Psychiatry

Psychiatry is a medical specialty that deals with four areas: prevention and research ( epidemiology ), further diagnostics and treatment (therapy) of psychiatric syndromes. TheTERM was introduced into psychiatry in 1808 by Johann Christian Reil and is a combination of the Greek psyche (ψυχὴ), meaning soul or spirit and iatros what doctor means (literally medicine of the soul). The main aim of psychiatry is to relieve psychological suffering which is a consequence of psychiatric disorders and increase psychological well-being of the psychiatric patient and his surroundings.



Content
 ==[Treatment  edit ] == Psychiatry basically makes use of the medical approach, but it has its own characteristics which in many ways different from that of somatic medicine. Treatments can include various modalities including different kinds of talk therapy, nonverbal therapy, medications such as antipsychotics , antidepressants , sedatives, and anxiolytics . In psychiatry, may in Belgium and Netherlands - as indeed in somatic medicine - people are held against their will and sometimes treated as if it is possible that they suicidal or (severe) automutilation want to commit or others like murder or mutilate [1] . Forced treatment is taking much less readily available than compulsory admission, which in many cases by doctors and family members of patients is regretted that should stand idly by in some cases how someone ruins themselves. There go in counseling and in politics vote on the possibilities to extend to compulsory treatment. [2]
 * 1 Treatment
 * The second major problem in psychiatry
 * 3 Diagnostics
 * 3.1 DSM
 * 4 Domains
 * 5 Common psychiatric disorders
 * 6 Compulsion
 * 6.1 Detention (IBS)
 * 6.2 law authorization (RM)
 * 6.3 Criminal
 * 7 Anti-Psychiatry
 * 8 Further criticism
 * 9   Training

Psychiatry is practiced by psychiatrists, but there are also many other practitioners dealing with psychiatric patients, who otherwise mostly "clients" are mentioned in this field. Numerically this is even more than in the majority. Examples include clinical psychologists and gz-psychologists, but also social-psychiatric nurses (Netherlands), psychiatric nurses , therapists , occupational therapists , social therapists , social workers andsocial workers . The psychiatrist - a doctor and nurse specialist - will be solely entitled to prescribe medication.

As in all medicine is also true in psychiatry that serious, virtually untreatable psychiatric illnesses and ailments go away, and / or are treatable. For some conditions exist which the drugs with varying successsymptoms suppress and sometimes can be phased out after a certain period. The effectiveness of medication varies from individual to individual, and often it is a test treatment is the only way to find out if there occurs effect. Drugs that cure in the sense that they are "the cause" of the disease remedy exist in psychiatry yet. ==The core problem of psychiatry [  edit <span class="mw-editsection-bracket" style="color:rgb(85,85,85);">] == <p style="margin-top:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">A major problem, perhaps the key problem in psychiatry is that the causes of most mental illnesses are not well known and in no way truly be understood until the bottom. A disease classification ( nosology ) such that usually resides in somatic medicine on an obvious cause or underlying mechanism is in psychiatry (yet) feasible. Therefore adopts a disease classification in psychiatry mainly emanates from the (group of) symptoms (see DSM-IV-TR). There is a lot of research done and still ongoing, including in many diseases biochemical abnormalities, genetic factors and environmental factors have been found associated with the disease, but a clear, demonstrable cause-effect relationship is usually not the case.

<p style="margin-top:0.5em;margin-bottom:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">Also always arises whether physical abnormalities, eg in the brains would be, cause or consequence of the disease. Over the centuries, therefore, for almost any psychiatric illness many assumptions made ​​about the cause, which are strongly subject to fashion and for which there is usually no evidence can be produced. There have been that mental illness periods especially in the area were blamed on the situation in the family of the patient as a child, to heredity, and go back to continue the history of possession by demons, etc. For most diseases, there besides various explanatory models that sometimes complementary and sometimes contradictory.

