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Psychiatry is a science focused on mental disorders and diseases, their diagnosis and treatment. Mentally ill patients are often stigmatized, and psychiatrists are treated only as prescribers. Such positions are definitely unfair - after all, a psychiatric patient is not different from an internal medicine patient, and psychiatrists do not only order medications to patients. In fact, psychiatry is now recognized - and for good reason - as one of the main pillars of modern medicine.

Psychiatryis included not only among the basic medical disciplines, but most likely it is the branch of medicine with which the greatest controversy is associated. For many people, the role of psychiatry in modern medicine is greatly underestimated, and wrongly. This science - contrary to appearances - began to function basically in the most distant times, and what is more, psychiatry is constantly developing. The history of the development of each medical discipline can certainly be considered interesting, however, the history of psychiatry is in some ways special.

List of summaries

  1. Psychiatry: history
  2. Criticism of psychiatry: the anti-psychiatric movement
  3. Psychiatry: the range of diseases
  4. Psychiatry: treatment methods used in psychiatry
  5. Psychiatry: prospects for this science in the future

Psychiatry: history

The functioning of the human body, both in physiological and pathological conditions, interested even prehistoric researchers. Contrary to appearances, however, they de alt not only with the bodily aspects, but also with the functioning of the human mind. Basically, mental problems have already been mentioned by Hippocrates (who for the first time used terms such as melancholy, paranoia or phobia), but also by Celsus, Aristotle and Galen.

In the case of primitive peoples, but also in the Middle Ages, people experiencing mental disorders were treated as possessed by ghosts or demons. One can even mention here how in the Middle Ages women who were mentally ill were considered witches - they usually met a very unpleasant fate, because such women were, for example, drowned, and sometimes even burned at the stake. The history ofpsychiatrywas also influenced by religion - often problems,which we would now consider to be a mental illness, in medieval times were considered possession by the devil.

In the 17th century, one of the first centers for the treatment of mentally ill patients was established. Such were established, among others in London and Paris. It was certainly a positive step in the development of psychiatry, but unfortunately it was not without its problems. In the case of these facilities, there were many negative opinions about the quality of treatment they provided.

Over time, the number of psychiatric facilities grew and newer theories related to the functioning of the human mind appeared (one can mention here the father of psychoanalysis, that is, Freud). The view on the pathogenesis and course of various mental illnesses has changed - here it is worth mentioning the works of Kraeplin and Schneider, who de alt with the issues of psychoses, including schizophrenia in particular.

The 20th century can be considered a time when many good and unfortunately bad things happened inpsychiatry . In the 1950s, psychiatric treatment fundamentally changed completely - it was then that the first antipsychotics and antidepressants began to become available. However, the 20th century is the time of the Second World War, during which mentally ill patients were treated with extremely unfavorable treatment. The Germans sometimes considered such people as people who should not be living at all. In turn, in the USSR, during the war, the term "asymptomatic psychosis" was introduced - as you can easily guess, the existence of this type of "disease entity" could have led to many abuses that were dangerous in its consequences.

So far, not a word has been mentioned about Polish psychiatry. The development of psychiatry definitely took place in our country as well, and mental diseases were de alt with by many respected specialists. One can mention here, for example, Jan Mazurkiewicz or Tadeusz Bilikiewicz, but special attention should be paid to another psychiatric authority - Antoni Kępiński. This Polish psychiatrist went down especially in the history of medicine not only because of his scientific achievements, but also because of his attitude towards the sick. Antoni Kępiński, first of all, believed that the most important thing is respect for other people - including those who are mentally ill. He also emphasized the importance of accepting the condition of patients and their problems.

Criticism of psychiatry: the anti-psychiatric movement

Psychiatry is criticized by many different people, but a particular aversion to this disciplinepeople belonging to the so-called the anti-psychiatric movement. Antipsychiatry had its origins in the 1960s and one of its main activists was Thomas Szasz, a psychiatrist by education.

According to the anti-psychiatric movementpsychiatryis merely a pseudoscientific discipline. Movement activists believe that, in fact, the diagnosis of mental illnesses is extremely subjective, and the drugs administered to patients are simply ineffective. Antipsychiatry also draws attention to the fact that psychiatric classifications are based on generally accepted principles and standards, so that people - he althy according to antipsychiatrists - may be wrongly considered to be people with mental problems.

Currently - due to the fact that various grounds of mental illnesses are better and better discovered, as well as the fact that psychiatric treatment is effective, in fact, antipsychiatry has lost its importance. However, psychiatrists still do not know everything, after all, some mental illnesses and their causes are insufficiently understood, and therefore constantly ( although much less often than in the past) one can encounter criticism of psychiatry by anti-psychiatric movements.

