Portal:Psychiatry/Selected article

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Portal:Psychiatry/Selected article/1
Vincent van Gogh's 1890 painting  At Eternity's Gate
Major depressive disorder (MDD) (also known as recurrent depressive disorder, clinical depression, major depression, unipolar depression, or unipolar disorder) is a mental disorder characterized by an all-encompassing low mood accompanied by low self-esteem, and by loss of interest or pleasure in normally enjoyable activities. This cluster of symptoms (syndrome) was named, described and classified as one of the mood disorders in the 1980 edition of the American Psychiatric Association's diagnostic manual. The term "depression" is ambiguous. It is often used to denote this syndrome but may refer to other mood disorders or to lower mood states lacking clinical significance. Major depressive disorder is a disabling condition which adversely affects a person's family, work or school life, sleeping and eating habits, and general health. In the United States, around 3.4% of people with major depression commit suicide, and up to 60% of people who committed suicide had depression or another mood disorder
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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 DSM-IV-TR, almost exclusively refers to self-mutilation. The term is synonymous with "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, 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 clear-cut 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.
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Portal:Psychiatry/Selected article/3
Auguste D aus Marktbreit.jpg
Alzheimer's disease(AD), also called Alzheimer disease, senile dementia of the Alzheimer type, primary degenerative dementia of the Alzheimer's type, or simply Alzheimer's, is the most common form of dementia. This incurable, degenerative, and terminal disease was first described by German psychiatrist and neuropathologist Alois Alzheimer in 1906 and was named after him. Most often, it is diagnosed in people over 65 years of age, although the less-prevalent early-onset Alzheimer's can occur much earlier. In 2006, there were 26.6 million sufferers worldwide. Alzheimer's is predicted to affect 1 in 85 people globally by 2050.

Although the course of Alzheimer's disease is unique for every individual, there are many common symptoms. The earliest observable symptoms are often mistakenly thought to be 'age-related' concerns, or manifestations of stress.

In the early stages, the most common symptom is inability to acquire new memories, observed as difficulty in recalling recently observed events. When AD is suspected, the diagnosis is usually confirmed with behavioural assessments and cognitive tests, often followed by a brain scan if available.

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Portal:Psychiatry/Selected article/4
Cloth embroidered by a patient diagnosed with schizophrenia
Schizophrenia (/ˌskɪtsɵˈfrɛniə/ or /ˌskɪtsɵˈfrniə/) is a mental disorder characterized by a disintegration of thought processes and of emotional responsiveness. It most commonly manifests as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, and it is accompanied by significant social or occupational dysfunction. The onset of symptoms typically occurs in young adulthood, with a global lifetime prevalence of about 0.3–0.7%. Diagnosis is based on observed behavior and the patient's reported experiences.

Genetics, early environment, neurobiology, and psychological and social processes appear to be important contributory factors; some recreational and prescription drugs appear to cause or worsen symptoms. Current research is focused on the role of neurobiology, although no single isolated organic cause has been found. The many possible combinations of symptoms have triggered debate about whether the diagnosis represents a single disorder or a number of discrete syndromes. Despite the etymology of the term from the Greek roots skhizein (σχίζειν, "to split") and phrēn, phren- (φρήν, φρεν-; "mind"), schizophrenia does not imply a "split mind" and it is not the same as dissociative identity disorder—also known as "multiple personality disorder" or "split personality"—a condition with which it is often confused in public perception.

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Sertraline Structural Formulae.png
Sertraline hydrochloride (brand names Zoloft and Lustral) is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class. It was introduced to the market by Pfizer in 1991. Sertraline is primarily used to treat major depression in adult outpatients as well as obsessive–compulsive, panic, and social anxiety disorders in both adults and children. In 2007, it was the most prescribed antidepressant on the U.S. retail market, with 29,652,000 prescriptions.