<p style="margin-top:0.5em;margin-bottom:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">Nowadays, especially the 'Biological Psychiatry' entrance, which suggests that most if not all psychiatric illnesses a pathological process underlying the brains. The underlying philosophical position that the mind only manifests itself thanks to underlying physical structures (the brains) is not accepted by everyone, and the debate actually has been raging since Descartes . The brains are very complex organ, which is not easily lend itself to research on living human beings. Nevertheless, there are in practicalTERMS a number of major successes in the treatment with drugs of the main 'big' psychiatric illnesses, depression andschizophrenia . The symptoms of these conditions can now be controlled with relatively high efficiency, so that for example people with psychosis tend nowadays no longer, as 50 years ago, for the rest of their life in a mental hospital arrive. ==<span class="mw-editsection" style="-webkit-user-select:none;font-size:small;margin-left:1em;line-height:1em;display:inline-block;white-space:nowrap;unicode-bidi:-webkit-isolate;font-family:sans-serif;"><span class="mw-editsection-bracket" style="color:rgb(85,85,85);">[Diagnostics  edit <span class="mw-editsection-bracket" style="color:rgb(85,85,85);">] == <p style="margin-top:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">Any form of rational medicine may only begin if there is a method exists to group patients with similar disorders under aDIAGNOSIS. Only then is it possible to get people with the sameDIAGNOSIS treatments set and systematically evaluate how well these work. To this it has suspended for a long time in psychiatry. Only by psychiatrists as Emil Kraepelin and later Eugen Bleuler, attempts were made ​​to design a system of psychiatric diagnoses. Traditionally, every psychiatrist had its own method for diagnoses and to establish which methods also differed greatly between countries and between schools in psychiatry. The diagnosis of schizophrenia meant, in Europe for example, something very different than in the United States . This makes it very difficult to determine whether a treatment has been in the clinic, one could also be useful in other, because in the clinic might be a totally different group of people were included that diagnosis. ===DSM <span class="mw-editsection" style="-webkit-user-select:none;font-size:small;margin-left:1em;line-height:1em;display:inline-block;white-space:nowrap;unicode-bidi:-webkit-isolate;"><span class="mw-editsection-bracket" style="color:rgb(85,85,85);">[  edit <span class="mw-editsection-bracket" style="color:rgb(85,85,85);">] === <p style="margin-top:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">To a stop to this confusion is called the Diagnostic and Statistical Manual of Mental Disorders (DSM) created. The current version is the DSM-5, which was completed in 2013 and in some areas major differences from the fourth edition. DSM-5 was published in 2014 in Dutch. In the DSM diagnoses are all operationally defined, that is, someone who talks to the patient and the book in your hand (or head) in the ideal case any diagnosis can tell whether it can be made ​​or not, and research by several doctors in the same patient in fact lead to the same diagnosis. This is an ideal that can never be reached, as also almost all psychiatric symptoms can occur in varying degrees, from normal to clearly pathological. When is someone pathologically jealous, gloomy or morbid? The assessment of whether an individual symptom is present in someone can therefore vary between different observers.

<p style="margin-top:0.5em;margin-bottom:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">There are many lists of symptoms in the DSM, in which the patient there is often some must have decided for theDIAGNOSIS can be made while there are usually a number of secondary symptoms of which may further support theDIAGNOSIS.

<p style="margin-top:0.5em;margin-bottom:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">The DSM does not claim the reason to know of the images described; it is purely an attempt to promote compliance by patients with similar symptoms also have a similar diagnosis, so that they can be treated with methods that have been investigated in a similar group of people and whoWORKED with it. The DSM is a nomenclature. The DSM also uses a multi-axis diagnosis of the patient in order to describe the situation as accurately as possible. It is not only looked at the immediate problem, but also on the personality structure, environmental factors, physical illness and suffering workload that situation.

