Talk:Psychiatry/Archive 7

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The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.


Article rewrite (10-17-07)

I, along with some other editors, have rewritten the article to address concerns listed above. All the new contributions have been referenced (nearly every sentence). The "Treatment settings" subsection still needs to be reworked. Further edits improving the rewrite are very much welcomed. Thanks, Chupper 00:05, 18 October 2007 (UTC)

Congratulations on moving forward with your hard work. I'm glad you kept in the section on professional ethics. Good luck to all in dealing with the anti-P and other controversies. Best wishes, HG | Talk 03:39, 18 October 2007 (UTC)
Thanks for your compliments HG. The article still needs a lot of work, even the sections I've rewritten, so I hope others continue revising. But hopefully we should be better than we were. Chupper 01:23, 23 October 2007 (UTC)

Weasel worded statement

User:scuro recently tagged the sentence "Psychiatry's shift to the hard sciences was thought by many to signify psychiatrists' lack of concern for their patients.[17]" with a weasel word tag. Scuro, I've changed the sentence to "Psychiatry's shift to the hard sciences had been interpreted as a lack of concern for patients.[17]" Originally I intended for that weasel worded statement to exist from a historical context, and didn't recognize the problem. The way it is worded now should be more specific in that the switch was interpreted as a lack of concern - maybe not by all - but it was interpreted that way by at least some. I'm looking at the source right now and it doesn't state who these people were, but I'm assuming they mean other mental health professionals, antipsychiatry apologetics, patients and others in society. In other words, some people interpreted it this way, but there is no standard label or stereotype I would be able to apply. And again, this is speaking from a historical context. Does it read better now? Chupper 03:59, 18 October 2007 (UTC)

The weasel word tag actually shows as "attribution" on the article page. That sentence is quite a statement and I simply wanted to know who stated it.--00:05, 21 October 2007 (UTC) —Preceding unsigned comment added by Scuro (talkcontribs)
I think the rewrite is very good. But I do with Scuro that the sentence needs attribution. The second statement is just as weaselly as the first, even if it is more specific. Any wording like "was interpreted" or "has been interpreted" are, by definition, weasel words unless the statement is commonly accepted information , like "there is night and there is day". Mattisse 13:20, 23 October 2007 (UTC)

ECT & no evidence of brain damage

I noticed that scuro also changed the sentence discussing ECT & brain damage to state that there is no evidence that it causes brain damage and referred me to the ECT page. My reference stated that there was little evidence, but I had a feeling they just couldn't find any. Three distinct references from the APA (which is linked to on the ECT page) state that there is no evidence of brain damage from ECT. I transferred those references to this article so that statement is clearly referenced. Since my reference didn't state that I wanted to get one in here which clearly specified that. Now we've got three :). Thanks scuro. Chupper 04:13, 18 October 2007 (UTC)

Not a problem. :)--scuro 00:02, 21 October 2007 (UTC)

ECT induces seizures. Seizures have, in fact, been shown to cause brain damage. It isn't a profound logical step to then assume that ECT causes brain damage. —Preceding unsigned comment added by 69.29.26.85 (talk) 21:41, 24 February 2008 (UTC)

Using that logic, bumping your head causes brain damage as does several alcoholic drinks...perhaps even a powerful sneeze. I did work extensively on the wiki ECT article and we researched this issue. You may want to look at the talk pages. I saw no medical or scientific body make the statement that ECT causes brain damage although I saw citations and reviews which stated the opposite..--scuro (talk) 22:23, 24 February 2008 (UTC)

Odd sentence

Psychiatry is one of the few medical specialties with a continuing, significant demand for research investigating its related diseases, classifications, origins, and treatments - erm, not sure exactly what this sentence means but I can't see a field of medicine where this doesn't apply...cheers, Casliber (talk · contribs) 13:48, 23 October 2007 (UTC)

Yea, here is an example of a sentence I needed to word better. Basically I was meaning to say that Psychiatry's research demand is so high because so little is known about the disorders themselves as well as treatments. Although you are right, almost all medical specialties have significant demand for research. Maybe it should be changed to Psychiatry, like many medical specialties, has a continuing, significant demand for research investigating its related diseases, classifications, origins, and treatments  ??? Chupper 15:27, 23 October 2007 (UTC)
Am thinking when expanded and explained the sentence can be dispensed with eventually but sounds a bit better and will do for now. going in the right direction anyway. cheers, Casliber (talk · contribs) 03:55, 24 October 2007 (UTC)

Just some thoughts on the article's references

Is it weird to have like half the references from the same source? I mean, the article looks like it is (mostly) well referenced, but if half of those are from the same source, doesn't it kind of dilute it? Is there some style guide over how to not over-reference a single source? Rhetth 16:23, 23 October 2007 (UTC)

No there isn't but I am aware of it. If/when this ever goes to FAC it will be about 1.5 times as long and have a whole bunch of other refs. I often put in sources like these as place-holders until better ones turn up. cheers, Casliber (talk · contribs) 21:42, 23 October 2007 (UTC)
Well, this depends. Like Casliber says it needs a lot of expansion for a FAC and more references will come. But if you compare it to the number of refs beforehand, it has improved dramatically. The bottom line is during the rewrite I only had access to about 16 books. Of those maybe 70% contained information helpful to the article. And I'm not sure half the references are the "same source". Beyond " A History of Psychiatry: From the Era of the Asylum to the Age of Prozac", I'm actually seeing a good variety of references. From a historical context I wasn't able to find a book much better than that one. It just presents so much information from an analytical perspective. And remember to differentiate the frequency references are used vs. the number of references. One of the reason that the History of Psychiatry book is listed so frequently is because page numbers were used in the references. That causes a lot of material in the same section to "look" the same. Of course, Rhetth, you are always welcome to add in more material with other references. Chupper 23:52, 23 October 2007 (UTC)

Reintroduction of controversy section

User:Mihai cartoaje recently reintroduced the controversy section back into the article. I left a message on his talk page about this. I don't see why we need to make the article worse again by segregating POV content into one section. Some other editors, along with myself, spent a lot of time trying to integrate these points throughout the article. I even added more "controversy" stuff by including more detail on the Rosenhan experiment. Am I way off base here, or haven't we already integrated everything??? Chupper (talk) 17:32, 23 November 2007 (UTC)

I haven't simply reintroduced the Controversy section; I also made additions. --Mihai cartoaje (talk) 01:49, 24 November 2007 (UTC)
And these "additions" aren't mentioned in the rest of the article? Mihai cartoaje, controversy sections should not be used in Wikipedia. First of all, I'll address these "additions":
There exist movements opposed to the practices of – and, in some cases, the existence of – psychiatry. These movements mostly originated in the 1960s and 1970s. Presently antipsychiatry encompasses a broad range of professional views, including a scholarly journal devoted exclusively to criticism of biopsychiatry, Ethical Human Psychology and Psychiatry[82], published by ICSPP.
"This is already mentioned in the history section. Chupper (talk) 07:50, 24 November 2007 (UTC)
I haven't added this but copied it from a previous version. I didn't know what to do with this. Anti-psychiatry is mentioned in the history section, but it seems to be something current and not only historical. It seemed unsuitable to have a controversy section with no mention of anti-psychiatry. --Mihai cartoaje (talk) 08:59, 25 November 2007 (UTC)
Right, but in the history section it states this is where anti-psychiatry movements emerged, not emerged and died out. No where in the prose does it say these movements no longer exist. Compare this to the biological perspective of psychiatry. It is also discussed at great length in the history section, but that doesn't mean its historical. We're just presenting its roots.
The point is the article dedicates an entire subsection to the anti psychiatry movement and a fabulous picture which says "Psychiatry kills". I don't know why you keep pushing this idea of having a "controversy" section. Wikipedia's NPOV policy page clearly discusses how "Segregation" of text or other content into different regions or subsections, based solely on the apparent POV of the content itself should be avoided. Chupper (talk) 19:36, 25 November 2007 (UTC)
The efficacity, adverse effects and the widespread and growing use of psychiatric medications has been challenged. The close relationship between psychiatry (and those prescribing psychiatric medication such as general physicians) and pharmaceutical companies has become increasingly controversial; same for the influence pharmaceutical companies are exerting on mental health policies [83] [84]. Pharmaceutical companies censored opposing ideas: [85]. Studies of pharmacogenetic polymorphism indicate that people of various ethnicities have an increased risk of side effects and toxicity.
POV. Who is it controversial to? Chupper (talk) 07:50, 24 November 2007 (UTC)
In the first case, I only copied it. In the second case, everyone with a conscience, and that is enough people for it to have two article citations.--Mihai cartoaje (talk) 08:59, 25 November 2007 (UTC)
Just stating its controversial means you are using weasel words. In addition this article isn't about psychopharmacology, its about psychiatry. While psychopharmacology is a big treatment option in psychiatry, its not the only one. I would think this would be better included in the psychopharm or psychiatric medication articles after the weasel words are removed. If it is to be included here, the same thing goes - weasel words need to be included, and it should be integrated into an appropriate section, such as "Treatment". Chupper (talk) 19:36, 25 November 2007 (UTC)
I found a citation for "The close relationship between psychiatry (and those prescribing psychiatric medication such as general physicians) and pharmaceutical companies has become increasingly controversial": [1]. --Mihai cartoaje (talk) 06:31, 28 November 2007 (UTC)
What "influence"?Chupper (talk) 07:50, 24 November 2007 (UTC)
The title of the first article says it: "Pharmaceutical Industry Agenda Setting in Mental Health Policies". For the exact method, you would have to read the article. From the second article, "The National Alliance on Mental Illness, an outspoken patient advocate, lobbies for treatment programs that also benefit its drug-company donors." --Mihai cartoaje (talk) 08:59, 25 November 2007 (UTC)
Fair enough, see above comments. Chupper (talk) 19:36, 25 November 2007 (UTC)
This is whole section is POV. And why is "Studies of pharmacogenetic polymorphism indicate that people of various ethnicities have an increased risk of side effects and toxicity" included? Are you trying to make a point here? Chupper (talk) 07:50, 24 November 2007 (UTC)
I only copied that. --Mihai cartoaje (talk) 08:59, 25 November 2007 (UTC)
So, why does it need to be included? I'm assuming you mean it doesn't. Chupper (talk) 19:36, 25 November 2007 (UTC).
In addition, the diagnostic reliability (Williams et al, 1992; McGorry et al, 1995; Hirschfeld et al, 2003]), has been challenged, especially when comparing the criteria of the different psychiatric manuals (van Os et al, 1999) .[86]
Rosenhan info already included. This adequately covers that topic. Chupper (talk) 07:50, 24 November 2007 (UTC)
This was copied from a previous version. --Mihai cartoaje (talk) 08:59, 25 November 2007 (UTC)
Again, so why does it need to be included? Chupper (talk) 19:36, 25 November 2007 (UTC)
Another concern centers on the issue of involuntary commitment, which centers on issues of civil liberties and personal freedoms.
This article isn't a list of complaints about psychiatry. This is something adequately covered in anti psychiatry and involuntary commitment. If this MUST be included in this article, it belongs somewhere else should be integrated. Chupper (talk) 07:50, 24 November 2007 (UTC)
I copied this. This is something psychiatry survivors sometimes complain about, though. --Mihai cartoaje (talk) 08:59, 25 November 2007 (UTC)
There have been multiple reports of wrongful treatments in psychiatry [87] [1] [2].
This information is already included. Chupper (talk) 07:50, 24 November 2007 (UTC)
It has been included for developping countries not western societies. --Mihai cartoaje (talk) 08:59, 25 November 2007 (UTC)
I'm not sure you've taken a close look. Read this: Incidents of physical abuse by psychiatrists took place during the reign of some totalitarian regimes as part of a system to enforce political control with some of the abuse even continuing to our present day.[50] Historical examples of the abuse of psychiatry took place in Nazi Germany [51], in the Soviet Union under Psikhushka, and in the apartheid system in South Africa.[52] It never states these just happened or still only happen in western societies. It just says its happened and it still happens. Theres even a "non western society country" included as an example. Both "non western society countries" and "western society contries" are included as examples. Chupper (talk) 19:36, 25 November 2007 (UTC)
Second, please stop trying to use this controversy section as your own POV fork, or should I say soapbox. One of the big reasons this article was rewritten was to integrate this info to the rest of the article and eliminate the "controversy" section. Honestly, the fact that you feel the need to consistently reintroduce it is making me a bit angry. Chupper (talk) 07:50, 24 November 2007 (UTC)