The efficacy of sertraline for depression is similar to that of older tricyclic antidepressants, but its side effects are much less pronounced. Differences with newer antidepressants are subtler and also mostly confined to side effects. Evidence suggests that sertraline may work better than fluoxetine (Prozac) for some subtypes of depression.[1] Sertraline is highly effective for the treatment of panic disorder, but cognitive behavioral therapy is a better treatment for obsessive-compulsive disorder, whether by itself or in combination with sertraline.[2] Although approved for social phobia and posttraumatic stress disorder, sertraline leads to only modest improvement in these conditions.

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Portal:Psychiatry/Selected article/6
Opening a window to the autistic brain.jpg
Autism therapies attempt to lessen the deficits and family distress associated with autism and other autism spectrum disorders (ASD), and to increase the quality of life and functional independence of autistic individuals, especially children. No single treatment is best, and treatment is typically tailored to the child's needs. Treatments fall into two major categories: educational interventions and medical management. Training and support are also given to families of those with ASD.

Studies of interventions have methodological problems that prevent definitive conclusions about efficacy. Although many psychosocial interventions have some positive evidence, suggesting that some form of treatment is preferable to no treatment, the methodological quality of systematic reviews of these studies has generally been poor, their clinical results are mostly tentative, and there is little evidence for the relative effectiveness of treatment options. Intensive, sustained special education programs and behavior therapy early in life can help children with ASD acquire self-care, social, and job skills,[3] and often can improve functioning, and decrease symptom severity and maladaptive behaviors; claims that intervention by around age three years is crucial are not substantiated. Available approaches include applied behavior analysis (ABA), developmental models, structured teaching, speech and language therapy, social skills therapy, and occupational therapy. Educational interventions have some effectiveness in children: intensive ABA treatment has demonstrated effectiveness in enhancing global functioning in preschool children, and is well-established for improving intellectual performance of young children.[4] Neuropsychological reports are often poorly communicated to educators, resulting in a gap between what a report recommends and what education is provided. The limited research on the effectiveness of adult residential programs shows mixed results.

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Portal:Psychiatry/Selected article/7
Ritalin.jpg
Methylphenidate (Ritalin) is a psychostimulant drug approved for treatment of attention-deficit hyperactivity disorder, postural orthostatic tachycardia syndrome, and narcolepsy. It may also be prescribed for off-label use in treatment-resistant cases of lethargy, depression, neural insult and obesity. Methylphenidate belongs to the piperidine class of compounds and increases the levels of dopamine and norepinephrine in the brain through reuptake inhibition of the monoamine transporters. Methylphenidate (MPH) possesses structural similarities to amphetamine and its pharmacological effects are more similar to those of cocaine, though MPH is less potent and longer in duration of action.
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Portal:Psychiatry/Selected article/8
1956 Alaska Mental Health Enabling Act.JPG
The Alaska Mental Health Enabling Act of 1956 (Public Law 84-830) was an Act of Congress passed to improve mental health care in the United States territory of Alaska. It became the focus of a major political controversy[5] after opponents nicknamed it the "Siberia Bill" and denounced it as being part of a communist plot to hospitalize and brainwash Americans. Campaigners asserted that it was part of an international Jewish, Roman Catholic or psychiatric conspiracy intended to establish United Nations-run concentration camps in the United States.

The legislation in its original form was sponsored by the Democratic Party, but after it ran into opposition, it was rescued by the conservative Republican Senator Barry Goldwater. Under Goldwater's sponsorship, a version of the legislation without the commitment provisions that were the target of intense opposition from a variety of far-right, anti-Communist and fringe religious groups was passed by the United States Senate.[6] The controversy still plays a prominent role in the Church of Scientology's account of its campaign against psychiatry.

The Act succeeded in its initial aim of establishing a mental health care system for Alaska, funded by income from lands allocated to a mental health trust. However, during the 1970s and early 1980s, Alaskan politicians systematically stripped the trust of its lands, transferring the most valuable land to private individuals and state agencies. The resulting drop in funding led to a severe effect on the provision of mental health care in Alaska. The asset-stripping was eventually ruled to be illegal following several years of litigation, and a reconstituted mental health trust was established in the mid-1980s.