<p style="margin-top:0.5em;margin-bottom:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">The DSM is therefore a descriptive list of mental disorders, for example depression , neurosis , psychosis , aboulie , OCD , schizophrenia , personality disorders, etc., such as, inter alia, in the Western world to prevent and have been investigated. (In countries with non-Western cultures sometimes phenomena that are psychiatric in nature in Western eyes but are placed within that culture in a different context, such as faith in winti in Suriname). The DSM will regularly (about every ten years), revised as insights about which properties are characteristic of a particular image change. This should of course not often happen because there is no scientific research can be set up based on a diagnosis and that diagnosis in the meantime is constantly changing. ==Areas <span class="mw-editsection" style="-webkit-user-select:none;font-size:small;margin-left:1em;line-height:1em;display:inline-block;white-space:nowrap;unicode-bidi:-webkit-isolate;font-family:sans-serif;"><span class="mw-editsection-bracket" style="color:rgb(85,85,85);">[  edit <span class="mw-editsection-bracket" style="color:rgb(85,85,85);">] == <p style="margin-top:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">Within psychiatry, the following areas can be distinguished.

<p style="margin-top:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">Besides psychiatric sub- specialties have also disciplines such as neurology , neurosurgery and psychology much common ground with psychiatry. ==Common psychiatric syndromes <span class="mw-editsection" style="-webkit-user-select:none;font-size:small;margin-left:1em;line-height:1em;display:inline-block;white-space:nowrap;unicode-bidi:-webkit-isolate;font-family:sans-serif;"><span class="mw-editsection-bracket" style="color:rgb(85,85,85);">[  edit <span class="mw-editsection-bracket" style="color:rgb(85,85,85);">] == <p style="margin-top:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">Psychiatric disorders manifest themselves in the course of life in a large percentage of the population. Approximately 0.5-1.1% of the population worldwide and in all societies, suffers from schizophrenia <sup class="reference" id="cite_ref-3" style="line-height:1;unicode-bidi:embed;">[3] <sup class="reference" id="cite_ref-4" style="line-height:1;unicode-bidi:embed;">[4] . A large part of the people make at least once in his or her life a depression, and at any time is approximately 5% of the depressed population <sup class="reference" id="cite_ref-5" style="line-height:1;unicode-bidi:embed;">[5] . Additionally come phobias and severe personality disorders very common. ==<span class="mw-editsection" style="-webkit-user-select:none;font-size:small;margin-left:1em;line-height:1em;display:inline-block;white-space:nowrap;unicode-bidi:-webkit-isolate;font-family:sans-serif;"><span class="mw-editsection-bracket" style="color:rgb(85,85,85);">[Compulsion  edit <span class="mw-editsection-bracket" style="color:rgb(85,85,85);">] == <p style="margin-top:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">A forced hospitalization in psychiatry is legally possible in three ways: ===Detention (IBS) <span class="mw-editsection" style="-webkit-user-select:none;font-size:small;margin-left:1em;line-height:1em;display:inline-block;white-space:nowrap;unicode-bidi:-webkit-isolate;"><span class="mw-editsection-bracket" style="color:rgb(85,85,85);">[  edit <span class="mw-editsection-bracket" style="color:rgb(85,85,85);">] === <p style="margin-top:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">A detention is the patient against his will with the written permission of the mayor, if necessary, temporarily placed with the help of police in a closed ward of a psychiatric clinic . Within five days an appointed lawyer visits the patient in the clinic. Two days after that comes the right buttons inTERMS of possible legitimate IBS. He can reverse or continue. Often in the presence of the psychiatrist of the department and family as the parents of the client. The session often takes less than 20 minutes. The judge comes with clerk and attorney to the clinic and maintains there an official session. The judge makes his decision almost always immediately known and the patient always receives an official letter containing the ruling.
 * Primary Psychiatry
 * Forensic psychiatry
 * Child and adolescent psychiatry
 * Geriatric Psychiatry
 * Neuropsychiatry
 * Social psychiatry
 * Transcultural Psychiatry
 * Hospital Psychiatry

<p style="margin-top:0.5em;margin-bottom:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">After removal of an IBS patient can go to an open ward for further treatment and can leave the ward by appointment. He can escape the treatment. ===Judicial authorization (RM) <span class="mw-editsection" style="-webkit-user-select:none;font-size:small;margin-left:1em;line-height:1em;display:inline-block;white-space:nowrap;unicode-bidi:-webkit-isolate;"><span class="mw-editsection-bracket" style="color:rgb(85,85,85);">[  edit <span class="mw-editsection-bracket" style="color:rgb(85,85,85);">] === <p style="margin-top:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">A court order is an authorization from the court to forced hospitalization in a closed ward of a psychiatric hospital. He is given after examination by the court and after the patient is heard. The mandate will be granted only in very severe and longer lasting psychological dislocation where the patient is arguably a danger to themselves and / or their environment.