Is there anyone else who has an opinion on this? --Mihai cartoaje (talk) 08:59, 25 November 2007 (UTC)

Well, lets find out. I'll create a new section below to get some more opinions. Chupper (talk) 19:36, 25 November 2007 (UTC)

Should we reintroduce "Controversy" section?

Mihai cartoaje has essentially proposed the reintroduction of a controversy section into this article. During the article rewrite I, along with another editor, tried to integrate these controversy points throughout the article. I even created a whole subsection called "Anti-psychiatry and deinstitutionalization". However, this doesn't seem to make everyone happy and I'm aware that others have different opinions. So I wanted to try and establish a consensus as to how to move forward.

Please state whether you believe the controversy section should be reintroduced, why or why not, and if you think it should be then what it should include or what should be moved back into it.
  • Don't include controversy section. Here's why:
    • I have always felt that controversy and criticism sections conflict with WP:NPOV (see - WP:NPOV#Article structure & WP:NPOV#Undue weight).
    • In addition the controversy section of this article in the past has become a soapbox for several editors. Sections like these, and in this specific situation, encourage unhelpful and POV edits, IMO. (Take a look at the edit history or past few archived talk pages)
    • All relevant information has been integrated into other parts of the article. Specifically, take a look at the lead section - 2nd paragraph, "Anti-psychiatry and deinstitutionalization" section, "Ethics" section, and "Transinstitutionalization and the aftermath" section. Future additions could also be easily introduced into appropriate sections.
Chupper (talk) 19:36, 25 November 2007 (UTC)
  • Oppose controversy section. On my last review of the article (a few days ago) I was amazed by the balance it has finally struck between the mainstream "we look after people with mental illness" and the controversial "psychiatrists are in the pay of the drug industry and administer SSRI/CBT/ECT inappropriately". This is a well-sourced, balanced, warts-and-all account that does not need a new "controversy" section. It complies very well with Wikipedia:Guidelines for controversial articles, and obviously WP:NPOV. Controversy sections are evil. JFW | T@lk 20:09, 25 November 2007 (UTC)

(edit conflict)

  • Don't include controversy section. for all the reasons Chupper has expressed plus the following:
Every discipline has controversy. For some reason Psychiatry has become a focal point for social and political criticisms that are not specific to Psychiatry but may apply equally to Psychology or other mental health fields, or even social policies as a whole. The term "Psychiatrists" is often applied in a very loosely when describing political behaviors that have nothing to do with Psychiatry as a scientific field. I do not think it falls under the label of "controversy" that the field of Psychiatry is still evolving and that there may be differing views, just as there are in Physics. If I go to the article, Physics, I want to learn what the field of physics encompasses, not all the squabbles, controversies, fringe theories or a section on "Controversies" about how physicists should bear moral blame for inventing the Bomb or are tearing down our moral fabric by reducing God to sub particles etc. IMO, this should be a clear, concise article on what the field of Psychiatry encompasses including differing views without sensationalizing it or turning Psychiatry into a politics. Mattisse 20:25, 25 November 2007 (UTC)
  • Don't include controversy section, but pls be willing to elaborate on controversial issues, as long as they are not given weight. I think the current rewrite, kudos to Chupper, sets out a strong framework for the article and elegantly incorporates several key controversies. Nonetheless, there may be other controversial issues that deserve to be woven into the article (without the need for a separate section). For instance, you might consider mentioning concerns over pharmacological treatments and linking to more expansive coverage elsewhere. Likewise, involuntary commitment. Furthermore, is there any reason the Ethics section can't be expanded a bit? For instance, I see no other place to mention notable political abuses of psychiatry, as in Punitive psychiatry in the Soviet Union. (FYI Chupper msg'ed me about commenting, since I had previously added Ethics and worked on the controversy section.) Thanks. HG | Talk 21:33, 25 November 2007 (UTC)
  • Oppose a separate reintroduction of controversy section as to how it stands now. There may be some scope for ethical issues to be talked about under General Considerations and other stuff sprinkled through the text in context, or possibly better as a heading in this area and raised in more detail. As it stands there needs to be a little more elaboration of the critiques in appropriate places. I am a bit busy for a couple of weeks but will try to do what I can.cheers, Casliber (talk · contribs) 22:09, 25 November 2007 (UTC)

Chupper has canvassed all your talk pages. And Chupper and Casliber had a conflict of interest. --Mihai cartoaje (talk) 02:36, 10 February 2008 (UTC)

Erm, I am not opposed to material being in the article, but mainly to the use of a controversy section as a heterogeneous dumping ground of all that's bad with psychiatry. Yes I am in the profession but I am also quite familiar with the weight of the material etc. cheers, Casliber (talk · contribs) 02:59, 10 February 2008 (UTC)
Casliber and myself don't have a conflict of interest. That statement makes no sense. And I have canvassed all of his talk pages? What the hell are you talking about? Chupper (talk) 03:47, 11 February 2008 (UTC)
  • Include: there can be sourced notable content about controversies and as such it can be added on Wikipedia. --Mihai cartoaje (talk) 06:53, 28 November 2007 (UTC)
    • Comment - Mihai cartoaje, thanks for your comments, but you have failed to address the issue at hand. Sourced, notable content about controversies can be added and is included. We are trying to determine whether the Controversy section needs to be reintroduced. I know the current stance seems to be not to include it, but I'm still curious why you feel this section could be included...? Chupper (talk) 00:12, 29 November 2007 (UTC)
  • Comment - on the subject of Involuntary commitments - the problem in the United States is that it is not possible to involuntarily commit a person for any length of time, other than incarceration as a law enforcement issue having nothing to do with psychiatry. (The only exception is the commitment in some states of repeat sex offenders. Also, in most states (I know it may be different in other countries) by far the greatest amount of involuntary holds are by police. Also, psychologists, social workers, and others can involuntarily commit (depending on the jurisdiction) and no one can be committed for more than a short time (72 hours in my state) without a court order. Mattisse 00:05, 29 November 2007 (UTC)

Update

OK - Mihai please don't attempt to override consensus - now see where I have placed drug controversy and also we do need to discuss ethics of involuntary treatment and patient incarceration under inpatient treatment - all other controversies I believe are mentioned though the text. In this way the pros and cons of each issue can be touched upon without some clumsy controversy section tacked on at the bottom.cheers, Casliber (talk · contribs) 14:04, 28 November 2007 (UTC)

