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Psychiatry

Reviewed by Psychology Today Staff

What Is Psychiatry?

Psychiatry is a specialty of medicine that focuses on researching, understanding, diagnosing, and treating diseases of the brain and disorders of the mind and behavior. Psychiatrists diagnose and treat a wide range of conditions, from Alzheimer’s disease, anxiety, and autism to mood disorders, Munchausen syndrome, psychosis, and suicidality. As physicians, psychiatrists are trained to recognize the many ways general physiologic processes and pathologies can influence mental functioning-and vice versa.

Practitioners are physicians who typically work in or are affiliated with medical settings. Psychiatry also has a number of fields of subspecialization; addiction psychiatry, child and adolescent psychiatry, forensic psychiatry, geriatric psychiatry, and neuropsychiatry are the best known.

Some psychiatrists devote themselves exclusively to research. Others may be affiliated with medical institutions where they both conduct research and evaluate and treat patients. Others may engage exclusively in patient treatment, in outpatient settings such as independent clinical practice, in a group practice affiliated with other physicians, or in a psychiatric facility. Many clinical psychiatrists have attending privileges in hospitals to accommodate patients needing care and supervision or experiencing a psychiatric emergency.

All psychiatrists begin care with an extensive evaluation of each patient that can provide important clues to the source and nature of the disorder. Psychiatric evaluation includes an interview in which the patient is asked to describe symptoms, personal and family history, medical history, and may include blood and other tests. Psychiatrists pay attention not only to what is said but to the emotional tone of responses, the cognitive factors informing them, and the behavior accompanying them.

Psychiatrists have at their disposal an array of treatments ranging from psychotherapy to pharmacotherapy to somatic therapies, including brain stimulation. Increasingly, for example, psychiatrists report paying attention to the reciprocal influence of bodily states on brain function and to gut health as a significant contributor to mental health, both of which are flourishing areas of research. Advances in the understanding of the role of diet, sleep, and regular physical activity on well-being in general and mental functioning, in particular, are also finding their way into patient management as well.

Tools such as neuroimaging may sometimes be helpful in diagnosis but currently are more widely used in clinical research to further the general understanding of mental disorders and the neurobiological dysfunction that gives rise to or accompanies them.

Contents

Basic Principles

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Most psychiatrists have subscribed to the biopsychosocial model of illness, which posits that biology, psychology (including thoughts and emotions), and social factors (relationships, socioeconomic conditions, culture) interact to influence health, disease, and human development.

One of its principal corollaries is that mental disorders have multiple causes: From anxiety to schizophrenia, symptoms of mental illness and distress arise from an array of factors, including stress reactivity, memory and other mental processes, social relationships, lifestyle including nutrition, and general environmental factors, including racism. The interplay and relative contribution of each factor vary from individual to individual.

Because of the enormous complexity of the human mind and the influences on it, disorders can often express themselves in a multitude of ways, and indeed, symptoms can shift over time.

Because of its power to relieve anxiety and induce states of calm, the physician-patient relationship-sometimes referred to as the therapeutic alliance-can be utiliz

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