<p style="margin-top:0.5em;margin-bottom:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">If one RM is imposed, the patient continues for as long as is deemed necessary there on a closed section. Treatment such as medication can only be given to avert immediate danger, or in agreement on. ===Criminal <span class="mw-editsection" style="-webkit-user-select:none;font-size:small;margin-left:1em;line-height:1em;display:inline-block;white-space:nowrap;unicode-bidi:-webkit-isolate;"><span class="mw-editsection-bracket" style="color:rgb(85,85,85);">[  edit <span class="mw-editsection-bracket" style="color:rgb(85,85,85);">] === <p style="margin-top:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">By order of the court may anyone under Article 37 of the Criminal Code be enforced for a year included in a psychiatric institution . This is only possible if the person is a danger to himself or others, or a threat to the general safety of people or goods. Condition is that the discretion existing offense, the person can not be attributed due to the lack of development or pathological disturbance of the faculties. ==Anti Psychiatry <span class="mw-editsection" style="-webkit-user-select:none;font-size:small;margin-left:1em;line-height:1em;display:inline-block;white-space:nowrap;unicode-bidi:-webkit-isolate;font-family:sans-serif;"><span class="mw-editsection-bracket" style="color:rgb(85,85,85);">[  edit <span class="mw-editsection-bracket" style="color:rgb(85,85,85);">] == <p style="margin-top:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">In the 70's was a movement that became known as the anti-psychiatry . She had severely criticized the traditional medical approach of psychiatry of that time. An important exponent was Ronald Laing, who is not himself charged to the anti-psychiatry. In the Netherlands, received the young psychiatrist Jan Foudraine with his book Who is wooden attention to a different way of thinking about mental disorders. A book adaptation resulting from the anti-psychiatry's One Flew Over the Cuckoo's Nest .

<p style="margin-top:0.5em;margin-bottom:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">While in psychiatry boosting personal discussion currently - partly because of the emergence of a primary "organic" based approach - seems largely died down, have a different level of psychiatrists as Stanislav Grof, Arno Gruen and Horst-Eberhard Richter, the issue of mental ( public) health now redefined as one of the main core issues of the secular, highly industrialized and globalized society. <sup class="reference" id="cite_ref-6" style="line-height:1;unicode-bidi:embed;">[6] <sup class="reference" id="cite_ref-7" style="line-height:1;unicode-bidi:embed;">[7] <sup class="reference" id="cite_ref-8" style="line-height:1;unicode-bidi:embed;">[8] ==Further criticism <span class="mw-editsection" style="-webkit-user-select:none;font-size:small;margin-left:1em;line-height:1em;display:inline-block;white-space:nowrap;unicode-bidi:-webkit-isolate;font-family:sans-serif;"><span class="mw-editsection-bracket" style="color:rgb(85,85,85);">[  edit <span class="mw-editsection-bracket" style="color:rgb(85,85,85);">] == <p style="margin-top:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">Much criticism and debate has focused on the efficacy, side effects and the routine use of psychiatric medications. Critics question whether psychiatric drugs do indeed have the effect being claimed. It is claimed that manufacturers have exerted influence on scientific research on the efficacy of drugs, for example to cover up reported side effects (increased risk of suicide in certain anti-depressants, especially among young people). Hard evidence for this cover, as indeed the claimed increased suicidality <sup class="reference" id="cite_ref-9" style="line-height:1;unicode-bidi:embed;">[9], is missing. The enthusiastic stories shortly after coming out of many products on the market such as the antidepressants from the group of the SSRI 's have led to its use grew explosively. This is a phenomenon that occurs in many drugs. Almost always, it follows a few years later a counter-reaction, the drug still appears also side effects have advantages and disadvantages and not toWORK as well as everyone wanted to believe. <sup class="reference" id="cite_ref-10" style="line-height:1;unicode-bidi:embed;">[10] Such a situation seems at the moment to act in the use of resources as Ritalin for ADHD, aDIAGNOSIS that is made ​​with more and more children who used simply as 'difficult' would be appointed.