Per my comment above, in the United States at least, involuntary commitment is really not an issue of abuse. Rather, the opposite is the case. The homeless population is blamed on the closing of so many state hospitals so that the mentally ill are turned out on the street (where they might prefer to be anyway). As for other countries, I don't know. But I do not think that political abuse should be blamed on psychiatrists. Mattisse 00:10, 29 November 2007 (UTC)
  • Comment - Thomas Szasz is a psychiatrist. Since he has earned that distinction, it would seem wrong to describe him only under a section for "critics" or "anti-psychiatrists". But if Szasz's beliefs should be detailed in the main section, then what cannot be? But then again, where in the main section should this be covered? On a related note, I'd also inquire about "the anti-psychiatry movement" mentioned in the text. Should there be an article anti-psychiatry movement? Should it be merged into this one as a subsection? Or is the concept ludicrous - a lumping of Daniel Defoe and Szasz and Zhores Medvedev and surrealists and Scientologists all into one assemblage that never met? (Based on the latter thought perhaps the text needs a rework...) While I cannot but marvel at the long succession of discredited ideas, mythological ailments, and pathological cures offered up in psychiatry, it seems like a field too weakly or inconsistently grounded on any theoretical basis to be universally wrong, or to have a unified opposition. 70.15.116.59 (talk) 15:55, 8 January 2008 (UTC)
There has been talk to turn Biopsychiatry controversy into Controversies in Psychiatry (or under a better name). That could be a generic article on the ethical, scientific and theoretical problems with psychiatry. Already there is a section on the criticism of genetics theory, chemical imbalance theory and a stub on the pharmacy industry. In this article the "big names" in psychiatric discourse could be named without disturbing this article which is about the "status quo" of psychiatry. --Benjaminbruheim (talk) 23:57, 8 January 2008 (UTC)

I must comment that, it is biased to have controversy sections for other articles, but not for this one. As long as the information is cited and verifiable, it should be included. What makes a good encyclopedia is citing sources and including relevant information. 64.236.121.129 (talk)16:41, 16 January 2008 (UTC)

Usually you have to argue for controversy sections. That's what we are or were doing here. You can't just argue that because other articles have them, this one should. If you have other reasons, please lay them out. Otherwise, Wikipedia has yet to create a "conform to other articles" policy. And the "As long as the information is cited and verifiable, it should be included." isn't correct. It shouldn't always be included, especially if its POV, or landing undue weight. Chupper (talk) 00:26, 17 January 2008 (UTC)
Incorrect. NPOV doesn't mean "No point of view". Criticisms may be added if they are cited and verifiable. Praise or endorsement may also be added under the same guidelines. Malamockq (talk) 03:16, 11 February 2008 (UTC)
What is incorrect? Just because something can be cited doesn't mean it should be included. Thats the bottom line. And lets all not forget here - didn't I include significant content discussing other points of view THROUGHOUT the article?
But what are we actually talking about here!!??!! There's a difference between whether to include content and whether or not to have a criticism section. We're discussing the latter. Chupper (talk) 03:47, 11 February 2008 (UTC)
My opinion is that problematic aspect of the psychiatry should be made addressed in the main part of the article. Putting them in the criticism section or even worse in a separate page may mislead people (and commenter) in thinking that they are just opinion of somebody who like to criticize the psychiatry. If we do not speak of what I euphemistically can generically refer to as "side effect" of the psychiatry, we were not give knowledge about what psychiatry is. It would be as if we, speaking of a diesel engine or a jet engine, we want to move the fact that the expel exhaust gas in the air to a criticism section or to a separate article on the ground that this is a criticism by some environmentalism organization. -- AnyFile (talk) 11:52, 14 February 2008 (UTC)

RfC on Talk:Biopsychiatry controversy

An RfC has been created on Talk:Biopsychiatry controversy on the subject: "Is the majority viewpoint of the psychiatric profession, and particularly of the psychiatric research community, that the biopsychiatric model of psychiatry is, by and large, accepted or rejected?" Comments from editors involved in this article/project may prove useful. HrafnTalkStalk 06:49, 6 January 2008 (UTC)

Neurology

Is it worth putting a section about the overlap of psychiatry with neurology. Does any body know to what extent this is? —Preceding unsigned comment added by 217.35.93.92 (talk) 23:42, 6 January 2008 (UTC)

I'm not sure if it needs its own section, but I think this is discussed somewhat in the history section and theory and focus section. Do you think it needs to be expanded? Chupper (talk) 00:58, 8 January 2008 (UTC)
I recall that in Germany the two fields are combined (?) - need a ref and someone familair with the german health care system to confirm this. cheers, Casliber (talk · contribs) 01:27, 17 January 2008 (UTC)

ECT and quality of life

This recent edit made me curious. I find conflicting report in literature. So stating it outright that it is the "best" treatment is problematic and seems defensive and should be attributed. Ie. some studies state that satisfaction is a complex factor, whilst other studies suggest that magnetic stimulation to be just as effective. The side effects are also reported to be stronger in qualitative studies. This makes me think that the current strong wording is inappropriate since the issue is complex; at least in an article on psychiatry, and not ECT. --Benjaminbruheim (talk) 19:32, 7 January 2008 (UTC)

I know I didn't even notice that addition until now. While the ref seems reputable, there is sometimes conflicting evidence for certain statements. If I have time, or if you want to, try to find some meta-analyses discussing ECT and maybe we can get a bigger picture. If I remember right - in my own personal studies - ECT is about the same as some antidepressants+psychotherapy combos. Of course this varies from person to person, but this might be something good to look at with a larger scale. Chupper (talk) 00:56, 8 January 2008 (UTC)
Checking Cochrane would be best. AFAIR it is at its least ambiguous with melancholia with psychotic features where there is immediate risk (by suicide or not eating) or with catatonia from whatever cause. As one moves farther from these diagnoses it becomes less clear-cut. Sever depression is certainly a bigger category than either of teh above categories and a more consensus based reference would be preferable than one recent study. cheers, Casliber (talk · contribs) 01:26, 17 January 2008 (UTC)

(outdent)...interesting things on cochrane [2] but not what I want immediately...I'll keep looking. cheers, Casliber (talk · contribs) 01:33, 17 January 2008 (UTC)

I've removed the ECT & quality of life statement. ECT is a controversial treatment and it being a treatment for depression or it increasing quality of life are two totally different things. Based upon the edits removing it and complaining about it, I think consensus would argue we would need a solid meta-analysis used as a reference to keep a statement such as this in the article. Chupper (talk) 14:18, 30 January 2008 (UTC)

Biology's fundamental belief ?

I'm a bit concerned about this statement. "Psychiatry falls into biology's fundamental belief that disease and health are different elements of an individual's adaptation to an environment." I think its a stretch to call this a "fundamental belief" of biology. I'm not certain it's accurate to say that the biological disciplines have any "beliefs" in the usual sense. What is the intent here? Bryan Hopping T 04:41, 17 January 2008 (UTC)

This is a paraphrase of the source - Guze, S. B. (1992). Why Psychiatry is a Branch of Medicine. New York: Oxford University Press, p 130. ISBN 978-0-19-507420-8. I'll see if I can't get a hold of it again and further analyze what was meant by this. Chupper (talk) 15:25, 25 January 2008 (UTC)
I'm sure that it makes perfect sense in the original source. It just seems a bit out of context here. It would be great if we could clarify. Bryan Hopping T 15:43, 25 January 2008 (UTC)

bridge?

What does the following sentence, the second sentence of the article, mean?

The art and science of the clinical application of psychiatry has been considered a bridge between the social world and those who are mentally ill

I really can not understand the ontological meaning of this sentence, but perhaps it is too much to ask for ontological meaning in the description of a subject that chose for itself a metaphysic name (psyche). And in the sentence there are abstract and metaphorical words with no explanation (bridge, social world, those who are mentally ill).

On a more practical level, this sentence is in contrast with Avoid peacock terms and Avoid weasel words policies.

Why is the clinical application of psychiatry believed to be an art and science? The fact that who practice this discipline want themselves seen in this way, this does not make the psychiatry an art or a science. More precisely the assertion of being scientific, while lacking real independent proof of that, is a clear symptom (to use term surely understandable by physician) of pseudoscience. Since the only available alleged scientific proofs in psychiatry are only auto-referential, psychiatry has a demonstrable level of science no more than astrology or homeopathy. -- AnyFile (talk) 09:16, 15 February 2008 (UTC)

