Psychiatry: Difference between revisions - Wikipedia

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{{Infobox medical specialty

~~{{Infobox medical specialty|focus=[[Mental health]]|specialist=[[Psychiatrist]]|title=Psychiatry|image=Psi and Caduceus.svg|glossary=[[Glossary of psychiatry]]}}~~

| title = Psychiatry

~~{{Infobox occupation~~

| image = Psi and Caduceus.svg

~~| type =[[Medical specialty]]~~

| ~~activity_sector~~ focus = [[~~Medicine~~Mental health]]

| specialist = [[Psychiatrist]]

~~| formation =~~

| glossary = [[Glossary of psychiatry]]

*[[Doctor of Medicine]] (MD)

*[[Doctor of Osteopathic Medicine]] (DO)

|subdivisions=[[Neuropsychiatry]], [[biological psychiatry]], [[social psychiatry]], [[interventional psychiatry]]|tests=[[Mental status examination]], [[psychological testing|psychological]], [[cognitive test|cognitive]], [[personality test]]s

*[[Bachelor of Medicine, Bachelor of Surgery]] (MBBS/MBChB)

*[[Clinical officer|Bachelor of Science in Clinical Medicine]] (Psychiatry)

*[[Clinical officer|Higher Diploma in Clinical Medicine and Surgery]] (Psychiatry)

*[[Clinical officer|Diploma in Clinical Medicine and Surgery]]

*[[Clinical officer|Diploma in Clinical Psychiatry]]

~~| employment_field =[[Psychiatric hospital]]~~

~~| related_occupation =~~

*[[Clinical psychology]]

*[[Psychosomatic medicine]]

*[[Psychotherapy]]

}}

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Initial psychiatric assessment of a person begins with creating a [[Medical history|case history]] and conducting a [[mental status examination]]. Physical examinations, [[psychological test]]s, and laboratory tests may be conducted. On occasion, [[neuroimaging]] or other [[neurophysiological]] studies are performed.<ref name=NIMHSite/> Mental disorders are diagnosed in accordance with diagnostic manuals such as the ''[[International Classification of Diseases]]'' (ICD),<ref name ="Do mental health professionals use diagnostic classifications the way we think they do? A global survey">{{Cite journal|author=First, M |author2=Rebello, T |author3=Keeley, J |author4=Bhargava, R |author5=Dai, Y |author6=Kulygina, M |author7=Matsumoto, C |author8=Robles, R |author9=Stona, A |author10=Reed, G |title=Do mental health professionals use diagnostic classifications the way we think they do? A global survey|journal=World Psychiatry|language=en|volume=17|issue=2|pages=187–195|pmid = 29856559| date = June 2018 | doi=10.1002/wps.20525|pmc=5980454 }}</ref> edited by the [[World Health Organization]] (WHO), and the ''[[Diagnostic and Statistical Manual of Mental Disorders]]'' (DSM), published by the [[American Psychiatric Association]] (APA). The fifth edition of the DSM ([[DSM-5]]), published in May 2013, reorganized the categories of disorders and added newer information and insights consistent with current research.<ref name=Kupfer>{{cite journal|vauthors=Kupfer DJ, Regier DA|title=Why all of medicine should care about DSM-5|journal=JAMA|volume=303|issue=19|pages=1974–5|date=May 2010|pmid=20483976|doi=10.1001/jama.2010.646}}</ref>

Treatment may include [[psychotropic]]s (psychiatric medicines), [[Interventional psychiatry|interventional]] approaches and [[psychotherapy]],<ref>{{cite journal|vauthors=Gabbard GO|title=Psychotherapy in psychiatry|journal=International Review of Psychiatry|volume=19|issue=1|pages=5–12|date=February 2007|pmid=17365154|doi=10.1080/09540260601080813|s2cid=25268111}}</ref><ref>{{cite web | title = Psychiatry Specialty Description | publisher = American Medical Association | url = https://www.ama-assn.org/specialty/psychiatry-specialty-description | access-date = 10 October 2020 | archive-date = 12 October 2020 | archive-url = https://web.archive.org/web/20201012155934/https://www.ama-assn.org/specialty/psychiatry-specialty-description | url-status = live }}</ref> and also other modalities such as [[assertive community treatment]], [[Community reinforcement approach and family training|community reinforcement]], [[substance-abuse treatment]], and [[supported employment]]. Treatment may be delivered on an [[inpatient]] or [[outpatient]] basis, depending on the severity of functional impairment or risk to the individual or community. Research within psychiatry is conducted on an interdisciplinary basis with other professionals, such as [[epidemiologists]], [[Nursing|nurses]], [[social workers]], [[occupational therapists]], and clinical [[psychologists]].