<p style="margin-top:0.5em;margin-bottom:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">Furthermore, there is in many psychiatric disorders, particularly depression, a natural tendency to cure or at least improved, and, although the added value of antidepressant in a large number of double-blind,randomizedTRIALS it has been shown, it is the difference with the non-treated control group by no means always spectacular. <sup class="reference" id="cite_ref-11" style="line-height:1;unicode-bidi:embed;">[11] <sup class="reference" id="cite_ref-12" style="line-height:1;unicode-bidi:embed;">[12] <sup class="reference" id="cite_ref-13" style="line-height:1;unicode-bidi:embed;">[13] <sup class="reference" id="cite_ref-14" style="line-height:1;unicode-bidi:embed;">[14]

==Education <span class="mw-editsection" style="-webkit-user-select:none;font-size:small;margin-left:1em;line-height:1em;display:inline-block;white-space:nowrap;unicode-bidi:-webkit-isolate;font-family:sans-serif;"><span class="mw-editsection-bracket" style="color:rgb(85,85,85);">[  edit <span class="mw-editsection-bracket" style="color:rgb(85,85,85);">] == <p style="margin-top:0.5em;line-height:22.3999996185303px;color:rgb(37,37,37);font-family:sans-serif;font-size:14px;">A recognized training in psychiatry started in the Netherlands and Flanders after obtaining the basic medical degree. It is a Master -after-Master training, so include:
 * Critics also point to problems with the reliability of the entire diagnostic system of psychiatry (Williams et al, 1992; McGorry et al, 1995; Hirschfeld et al, 2003]).
 * Some psychiatrists are also not convinced of the 'biological hypothesis' which was mentioned in the introduction.
 * There is also repeatedly stressed the history of psychiatry, in which many atrocities were committed, including the lightly used electroshock and brain surgery.
 * Under certain political systems in the past under the guise of psychiatry - with or without the consent and participation of psychiatrists - excesses occurred, as in Hitler's Germany, in the Soviet Union under Stalinand even beyond. Notorious is also highly controversial and secret Project MK-ULTRA and particularly the role that the then leading American psychiatrist Donald Ewen Cameron filled it with his so-called Psychic driving experiments.
 * There is evidence that advanced psychotherapy may be more effective in acute psychosis than just medical treatment, even in the acute phase (first three weeks) of an image <sup class="reference" id="cite_ref-15" style="line-height:1;unicode-bidi:embed;">[15] . In addition, there is evidence that the use of antipsychotics increases the risk of chronic disease, it can have some serious side effects (including Neuroleptic malignant syndrome ) and may include in older users lead to a premature death.<sup class="reference" id="cite_ref-16" style="line-height:1;unicode-bidi:embed;">[16] <sup class="reference" id="cite_ref-17" style="line-height:1;unicode-bidi:embed;">[17] <sup class="reference" id="cite_ref-18" style="line-height:1;unicode-bidi:embed;">[18] The British government organization National Institute for Health and Clinical Excellence (Nice) is attempting healthcare now with guidelines to be encouraged to improve access to psychotherapeutic treatment of schizophrenia. <sup class="reference" id="cite_ref-19" style="line-height:1;unicode-bidi:embed;">[19]


 * University of Antwerp
 * University of Amsterdam
 * Vrije Universiteit Brussel
 * Ghent University
 * University of Groningen
 * Leiden University
 * Maastricht University
 * Catholic University of Leuven
 * Erasmus MC - University Medical Center Rotterdam
 * Utrecht University
 * Radboud University Nijmegen