Here goes the crap again!!! It's the return of Anyfile! Sorry, I guess I shouldn't be so sarcastic, but I guess I'm just getting tired of these "metaphysical", "scientific proofs" [sic], and "pseudoscience" crap allegations. Anyfile, your dream may soon come true, and you may in fact drive me from editing Wikipedia :). Why? Because I actually waste my time and respond to your biased, one-sided and debate driven questions.
Well, lets take a look at that sentence you are talking about in the lead section. Note that lead sections are summaries of whats in the article. So to get a better understanding, lets go to the part of the article it is summarizing.
Psychiatry, a word coined by Johann Christian Reil in 1808, has historically been seen as a specialty of medicine which acted as an intermediary between the world from a social context and the world from the perspective of those who are mentally ill.[1] Those who practice psychiatry are different than most other mental health professionals and physicians in that they must be familiar with both the social and biological sciences.[2] The discipline is interested in the operations of different organs and body systems as classified by the patient's subjective experiences and the objective physiology of the patient.[3]
So what does it mean? Well here's two options, listen to me, or wait, this is original, go to the source thats cited and see the original context! Since I'm 99.8% sure you won't do the latter, you can just listen to me :). Have you ever met someone who is suffering schizophrenia, Anyfile? Or, how about depression? I have! Several times! Those poor folks suffer from delusions and hallucinations. Some of them think that the prison staff was God. Others think they live in space. Or how about those who are depressed? Oh yes, they are in touch with reality, but maybe too much. They suffer extreme sadness to the point its painful, and terrible and they can't even function in life. Who tries and helps these people? Who tries to communicate with them? The answer? Good ole' mental health professionals. They have to create this 'bridge' and connect with their patients and clients. So why is psychiatry seen as a bridge? Because its one of the few connections between society and those suffering from mental disorders. Maybe scan over the early history section and see how society used to deal with those suffering from psychotic disorders. I can tell you they didn't try to connect, and it wasn't pretty.
Alright, moving right along... Um.... How can I say this nicely... How in the hell are "bridge", "social world", and "mentally ill" peacock terms or weasel words? I mean seriously? Peacock terms are biased, ultra positive statements. Like "Psychiatry is the best thing in the world!" There is a peacock term. Or a weasel word? "Critics argue that psychiatry is bullshiz." There is a weasel word (critics argue). I think Anyfile is pissed off because others have changed or removed your edits citing policy, and now you want some revenge! Well, GO ANYFILE! YAY!
OK, on your last thing. Anyfile, psychiatrists and researchers involved with psychopharmacology have constantly said (in references, I used one in the article), that while research that goes into medicine is scientific, the treatment for it can be a totally different thing. What do I mean by this? Well here's a quote from the article. "...psychiatry also recognizes that the environment of the human species is complex and includes physical, cultural, and relational elements.[4] In addition to external factors, the human brain must recognize or organize an individual's hopes, fears, desires, fantasies and feelings.[4] Psychiatry's difficult task is the attempt to envelop the understanding of these factors so that they can be studied both clinically and physiologically.[4]. Does that sound like an art to me? Hmm.. yes. Trying to help a caseload of 20-30 patients and doing whatever you can to help them - is that science or art? Probably both.
And, here goes your crap again. Big time crap. So much crap, in fact, its dripping from the ceiling. You said Since the only available alleged scientific proofs in psychiatry are only auto-referential. How much more wrong could you be!!!! Psychiatry and its research are interdisciplinary! How many times is that mentioned throughout the article? How many times is it referenced?
Uh oh! Here comes even more crap! So much crap I can't even breathe! Like I take a breath, and little crap particles get into my respiratory system. "More precisely the assertion of being scientific, while lacking real independent proof of that, is a clear symptom (to use term surely understandable by physician) of pseudoscience." Anyfile, guess what! You win! Psychiatry is a pseudoscience! YAYAYAYAY! Here it is, I'm saying it, Anyfile is saying it! No one can get in our way! All citizens of the world, bow down to us and heed our commands! Psychiatry is a pseudoscience!
Alright, maybe I shouldn't be so mean. Maybe folks could even say I'm attacking other editors (through my sarcasm), more specifically, you, Anyfile. And you know what? They would be right! Why am I doing this? Why am I finding this so comical? Why am I hoping that when you read this you get mad? Here's why - We have had this discussion several times. Each time, I take out several hours to respond to you, politely, and address your concerns. I use references to show I'm not the only one. I try to remain unbiased.
But to you, Wikipedia is a soapbox, and will always be such. Why? Because even after addressing all of your concerns, you wait. You wait, several months. Then you come back, rehash and restate the same complaints again, and again, and again, and again, and again, and again. So, back in our discussion, it looks like you have conceded, and you realize you can't be biased here on Wikipedia. But, hey, if you wait a few months, complain about something else, and reinsert your old rhetoric, and no one refutes it (because at some point, someone won't have the time), then you'll finally get your way, because you have, then, at that point, created the image that you are correct. But my friend, you are wrong. Go back through the archives or to your talk page, and on your next reply, let me know what the article count (in peer reviewed journals, that is) was for articles focused on psychiatric research. Come on Anyfile, what was the number?
I'm done. Chupper (talk) 15:01, 15 February 2008 (UTC)
I am sorry if this is against what you your desire, but if the aim of writing this article is that somebody who read it can understand, than it is important if the second sentence of this article is understandable or not. If a person many year ago has written a sentence saying that psychiatry is bridge, this sentence does not make psychiatry a bridge. -- AnyFile (talk) 16:51, 15 February 2008 (UTC)
To answer your question I have many people "helped" by psychiatrist. Me included. No one of them was saying that a stuff was god. Some of them have problems, some of them were sad, but the pshychiatrists were not helping them (and me), but just creating more problem to them. Perhaps there are some people who really get benefit from psychiatrists, but why psychiatrists should use the same system on people who get only harm and sad from that? And to make thing more clear, I would not here to write this if I were not been victim of this system. -- AnyFile (talk) 16:57, 15 February 2008 (UTC)
Regarding the bridge thing - it is called using figurative language, or a "figure of speech". It is not a literal meaning. Take a look at Literal and figurative language. Chupper (talk) 13:30, 16 February 2008 (UTC)



The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

Dual dx

I just ran into Dual diagnosis which is orphaned. It is a pretty significant topic in psychiatry and I found no mention of it here either. Shouldn't it be? JoeSmack Talk 16:15, 22 February 2008 (UTC)

It is no longer orphaned, but it could probably still stand to be mentioned in several other articles, including this one. -Lilac Soul (talk contribs count) I'm watching this page so just reply to me right here! 20:21, 27 February 2008 (UTC)

What about a link to the Rosenhan experiment. That should be quite valid. —Preceding unsigned comment added by 92.40.16.212 (talk) 23:49, 14 December 2009 (UTC)

antipsychiatry picture

Hello all, I really don't like the fact that the antipsychiatry part is illustrated with a picture of scientologist activists. Scientology uses psychotests that are 1. in the field of psychiatry and 2.far worse in its material effect than psychiatry itself. I will therefore delete the picture from the article if no one has a claim for it. Karibou (talk) 02:30, 16 May 2008 (UTC)

I understand your concern and am aware that those in the anti-psychiatry movement and scientologists are two very different camps. The picture was originally included because, simply, it was a good illustration of a group of people protesting psychiatry. Rather than just removing it though, please replace it with another free image. Chupper (talk) 00:22, 17 May 2008 (UTC)
It's a well known fact that many leading anti-psychiatry groups activley wish not to be associated with Scientology or the CCHR. An image dotted with Scientologists would work to represent the entire anti-psychiatry movement as merely cult-driven nonsense and propaganda-pandering.


It's a good idea, I'll look for another picture :). Karibou (talk) 15:10, 17 May 2008 (UTC)

Sorry, I couldn't find any other picture.. I think it would be better to delete this picture anyway, as the scientology has a practice of psychiatry in itself. —Preceding unsigned comment added by Karibou (talkcontribs) 12:10, 27 May 2008 (UTC)

You could probably get permission for free use of a pic from these guys MindFreedom media, I guess they could be considered the leading secular org routinely protesting these issues, they organised a widely-reported "hunger strike" a few years ago. EverSince (talk) 11:47, 13 June 2008 (UTC)

Intro

I'd like to suggest that the introduction could be more of a general summary of each section of the main article, as per Wiki guidelines I believe, and not incorporate so many cited points (which I believe should be within each section instead). I could make such changes if no objections. EverSince (talk) 23:35, 10 June 2008 (UTC)

Citations in the lead is an ongoing headache. I personally don't like them, adhering to the idea that anything in the lead should be in the body of the article and hence cited there instead. However, the current guidelines note that material likely to be challenged should be cited in the lead as well. Given this is such a contentious topic, my gut feeling would be to leave them there. As far as I can see, the lead is a summary of each section, though streamlined so it is seamless. What are yoy proposing to add or remove? Cheers, Casliber (talk · contribs) 00:03, 11 June 2008 (UTC)
Only the points likely to be challenged need be cited in the intro. Based on past debates here over certain introductory claims, I can see that one or two key citations might be needed. It shouldn't be filled up with them so that no other intro appears possible, when in fact the intro is meant to reflect the article as it evolves. EverSince (talk) 02:07, 11 June 2008 (UTC)
O-kay...which do you think need to go and which to remain then? Cheers, Casliber (talk · contribs) 02:29, 11 June 2008 (UTC)
...i'm not trying to specify in advance what exactly should be there, I can't, just saying that there's currently too many & many not in the main article, and I'd like to just see how it goes trying to merge the sources into the right point in the article and resummarising that and see what people may want to revert or revise in the usual wiki way. EverSince (talk) 03:19, 11 June 2008 (UTC)
Sorry guys to jump in here, I just thought I would make a quick comment. I used to be one of those people who didn't cite in the lead. It is a summary, right? So why cite a summary when its cited in detail below? But I've gone through two GA noms now and a couple of peer revies and both times the reviewers made a big deal out of citing the lead. So now I've made it a habit to cite stuff in the lead. Unless things are changing, if this article goes to GA nomination or FA nomination, reviewers are going to want the lead cited. For the record, I feel like it shouldn't be, but I've wasted too much time thus far to go back and find the citations for everything. Chupper (talk) 14:20, 11 June 2008 (UTC)
Oh, and one more thing in terms of "summarization" - The first paragraph of the lead should be a summary. You'll find all these points in the article. The second paragraph has turned into a summary of the history section. Eversince, you should be able to find the cited points throughout the article. They should not just exist in the lead. The lead might need to be reorganized though. The first paragraph should probably be expanded to include more points from the article. Chupper (talk) 14:24, 11 June 2008 (UTC)
I agree about reorganising the 1st para a little to include more of the points from the article. And perhaps in turn the history summary could become a bit briefer. I take your point about reviewers possibly wanting certain cites and as I say I can see that certain ones may be necessary (and wouldn't be difficult to copy more over if necessary). An extremely contested article like evolution which is FA class doesn't have any cites in the 1st paragraph though, and only half as many as this one in the rest - and a lot of those are covering very technical claims rather than general description of a profession as is the case here. I for one appreciate the effort you put into sourcing this article more and I see that the majority are also in the article so it shouldn't be too bad to reorganise a bit without losing anything you did. EverSince (talk) 15:20, 11 June 2008 (UTC)