Psychiatry: the range of diseases

Some people think that psychiatrists only deal with depression and schizophrenia - but this is definitely not the case. The list of various mental disorders de alt with by the above-mentioned specialists is exceptionally long. Psychiatry is a science that focuses on the issues of mood disorders, eating disorders, but also sleep disorders and sexual disorders. Only a modest range of psychiatric units is presented here, but it is worth adding that psychiatrists treat patients of all ages. Specialists in this field can conduct therapy both in children and in young adults or the elderly.

Psychiatry: treatment methods used in psychiatry

The criticism of psychiatry by some circles certainly had its origins in the methods of treatment used by psychiatrists. Fortunately, insulin coma or lobotomy are no longer practiced methods of psychiatric treatment. Currently, psychiatrists have many other - not only safer, but also more effective - therapeutic methods.

It has sometimes been considered that psychiatric treatment is based on administering drugs to patients. Indeed, in modernpsychiatrypharmacotherapy plays a significant role, although this is because of the effects that can be achieved thanks to such treatment. In psychiatrypsychotropic drugs are used mainly, including:

  • antidepressants
  • antipsychotics (neuroleptics)
  • sedatives (such as benzodiazepines)
  • mood-normalizing drugs (e.g. lithium s alts)

Pharmacotherapy is definitely not the only treatment option that psychiatrists offer to patients. In addition to pharmacological treatment, psychotherapy is the second therapeutic pillar in psychiatry. There are many types of psychotherapy, such as, for example, cognitive psychotherapy, systemic therapy and behavioral therapy. Psychoeducation is also of great importance for the condition of patients.

Other methods of treating mental illnesses are used much less frequently than the above mentioned ones. We are talking about electroconvulsive therapy or psychosurgery.

Mental diseases can be treated both in outpatient and inpatient settings. The choice depends primarily on the patient's condition. Mild depressive or psychotic disorders - as long as the patient visits a doctor regularly - can be treated in a mental he alth clinic. In the case of people whose mental state is severe and the symptoms are extremely severe, hospitalization may be more beneficial.

Psychiatric hospitals are sometimes associated as exceptionally gloomy facilities and as places where all rights of patients are violated. Such an opinion is extremely unfair, because currently the quality of psychiatric care - although still insufficient - is constantly improving. The use of direct coercion by psychiatrists or the admission of patients to psychiatric hospitals against their will may have negative associations. However, it is worth mentioning here that the conditions of their application are regulated by the Mental He alth Act, and in addition, the above-mentioned ones are used only when the situation absolutely requires it.

Psychiatry: who are psychiatrists? How to become a psychiatrist?

Psychiatry is one of the compulsory subjects in the study program of medicine. After completing these 6-year studies and completing a postgraduate, 13-month internship, a young doctor may choose to specialize in psychiatry. It is worth adding that people planning to deal with mental he alth have two options: they can train in adult psychiatry, but they can also choose child and adolescent psychiatry as their specialization. Eventually - after a few years of specialization - the doctor becomes a psychiatrist.

A psychiatrist definitely has to be a doctor, but he can also become a psychotherapist. However, for this to happen, the psychiatrist must undergo a course of psychotherapy himself.

Psychiatry: prospects for this science in the future

From its beginnings, psychiatry has undoubtedly experienced an extraordinary development. Currently, we are learning more and more dependencies between inherited genes and mental diseases, in addition, thanks to more and more modern imaging techniques, it becomes possible to detect deviations specific for various units, either in morphology or in the functioning of the central nervous system.

Constant development also applies to some areas related to psychiatry. For example, psychogeriatry is more and more often distinguished, dealing with mental problems of old age. Neuropsychiatry, which combines psychiatry and neurology, is also gaining more and more importance.

One thing can be said for sure: we already know quite a lot about psychiatry, the functioning of the human mind and the abnormalities related to it. However, this knowledge is still not complete, so we can only expect that the development of psychiatry will continue and that mental diseases will become less and less enigmatic for science. Sources:1. Psychiatry, scientific editor M. Jarema, J. Rabe-Jabłońska, ed. PZWL, Warsaw 20112. Psychiatry, B.K. Puri, I. H. Treasaden, eds. Ed. Polish J. Rybakowski, F. Rybakowski, ed. Elsevier Urban & Partner, Wrocław 2014

About the authorBow. Tomasz NęckiA graduate of medicine at the Medical University of Poznań. An admirer of the Polish sea (most willingly strolling along its shores with headphones in his ears), cats and books. In working with patients, he focuses on always listening to them and spending as much time as they need.

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