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Portal:Psychiatry/Selected article/9
St Petersburg Psychiatric Hospital of Specialized Type with Intense Observation.JPG
In the Soviet Union, systematic political abuse of psychiatry took place. Political abuse of psychiatry is the misuse of psychiatric diagnosis, detention and treatment for the purposes of obstructing the fundamental human rights of certain groups and individuals in a society. In other words, abuse of psychiatry including one for political purposes is deliberate action of getting citizens certified, who, because of their mental condition, need neither psychiatric restraint nor psychiatric treatment.[11] Many authors, including psychiatrists, use the terms "Soviet political psychiatry" and "punitive psychiatry" instead. In the book Punitive Medicine by Alexander Podrabinek, the term “punitive medicine” identified with the term “punitive psychiatry” is defined as “a tool in the struggle against dissidents who cannot be punished by legal means.”[24]:63 Punitive psychiatry is not a special subject, not some special psychiatry but a phenomenon arising with many applied sciences in totalitarian countries where they are often forced to serve a criminal regime.

Psychiatric confinement of sane people is uniformly considered a particularly pernicious form of repression and Soviet punitive psychiatry was one of the key weapons of both illegal and legal repression. Soviet psychiatric hospitals were used by the authorities as prisons in order to isolate hundreds or thousands of political prisoners from the rest of society, discredit their ideas, and break them physically and mentally. This method was also employed against religious prisoners, including especially well-educated former atheists who adopted a religion; in such cases their religious faith was determined to be a form of mental illness that needed to be cured.

Following the fall of the Soviet Union, it was often reported that some opposition activists and journalists were detained in Russian psychiatric institutions in order to intimidate and isolate them from society. In modern Russia, the fact that a person is a human rights defender again means that the person risks receiving a psychiatric diagnosis.

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Portal:Psychiatry/Selected article/10
Narrenturm Vienna June 2006 575.jpg
Anti-psychiatry is a configuration of groups and theoretical constructs that emerged in the 1960s, which challenged the fundamental assumptions and practices of psychiatry and sought to develop alternatives. Its igniting intellectual influences were Michel Foucault, R.D. Laing, Thomas Szasz and Franco Basaglia. The term was first used by the psychiatrist David Cooper in 1967.

The anti-psychiatry movement says that the specific definitions of, or criteria for, hundreds of current psychiatric diagnoses or disorders are vague and arbitrary, leaving too much room for opinions and interpretations to meet basic scientific standards. They also say that prevailing psychiatric treatments are ultimately far more damaging than helpful to patients.

Some mental health professionals and academics profess anti-psychiatry views, as do a number of former and current users of psychiatric services. Some critics focus their attention on what is known as biological psychiatry.

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  1. ^ Cite error: The named reference pmid10529069 was invoked but never defined (see the help page).
  2. ^ O'Kearney, R. T.; Anstey, K.; Von Sanden, C.; Hunt, A. (2006). "Behavioural and cognitive behavioural therapy for obsessive compulsive disorder in children and adolescents". In O'Kearney, Richard T. Cochrane Database of Systematic Reviews (4): CD004856. doi:10.1002/14651858.CD004856.pub2. PMID 17054218.  edit
  3. ^ Cite error: The named reference CCD was invoked but never defined (see the help page).
  4. ^ Cite error: The named reference Rogers was invoked but never defined (see the help page).
  5. ^ "One of the most controversial pieces of legislation tackled by Congress in 1956" - Congressional Quarterly Almanac, 1957; quoted in Felicetti, Daniel A., Mental health and retardation politics: the mind lobbies in Congress, p. 27. Praeger, 1975. ISBN 0-275-09930-X.
  6. ^ Nickerson, Michelle M. "The Lunatic Fringe Strikes Back: Conservative Opposition to the Alaska Mental Health Bill of 1956", in The Politics of Healing: histories of alternative medicine in twentieth-century North America, ed. Robert D. Johnston, pp. 117-152. Routledge, 2004. ISBN 0-415-93338-2.