Removal of Anti Psychiatry material

This is an article on psychiatry no antipsychiatry. for original research and POV of psyhiatry there's already a page on that. —Preceding unsigned comment added by 64.235.220.41 (talk) 20:02, 21 June 2008 (UTC)

It's cited with several references. Furthermore, it's linked; anti-psychiatry is undoubtedly associated with psychiatry. It's like saying there's no point in having a section about Prince Charles on Diana, Princess of Wales, because there's already an article on him. PeterSymonds (talk) 20:18, 21 June 2008 (UTC)
Not quite. It would be like having a detailed "Anti Prince Charles" section when an "Anti Prince Charles" article already existed. As it is, there's already a whole "antipsychiatry" article. There's no need to include some of it's (arguably questionable) material on the main article on psychiatry. A link should be sufficient. —Preceding unsigned comment added by 72.0.201.187 (talk) 20:42, 21 June 2008 (UTC)
Keeping the right amount of antipsych stuff in this article has always been a tricky thing. There are some who try to use this article as a soap box to present their opinions and they add antipsych stuff all over the place and in hefty quantitites. The entire treatment settings section, for example, needs to be rewritten to provide a more balanced and coherent explanation of psychiatric treatments, their negatives and positives. Anti-psychiatry information and important negative aspects of psychiatry need to be included, though. Anti-psych is a "sub article" of this one, and IMO should have its own section or subsection here. Chupper (talk) 15:21, 22 June 2008 (UTC)
I concur with Peter and Chupper above. This is really quite a small and well-weighted crit section. Sourced as well. forestPIG 22:16, 22 June 2008 (UTC)
Is this just about the bit in history describing the antipsychiatry movement coming to the fore? That's not even a criticism section (which aren't favoured anyway), it's just part of the historical context and influences, and so mild it doesn't even mention lobotomies and with ECT adds a sort of defensive argument.
I think there's a danger of attributing anything negative to antipsychiatry whether exclusive to that movement or not, and perhaps POV forking it. At the end of the day there are differing perspectives - pro and con - from different psychiatrists, other medical fields, other mental health clinicians and researchers, philosophers, service users, the public, lawyers etc. This article has to focus on explaining psychiatry, but only via representing throughout the article, fairly and with due weight, all significant reliably-sourced views as per WP:NPOV. EverSince (talk) 11:50, 24 June 2008 (UTC)
I've got to agree with EverSince. Wikipedia articles have to be a representative and relevant sample of verifiable knowledge on the topic, and neutrally report opposing opinions as opinions, in proportion to how many people, experts or scholars hold the opinions. It's no fair to create an article, create a long section in that article, and then exclude verifiable, relevant information from that section just because it embarrasses the subject or because the facts are elsewhere in a POVFORK like Anti-Psychiatry. Another problem is that Psychiatry is itself a POVFORK. Maybe the history sections of both articles should be merged together into one article, and the rest of both articles should be merged together into another article. Anti-psychiatry is the article that could do without a redundant section that is simply a summary of another article, as History of anti-psychiatry exists as both a section in Anti-psychiatry and as an article. Maybe all three articles need cleanup to delete awkward grammatical structures that make the articles longer without adding much meaning. 24.7.55.22 (talk) 08:07, 8 May 2009 (UTC)

Photo of a psychiatric hospital room

That photo is awful! Do psych wards really look like that in the USA? In Australia and newer hospitals in the UK they look like small hotel rooms (bad hotels admittedly). The photo looks more like a medical ward or something from a sci-fi movie -- was it put there by an anti-psychiatry person? Suggest we remove it. --Anonymaus (talk) 21:11, 23 June 2008 (UTC)

It's interesting, I've had almost the same response over at Emergency Psychiatry, but I removed it there because it wasn't a emergency psychiatric room. It was not put there by an anti-psychiatry person, it was put there by me.
It is a psychiatric patient room. Of course, there are a wide variety of rooms. You probably should ask yourself first the context of the image, before you doubt it. Inpatient vs outpatient? In a hospital? In an office? I'm sure this is an inpatient room designed for patient monitoring. Its a good image of an inpatient room and serves to remind the reader of the medical context of psychiatry. Of course we could include an outpatient room (which is typically just the psychiatrist's office) in addition to that one to provide more of a spectrum, but I don't think this image should be removed. Chupper (talk) 22:58, 6 July 2008 (UTC)
I believe you. It's just that I've seen dozens of inpatient pychiatric units on three continents (admittedly not in North America), and I've never see anything like it. Maybe I'll take a photo of one of our "nice" rooms. --Anonymaus (talk) 23:23, 6 July 2008 (UTC)
Yea, that would be awesome. Chupper (talk) 21:49, 15 July 2008 (UTC)
I was musing the same thing - our beds certainly look nothing like that. Cheers, Casliber (talk · contribs) 04:35, 20 July 2008 (UTC)
"I'll take a photo of one of our "nice" rooms. --Anonymaus" Is it POV to prefer "nice rooms" ?24.7.55.22 (talk) 08:10, 8 May 2009 (UTC)

Testing, testing

Rather surprisingly, this article currently has only a single instance of the word "test" and no instances of the word "testing". Does psychiatry really leave all the testing to psychology? Martinevans123 (talk) 21:21, 6 July 2008 (UTC)

Actually I count 8 instances of the word. But let's be more clear on testing, though. With testing, there is psychological testing (like intelligence, or personality or symptom severity, etc.) and medical testing (MRI, blood test, physical exam, EEG). And conducting psychological tests also has many parts - including administration, analysis, interpretation.
Pyschiatrists don't specialize nor are they specifically trained for psychological testing. Pyschiatrists are trained in medical testing (lab tests, imaging, physical exams). Psychiatrists do use psychological testing for diagnosis and treatment checkup, though. Psychological testing can be ordered by a psychiatrist and takes place under the supervision of a psychologist. It probably depends on the circumstance, but psychiatrists may also conduct psychological testing; it just depends on the complexity of test (and the training of the psychiatrist).
So let me give you an example of "testing" that a psychiatrist might conduct. If someone comes into a hospital or clinic with psychotic symptoms (with no history), a psychiatrist may order an MRI to check for tumors, blood work to check for the presence of illicit or other drugs, get a psychosocial history, talk to the patient and request an MMPI. The results of these psychological and medical tests then guide the next step.
A lot of this info is included in the article. Take another look and see if you can't find it. Also, if you are knowledgeable on the subject and have some good references, go ahead and add some stuff in. Chupper (talk) 23:11, 6 July 2008 (UTC)
Thanks, your clear explanation deserevs to be in the article. And yes I should have looked for "tests" as well as "test" and "testing". Or better still, just have read more carefully. But should the Rorscharch, for example, be classed as a psychological test or a psychiatric test? Or doesn't it matter? Martinevans123 (talk) 00:03, 7 July 2008 (UTC)
While the Rorschach could be used in a psychiatric setting, it still probably deserves to be called a "psychological" test. I'm not sure if there would ever be any "psychiatric" testing outside of medical and psychological contexts. Also, I'll try to clear all this up in the article. Thanks for your comments. Chupper (talk) 21:48, 15 July 2008 (UTC)

How much evidence for psychiatry?

