diagnose mental health conditions.

Some psychiatrists also complete fellowship programs to specialize in a particular area of psychiatry, such as child and adolescent psychiatry, which focuses on the mental health in the pediatric population, or consultation liaison psychiatry, which studies the interface of physical and mental health in the medical population.

The historical line aims to rediscover and unearth the lost practices of psychiatry and psychology pioneered by Muslim scholars of different fields in Islamic history that allude to the significance of mental health as an integral part of premodern Islamic culture. These practices encompassed basic mental healthcare, as well as how mental illnesses were perceived, classified, diagnosed, and treated at the time. This research sheds light on the forgotten significance of mental health that is now common in modern Muslim cultures. To date, the lab has reviewed and synthesized over 200 medical manuscripts written from between the 6th and 17th centuries. 041b061a72


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