I found a reference to the study entitled What proportion of primary psychiatric interventions are based on evidence from randomised controlled trials? in Complementary And Alternative Treatments in Mental Health Care. It says that the study shows that much of current psychiatry is not supported by RTCs (4). Should this page have a section discussing the evidence? I think it should. Looking up that paper in Google Scholar leads to more current works. Also, that book says that hypnosis is a mainstream psychiatric practice. Is that true? It is not reflected in this article. II | (t - c) 08:17, 19 July 2008 (UTC)

The abstract is extremely vague - one would really need to read the whole article to figure out what it was on about.
Regarding hypnosis -it is used less now than it used to be - the classical application was in abreaction. It is not usually seen in public sector inpatient or outpatient practice. Cheers, Casliber (talk · contribs) 09:02, 19 July 2008 (UTC)
Hypnosis is still around, yes. When looking at controlled trials, though, less than 20% of individuals can actually be hypnotized. When looking at its prevalence as a treatment in psychiatry, its basically non-existent. Of all the references I used in this page, none of them discussed hypnosis as a treatment. This falls in line with my personal experience - I've never heard of or seen hypnosis be used in a psychiatric setting. Chupper (talk) 19:31, 19 July 2008 (UTC)
With reference to psychiatric training in the UK, about twenty years ago hypnosis was something the older practitioners tended to have in their repertoire, but the younger ones did not take much interest. It seemed to be used more in the guise of relaxation therapy. There was a professional organisation (the British Society for Medical and Dental Hypnosis) which was originally started by dentists: they held training courses which seemed to attract mainly general practitioners. Unlike counselling and psychotherapy courses, which were attended by casually dressed folk, with a female preponderance, BSMDH courses attracted a lot of men in dark suits, which may tell us something. There were a few full time medical hypnotists in private practice, who did not all have a psychiatric background. There was a lot of emphasis on combating "lay" hypnotists, especially stage performers and those who advertised to the public (which medical practitioners were not then allowed to do) and limiting training to doctors and dentists. This coincided with the growth of Neurolinguistic Programming and Ericksonian Hypnosis, largely outside the sphere of medicine and psychology. There is a large market for hypnotic methods to deal with bread-and-butter topics like weight loss and smoking cessation, without sailing across to the wilder shores of "past-life regression.". There was a separate organisation for Speech Therapists, and psychologists had the British Society of Experimental and Clinical Hypnosis. In the past couple of decades a few university courses (originally diploma, and now MSc) have been set up in clinical hypnosis, usually to give part time training to health professionals. This year the medical/dental and psychological societies have merged and their training is now open to a wider range of qualified health profesionals, including nurses. A few psychiatrists are involved with this, but there is more interest among them in brief psychotherapies of various kinds, as well as cognitive behaviour therapy. NRPanikker (talk) 20:43, 19 July 2008 (UTC)

Brains and minds

"The brain is the most important organ studied by psychiatrists".

Hmmm, not the most original caption for an MRI scan of a human head (... containing, surprisingly, a brain!). But are most psychiatrists really interested in brain (mis)function? I thought they were more concerned with mind (mis)function, which is usually far more difficult to get a picture of. I don't want to start a huge philosophical debate about mind/body dualism, but isn't the "study of the brain" more the field of neurologists and physiological psychologists? Martinevans123 (talk) 21:32, 20 July 2008 (UTC)

...and what exactly are the other "important organs" they study? Martinevans123 (talk) 22:22, 20 July 2008 (UTC)

Well, what about the face and the hands, of which anyone communicating with another has to be aware? When dealing with anxiety, the functioning of the autonomic nervous system, which affects all of the body, needs to be considered. Those psychiatrists who deal with epilepsy and movement disorders, and other neuropsychiatric topics which are prominent among intellectually (learning) disabled and elderly people, have to be concerned with brain function. but most psychiatrists do not need to study the brains of individual patients. Most psychiatric research treats the brain as a "black box." Perhaps psychology will be reduced to neurology, or even molecular biology, one day: but people have been trying for centuries to reduce chemistry to physics, without great success, so it may take a little longer. NRPanikker (talk) 02:28, 21 July 2008 (UTC)
I can't see psychology being reduced to neurology while we still have faces abd hands... (or even organs?)Martinevans123 (talk) 07:48, 21 July 2008 (UTC)
I also laughed at the caption of the MRI. The images in this article range from MRIs to syringes and hospital beds ... (what could we use as an image of a "mind"? Perhaps a Mark Rothko or Jackson Pollock painting? Or some Outsider Art?) How about this for an alternative caption: :"MRI image of a brain: mental illnesses may be associated with brain dysfunction"? Perhaps this article needs a discussion of the assumptions within psychiatry on the relationship between mind and brain (the Biopsychosocial model article is unsatisfactory in many ways and doesn't relate directly to psychiatry. Anonymaus (talk) 03:49, 21 July 2008 (UTC)
Yes, that's a much better suggestion. Martinevans123 (talk) 07:52, 21 July 2008 (UTC)
Not so sure. How many psychiatrists have (or would want) access to an MRI scanner? Given that this picture is at the start of the article it gives a very misleading impression of what psychiatrists do and what most psychiatry is about. Might be more accurate to show an MRI image of a llghtly poached brain following an ECT session; or maybe a metric tonne of gleaming Prozac pills?20.133.0.13 (talk) 08:47, 21 July 2008 (UTC)

Wow, I really didn't think the MRI image would be a big deal. Here's my take on it, and why it seems obvious to include it.

  1. Psychiatrists are physicians. Physicians study and are well versed in physiology and anatomy. Psychiatrists are well versed in the physiology and anatomy of the brain.
  2. As clearly stated in the article, psychiatrists have a broad depth of knowledge in the social and biological sciences. If someone can add in a good image that represents the mind, that would probably be good, but to say psychiatrists don't study the brain (from a physiological and anatomical perspective)... thats just incorrect.
  3. What other organ systems are psychiatrists interested in? Well, the nervous system (i.e. brain) is number one. But what about the endocrine system? Doesn't a psychiatrist need to differentiate between something wrong in the brain vs. something wrong with a hormone? Or what about the circulatory system? Blood pressure plays a big role in anxiety disorders. The circulatory system is also the main system of transport for psychiatric medications, the leading treatment option in psychiatry.
  4. Yes, you could get into a major debate about whether psychiatry focuses on brain vs. mind. What is obvious to me is that so little is understood about the brain from a psychiatric context. Sometimes because so little is known, people take that to mean that psychiatry ignores the brain. It doesn't - take a look at psychiatric, neuropsychological and neuroscience research. It's all about the brain! This lack of understanding doesn't mean that the brain isn't important to psychiatrists. It's quite the contrary. An understanding of the brain is critical in the practice of psychiatry, both in the understanding of neurobiological, electrophysiological and genetic traits of mental disorders and the application of treatment (again, mostly psychopharmacology).
  5. In response to the comment by 20.133.0.13 - ANY psychiatrist working outpatient or inpatient in a hospital will have access to an MRI (among other devices). Psychiatrists working in private practice, probably not. And what do you think the "metric tonne" of prozac pills does to the brain? You can see changes in... wait for it... FMRI when using medications. And another aspect of MRI - I heard a psychiatrist in the U.S. say it best - "it's not very effective to treat a tumor with psychotherapy." Because psychiatrists are specialized physicians, they work with a team of other doctors to provide treatment. If someone comes in with symptoms mirroring a mental disorder, but the cause is something beyond the scope of practice for a psychiatrist (i.e. tumor), it is the psychiatrists responsibility to diagnose, consult or refer the patient to the appropriate department.

I liked Anonymaus's caption alternative, but I think it is safe to say that MOST mental disorders are ASSOCIATED with brain dysfunction or irregularities. Again, I stress associated. The causal relationship is not known, but differences in neuroanatomy and neurobiology have been found in the major classes of mental disorders.

Lets not forget that psychiatrists are physicians. 4 years of medical school gives you a lot of education of physiology and anatomy. The amount of pictures focused on biological aspects of psychiatry may be way too heavy. This was not my intention, though. Showing images of a brain (which I hoped I've shown to be very important in psychiatry) or hospital bed is a lot easier then showing images of a "mind" or other social subject of psychiatry. But, that is no excuse. If you can find good representations, lets post them. Also, if you guys want to switch it to the alternative caption, let me know - I've got a good reference. Chupper (talk) 17:34, 21 July 2008 (UTC)

Perfectly coherent and persuasive argument, Chupper, although I've never considered any of the bodily systems you mention as "organs" proper. I'd definitely change the caption. Martinevans123 (talk) 07:15, 22 July 2008 (UTC)
We don't really need a reference for a caption do we? But tell us anyway. Anonymaus (talk) 09:37, 22 July 2008 (UTC)
Yes fair and reasonable argument Chupper. But I still disagree with that picture. Psychiatrists do not typically use MRI, or any other brain imaging technique; nor have they ever. In my experience, their tools are typically notebook and pencil, backed up with medication and medical records. (Unless you're Radovan Karadžić, of course.)20.133.0.13 (talk) —Preceding undated comment was added at 13:01, 22 July 2008 (UTC)
Anonymaus, I'm no expert on Wikipedia policy and you know a whole lot more on the subject of psychiatry then I do! But I would just assume if you are describing a picture in the caption, no reference would be needed. If you were including a claim, however, a reference makes sense to me. So if you have a picture of a red dot and say "A red dot", you are simply describing the image. But if you say "A red dot. Red dots are often used in underwear", you may need a reference :). Chupper (talk) 00:13, 28 July 2008 (UTC)
Mm, yes, good point:).Anonymaus (talk) 13:50, 4 August 2008 (UTC)

I can't resist suggesting whether [this butterfly picture] might be a more accurate reflection of modern psychiatry than the existing one in the article... :) EverSince (talk) 21:12, 6 September 2008 (UTC)

Ouch. But that butterfly does look rather blue, doesn't it. Not just common-or-garden NHS beige like most of the rest of us. Oh-oh, wait a minute, wasn't that a Rorschach image on that webpage? Darn it, that's another generation's projectve test validation scores trashed! Martinevans123 (talk) 21:36, 6 September 2008 (UTC)
Gosh, those skies are blue in America, aren't they. But surely even the American Lady can't keep that clover all to herself anymore? Neverless, Anonymous, a vast improvement and not without an essential fagility lacking in the original image. Martinevans123 (talk) 21:01, 8 September 2008 (UTC)

Hi - just introducing myself

Hello - didn't quite realize what a welter of controversy was present in the formatting of articles on psychiatry.

If I might suggest a good point to begin, would be to try to bring into the picture some new articles on social perception of psychiatric illness.

Of course, there are those who don't believe that psychiatric illness exists. I am sympathetic. I am also sympathetic to the wide range of viewpoint rejecting science, to various degrees. Just not sure if that viewpoint moves science forward very much. Not sure if I want to spend my time trying to argue for the existence of gravity, or evolution. And am quite wary of struggling to pursue negotiations on text, within an on line community that considers The Earth as a Floating Disk on the Primordial Body of Water (or ether, or what have you) vs. the earth as subject to the force of gravity as equally valid viewpoints, both of which have references to back them up.

Thnx.

Menelaus2 (talk)

In response to your comment above, and as an addendum to what I left on your talk page, take a look at this quote from the founder of Wikipedia.
From Jimbo Wales, paraphrased from this post from September 2003 on the mailing list:
  • If a viewpoint is in the majority, then it should be easy to substantiate it with reference to commonly accepted reference texts;
  • If a viewpoint is held by a significant minority, then it should be easy to name prominent adherents;
  • If a viewpoint is held by an extremely small (or vastly limited) minority, it does not belong in Wikipedia regardless of whether it is true or not and regardless of whether you can prove it or not, except perhaps in some ancillary article.
And when it states "ancillary" article, it doesn't mean that an article can just be created if it is in the extreme minority. It still must prove significant. A good example of an ancillary article within this context is Anti-psychiatry. Those viewpoints are held by the minority, but it is still substantial enough to mention. Therefore it gets mentioned in the main article and splits off to its own article. Chupper (talk) 00:09, 28 July 2008 (UTC)

History

Section says William Tuke adopted the methods of Pinel. Nothing I've read suggests this, but the source is an old book that doesn't seem to be online, can anyone clarify what it claims? It also implies the moral treatment movement was psychiatric, but Tuke was a religious layman who explicitly rejected the harsh and pessimistic biomedical methods and theories of the day. Pinel did so in a different way, and himself was partly adopting the methods of ex-patient and superintendent Jean-Baptiste Pussin and his wife. EverSince (talk) 04:29, 27 September 2008 (UTC)

Things you don't know about psychiatry......

It's killed many more people than it's cured. In fact, it hasn't cured any people. When people take the medications, the things that are said to be side effects are actually effects that happen to everyone that takes them. These medications actually damage your body. They don't cure anything, they cover things up. When psychiatrists proscibe something to you, you become a subject of trial and error. Ask any psychiatrist personally and they'll tell you, but they hide it in public so that their money will continue to flow in. Psychiatry make more money than any other business in the world and has only killed or damaged people. Find out the facts.

http://www.cchr.org/#/home —Preceding unsigned comment added by Lieli56 (talkcontribs) 02:35, 9 November 2008 (UTC)

This is not the place for forum-style discussion. There are many other places to do that on the interwebs. XJeanLuc (talk) 17:17, 28 January 2009 (UTC)
CCHR is scientology in disguise. Beware of what this man says. —Preceding unsigned comment added by 71.236.251.223 (talk) 16:51, 10 February 2009 (UTC)

Uh "but they hide it in public", what? 203.59.213.54 (talk) 10:05, 17 August 2009 (UTC) Xenu

Excuse me, Scientologist alert. Hope it does not spread again...Hill Crest's WikiLaser (Boom). 16:18, 5 February 2012 (UTC)

Approaches to psychiatry

Have added some info about different approaches in psychiatry. The most prominent view point currently in the western world is a biologically based one. However there are other ways to approach these problems which could use more development. They can be view psychologically, socially, or as a narrative for example.--Jmh649 (talk) 01:04, 5 December 2008 (UTC)

POV tag

This article gives a very one sided view of psychiatry and at this point I think does psychiatry a bit of a disservice.

  • Imaging as far as I am aware is used for research only not diagnosis. It is used to exclude other illnesses but this is not made clear.
  • Little or no discuss takes place about psychotherapy or lifestyle interventions. It has been show for example that exercise, cognitive behavior therapy, and SSRIs are all equally effective in depression. What about group therapy which is often lead by a psychiatrist or the assessment of psychiatric fitness.
  • One of psychiatry main purposes is to provide people with safe environments were they will not kill themselves of others. We lock up suicidal people to protect them from themselves and we lock up the criminally insane to protect others. Psychiatry is the only profession which can lock up people against their will and force treatment. If a medically ill person does not want treatment no one can force them.
  • This article has too much emphasis on pharmacological treatment / approach.

--Jmh649 (talk) 01:26, 5 December 2008 (UTC)

It is often the case on Wikipedia that the largest-scope articles are some of the weakest, because only an expert has the perspective to handle such an article properly, and experts are hard to come by. You seem to be an expert: please improve the article in any way that seems right to you, so long as you give good sources for any claims that might be controversial. You don't have to give sources in order to remove dubious unsourced statements, but it would be nice to justify each action on this talk page, even if only briefly. Looie496 (talk) 16:54, 5 December 2008 (UTC)
Are psychiatrists the only ones allowed to lock people up and do things to them against their will? What about policemen, judges and prison officers? For centuries before there was any effective treatment for them, lepers were confined away from everyone else. In modern times and in many countries people with certain infectious diseases can be forcibly removed if they refused to take treatment or to go into hospital. Currently there is a move towards locking up sex offenders for life and applying modern equivalents of castration, by judicial order and in accordance with popular notions of sex offending. In the USA psychologists, rather than psychiatrists, may be asked to determine "fitness to be executed." NRPanikker (talk) 03:35, 24 December 2008 (UTC)
I was specifically referring to the field of medicine. But excellent points. If someone is bleeding they can refuse a blood transfusion and die from a lack of blood. You cannot commit someone of sound mind and force treatment upon them. I guess public health might be an exception. I have no idea what power they have if someone say has chlamydia and refuses treatment.--Jmh649 (talk) 13:49, 24 December 2008 (UTC)
Forcing medical treatment on people happens all the time, such as forcing abortion on women whose life is in danger, and keeping people alive against their will on ventilators (even with signed proof that it is agains tthe patients wishes) and tying people to the bed if they don't want to be treated - the later i saw happen in a UK hospital, when a woman didn't want a tetanus injection after getting cut. Psychiatrists actually have a lot more oversight to prevent such things, compared to ER doctors.Dillypickle (talk) 08:50, 19 January 2009 (UTC)

Yes but tying a women to the bed to give a tetanus shot is illegal and if the person was of sound mind they would be able to charge everyone involved with assault. I have people refuse tetanus every once in a while and it is their right to do so. If someone want to leave and is of sound mind they can. If someone is not of sound mind one can admit them against their stated wishes. And do so legally.Jmh649 (talk · contribs · email) 18:24, 19 January 2009 (UTC)

Maybe it is different in different countries. Forcing treatment on people of sound mind is legaly mandated in countries that have laws agains euthynasia by withdrawal of treatment, for example. Psychiatirsts can assess the patient as being of as sound a mind as they want, but doctors can still (or even must) force treatment. Or the definition of "not of sound mind" becomes "refuses treatment the doctor wants to give". Here at least, people forced to have a tetanus against their wishes are also forced to pay for it - suddenly they become compus mentis when the hospital wants the money!

Psychiatrists may be able to lock people up more easily, but forced treatment is certainly not something that only psychiatrists can do.Dillypickle (talk) 11:26, 15 February 2009 (UTC)

Bad introduction, goes around in circles and not based on material, observable things

The definition of "psychiatry" here depends on the term "mental disorder". The problem with this is that it takes for granted that the reader knows what the writer means by "mental disorder". But that is not obvious. When you click on "mental disorder", the definition is based on the terms "psychological" and "distress" and "disability", once again taking for granted that the reader knows what the writer means or intends to mean. However, all of these terms are vague, are subject to large disagreement between whatever the writer means by that and how the reader interprets it. Why is it that the meaning of these terms is treated as if it were obvious? --Prebteu9832 (talk) 15:04, 23 December 2008 (UTC)

These are some valid points. Psychiatry is less of a science than the rest of medicine. No psyc illness has an objective test ( they are all diagnosed by subjective tests ). Therefore the definition is subjective and subject to interpretation. There is nothing one can do to fix this. --Jmh649 (talk) 16:49, 23 December 2008 (UTC)
If we considered only "material, observable things," it would hardly be possible to discuss this subject at all. Such a set of blinkers might be no hindrance to a study of physics, but a mindless psychology can go only so far in making sense of "distress."
However, neither the specialty of psychiatry, nor the broader field of medicine are sciences. Rather they are practical arts, like engineering, teaching or cookery. Practitioners may make use of science, but they are not primarily concerned to make general statements about the nature of the world or the things in it. Scientific orthodoxy is constantly changing, and the further back one looks the less beneficial, according to current thinking, does it seem for some of the doers of times past to have followed the intellectual fashions of their time. Perhaps engineering may have become applied physics: but teaching is not yet applied psychology, cookery is hardly applied chemistry and medicine is by no means applied physiology. The vexed relationship between theory and practice, which was discussed in another context by Karl Marx, was set out well almost 2000 years ago by the proto-Wikipedian Aulus Cornelius Celsus in the introduction to his De Medicina. NRPanikker (talk) 03:50, 24 December 2008 (UTC)

ECT and brain damage

If one is to claim that ECT causes brain damage one needs a newer ref then 1977. --Jmh649 (talk) 14:18, 6 January 2009 (UTC)

Discussion over "brain damage", although obviously worthy of the most rigorous scrutiny, may be somwehat missing the point? Any treatment which essentially makes the patient forget who they are is likely to be hotly debated by anyone seeking to protect civil liberties, whether or not physical structures are provably damaged. The more disturbing, but seemingly much more likely side-effect of ECT, is not so much "brain demage" as "personality removal". Likewise the issue of "threats to keep patients in line", however disturbing, may be a slight distraction - the treatment seems to "work" by "wiping the mental slate clean" and can thus only succeed where the traditional roles of submissive patient and empowered physician are clearly defined. Surely the thrust of anti-Psychiatry was not the risk of unfortunate side-effects, but the self-perpetuating imbalance of whole treatment paradigm? Martinevans123 (talk) 13:34, 25 January 2009 (UTC)

Something missing in the article: A modern view on psychiatry

So here is the thesis about psychiatry and its eligibility: (1) Question of the subject/person: "Why?. (2) The result: deficit. (3) Arbitrary cycle of 1 and 2 made possible by the deprivation of liberty (personal freedom) and by the use of drugs of the pharmaceutical industry. Conclusion: The psychiatry and its most valuable working appliance the psychiatric hospital is an attempt of an autonomous killing machine as well as a felicitous attempt of a supposed control body successfully crept into the constitutional state. 77.56.180.238 (talk) 12:32, 25 January 2009 (UTC)

Tend to agree. Martinevans123 (talk) 13:35, 25 January 2009 (UTC)
Any changes to this article would need to be based on reliable sources, not on personal views. The comments in this section and the previous one aren't productive. Looie496 (talk) 18:43, 25 January 2009 (UTC)
Well, Doc James is quite right to ask about more recent references to brain damage, even if I think he may be missing the point.And any editor is free to question the balance in any given article, aren't they?. I see plenty of labels stuck all over articles to mark them for improvement, without them actually being improved - how productive are those? Maybe comments can be productive if they encourage others to improve? Isn't it fair to discuss fully any changes before making them? Do you think this article provides an adequate modern view on psychiatry? And which are your reliable sources? Martinevans123 (talk) 21:13, 25 January 2009 (UTC)
I didn't mean to disagree with DocJames, I think he is right. Regarding the rest, I'm not an expert on psychiatry and haven't contributed to this article, I'm just pointing out my general experience that comments based on personal opinions rather than sources are pretty much universally ignored, or at any rate don't lead to improvements. Looie496 (talk) 02:48, 29 January 2009 (UTC)
I agree, you are right. I think personal experience can occasionally cloud one's encyclopedic judgement. Or is that tune? Martinevans123 (talk) 09:32, 29 January 2009 (UTC)
Sources are for example the moving pictures One Flew Over the Cuckoo's Nest (film), Spider (film) and Quills (film). The protagonists do not know why they are not allowed to go out of the psychiatric hospital/asylum/sanatorium. (just three examples). The equal thesis stands if you'd remove the hospital/asylum/sanatorium and consider only the medical speciality Psychiatry. EDIT: reliable sources on Psychiatry??? :] 77.56.182.171 (talk) 19:25, 29 January 2009 (UTC)

POV tag redux

I have removed the POV tag from this article on the grounds that it is non-functional, and only serves to make the article ugly. The neutrality of this article is always going to be disputed no matter what, so I feel that we just have to make an executive decision not to disfigure the article with a useless tag, but (of course) to deal with specific issues when they are raised. I have acted boldly here, and hope that other editors will support this action. Looie496 (talk) 18:20, 15 February 2009 (UTC)

Please restore the tag. It is exactly because the "neutrality of this article is always going to be disputed no matter what" that there must be a tag. If the neutrality of a Wikipedia article is disputed so persistently, then its tag is neither disfiguring nor useless. Besides, the article will be a POVFORK until merged with Anti-psychiatry. 24.7.55.22 (talk) 08:37, 8 May 2009 (UTC)
Erm, no that would be a fringe viewpoint. Casliber (talk · contribs) 08:45, 8 May 2009 (UTC)
How do you identify that as a fringe theory? 24.7.55.22 (talk) 20:12, 8 May 2009 (UTC)
"'Sometimes people have edit wars over the NPOV dispute tag, or have an extended debate about whether there is a NPOV dispute or not. In general, if you find yourself having an ongoing dispute about whether a dispute exists, there's a good chance one does, and you should therefore leave the NPOV tag up until there is a consensus that it should be removed. However, repeatedly adding the tag is not to be used as a means of bypassing consensus or dispute resolution. If your sole contribution to an article is to repeatedly add or remove the tag, chances are high that you are abusing your "right" to use the tag.'" Also, "'If you come across an article whose content does not seem to be consistent with Wikipedia's NPOV policy, use one of the tags below to mark the article's main page.'" 24.7.55.22 (talk) 21:29, 8 May 2009 (UTC)
If the article is not neutral, then there must be some specific statement in it that is not neutral. What statement, please? You're not going to be able to keep a tag on this article without at least stating what part of it you feel is not neutral. Looie496 (talk) 21:43, 8 May 2009 (UTC)
I saw the NPOV tag at the top of the article, so I came here assuming there was some debate over the neutrality of something in the article. Apparently there isn't, and so the tag really shouldn't be there. Dgf32 (talk) 20:44, 21 May 2009 (UTC)
If an editor finds a statement in the article that isn't NPOV it should be identified and fixed. If editors disagree as to whether a particular statement is NPOV or not or if editors disagree on how to improve a statement to be NPOV, then we should resolve the matter by a discussing here on the talk page. While that discussion is going on, the NPOV tag may be placed on the article. Since there's no NPOV problem being resolved by discussion on the talk page and no particular NPOV issue identified, the tag should be removed. If an editor does identify a statement that isn't NPOV, let's fix it. I'd be very happy to help resolve any disagreements regarding neutrality if they do arise.Dgf32 (talk) 20:50, 21 May 2009 (UTC)

No article on Frontier Psychiatry?

It was a huge movement during the 1800's in the American mid-west and again through the 90's. 203.59.213.54 (talk) 09:55, 17 August 2009 (UTC) Sutter Cane

Psychiatry for the indigent

I've had extensive contact with poor Americans on Medicaid and with Canadians (who, given Canada's government-funded health care system, nearly all receive Medicaid-quality health care). The psychiatric patients among them tell me the only treatment they get is medication prescribed in five-minute med-check appointments. In fact, in Canada, it is nearly impossible to get ongoing monitoring from a psychiatrist at all, and most psychiatrists do only a one-hour consultation with follow-up monitoring by the family practitioner. These kinds of things need to be out in the open, not concealed where the medical community wants them. I am not a scientologist or an anti-psychiatry activist, just someone who is sick and tired of the truth being buried alive because of technicalities. My attempts to add this information to the article have been blocked several times. To the people doing the blocking, if you have any good faith at all, let's talk. What would satisfy you? Durwoodie (talk) 18:19, 12 October 2009 (UTC)

  • Your statements are replete with unsubstantiated (and often wrong) accusations. Canadians only receive Medicaid-quality care? Really? Do you have a reliable source for that? What truth is being buried? There are thousands of people whose life is better because of psychiatric treatment. There are sources for that. And, unfortunately, there are thousands of people who don't respond well or even at all to psychiatric medication. And many psychiatric medications have serious side effects. Nobody is denying that, so please stop the conspiracy-theory talk. If you want to add info to a WP article, you will have to follow WP's policies and guidelines. Please star with reading the guidelines on reliable sources and neutral editing. --Crusio (talk) 18:25, 12 October 2009 (UTC)
The "sources" you refer to are all mental health industry insiders, who have a vested interest in perpetuating certain myths. If those are the only sources that are permitted to be used, nobody will ever find out what's really going on. Whatever. I'm glad that you didn't simply arrange to have me shot to death as a "troublemaker"--or, worse yet, locked up in a psychiatric facility for that reason. Durwoodie (talk) 18:33, 12 October 2009 (UTC)

New Edit

I have written an article on Toronto Journalist and author Patricia Pearson's book about her battle with diagnosed anxiety, A Brief History of Anxiety (Yours & Mine) and added a reference in the See Also section. Hopefully this will meet with other editors' approval. Durwoodie (talk) 20:37, 12 October 2009 (UTC)

My reference was deleted by Crusio, and in case you want to know what side his bread is buttered on, click here: [[3]] Durwoodie (talk) 23:42, 12 October 2009 (UTC)
This article does not include a criticisms section and shouldn't, because psychiatry has more than one way of treating mental disorder (so this page would easily get cluttered with psychology criticism, too). Your edit is relevant to the biopsychiatry controversy article and actually an improvement there, but not here. Thank you for your contribution to that article, but this is not the place. MichaelExe (talk) 23:51, 12 October 2009 (UTC)

neeed a psych asap

i need an affordable psych currentley seeing one too exspensive exhausted all options this is my last chance rx alprazolam .5every 6 hrs prozac 20 mg daily —Preceding unsigned comment added by 174.59.148.152 (talk) 21:51, 25 March 2010 (UTC)

  1. ^ Gask, L. (2004). A Short Introduction to Psychiatry. London: SAGE Publications Ltd., p. 7 ISBN 978-0-7619-7138-2
  2. ^ Storrow, H.A. (1969). Outline of Clinical Psychiatry. New York:Appleton-Century-Crofts, p 1. ISBN 978-0-39-085075-1
  3. ^ Guze, S. B. (1992). Why Psychiatry is a Branch of Medicine. New York: Oxford University Press, p 131. ISBN 978-0-19-507420-8.
  4. ^ a b c Cite error: The named reference Guze130 was invoked but never defined (see the help page).