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[[File:American Lady Against The Sky.jpg|thumb|The word ''[[wiktionary:psyche|psyche]]'' comes from the [[ancient Greek]] for '[[soul]]' or '[[butterfly]]'.<ref>{{cite magazine| vauthors = Rabuzzi M |title=Butterfly Etymology|magazine=Cultural Entomology Digest |issue=4 |url= http://www.insects.org/ced4/etymology.html |date=November 1997|archive-date=3 December 1998|archive-url=https://web.archive.org/web/19981203024144/http://www.insects.org/ced4/etymology.html}}</ref> The fluttering insect appears in the [[coat of arms]] of Britain's [[Royal College of Psychiatrists]].<ref>{{cite journal|vauthors=James FE|date=July 1991|title=Psyche|journal=Psychiatric Bulletin|volume=15|issue=7|pages=429–31|doi=10.1192/pb.15.7.429|doi-access=free}}</ref>]]

The term ''psychiatry'' was first coined by the German [[physician]] [[Johann Christian Reil]] in 1808 and literally means the 'medical treatment of the [[soul]]' (''[[Wikt:psych|ψυχή psych-]]'' 'soul' from [[Ancient Greek]] ''psykhē'' 'soul'; ''[[Wikt:-iatry|-iatry]]'' 'medical treatment' from Gk. ιατρικός ''iātrikos'' 'medical' from ιάσθαι ''iāsthai'' 'to heal'). A medical doctor specializing in psychiatry is a [[psychiatrist]] (for a historical overview, see: [[Timeline of psychiatry]]).

==Theory and focus==

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{{legend|#cb0000|more than 150}}{{div col end}}]]

Though the medical specialty of psychiatry uses research in the field of [[neuroscience]], [[psychology]], [[medicine]], [[biology]], [[biochemistry]], and [[pharmacology]],<ref name=Pietrini>{{cite journal|vauthors=Pietrini P|title=Toward a biochemistry of mind?|journal=The American Journal of Psychiatry|volume=160|issue=11|pages=1907–8|date=November 2003|pmid=14594732|doi=10.1176/appi.ajp.160.11.1907|doi-access=free|department=Editorial}}</ref> it has generally been considered a middle ground between [[neurology]] and psychology.{{sfn|Shorter|1997|p=326}} Because psychiatry and neurology are deeply intertwined medical specialties, all certification for both specialties and for their subspecialties is offered by a single board, the American Board of Psychiatry and Neurology, one of the member boards of the American Board of Medical Specialties.<ref>{{citation|title=Specialty and Subspecialty Certificates|date=n.d.|website=American Board of Medical Specialties|url=http://www.abms.org/member-boards/specialty-subspecialty-certificates/|access-date=27 July 2016|archive-date=23 January 2020|archive-url=https://web.archive.org/web/20200123231140/https://www.abms.org/member-boards/specialty-subspecialty-certificates/|url-status=live}}</ref> Unlike other physicians and neurologists, psychiatrists specialize in the [[doctor–patient relationship]] and are trained to varying extents in the use of psychotherapy and other therapeutic communication techniques.{{sfn|Shorter|1997|p=326}} Psychiatrists also differ from psychologists in that they are physicians and have post-graduate training called residency (usually four to five years) in psychiatry; the quality and thoroughness of their graduate medical training is identical to that of all other physicians.<ref name=Hauser>{{cite web| vauthors = Hauser MJ |title=Student Information |url= http://www.psychiatry.com/student.php |website=Psychiatry.com|access-date=21 September 2007|archive-url=https://web.archive.org/web/20101023095258/http://www.psychiatry.com/student.php|archive-date=23 October 2010}}</ref> Psychiatrists can therefore counsel patients, prescribe medication, order [[medical laboratory|laboratory test]]s, order [[neuroimaging]], and conduct [[physical examination]]s.<ref name=NIMHSite>{{cite web|publisher=National Institute of Mental Health|date=January 31, 2006|title=Information about Mental Illness and the Brain (Page 3 of 3)|website=The Science of Mental Illness|access-date=April 19, 2007|url=http://science-education.nih.gov/supplements/nih5/Mental/guide/info-mental-c.htm|archive-date=12 October 2007|archive-url=https://web.archive.org/web/20071012140052/http://science-education.nih.gov/supplements/nih5/Mental/guide/info-mental-c.htm}}</ref> As well, some psychiatrists are trained in [[interventional psychiatry]] and can deliver interventional treatments such as [[electroconvulsive therapy]], [[transcranial magnetic stimulation]], [[vagus nerve stimulation]] and [[ketamine]].<ref>{{Cite web |date=2024-07-27 |title=Handbook of Interventional Psychiatry - Handbook of Interventional Psychiatry |url=https://interventionalpsych.org/ |access-date=2024-08-28 |website=interventionalpsych.org |language=en-US}}</ref>

===Ethics===

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* Brain injury medicine<ref>{{cite web|url=https://www.abpn.com/become-certified/taking-a-subspecialty-exam/brain-injury-medicine/|title=Brain Injury Medicine|website=American Board of Psychiatry and Neurology|access-date=2017-08-20|archive-date=2017-08-20|archive-url=https://web.archive.org/web/20170820203143/https://www.abpn.com/become-certified/taking-a-subspecialty-exam/brain-injury-medicine/|url-status=live}}</ref><ref>{{cite journal| vauthors = Hausman K |date=6 December 2013|title=Brain Injury Medicine Gains Subspecialty Status|journal=Psychiatric News|volume=48|issue=23|page=10|doi=10.1176/appi.pn.2013.11b29}}</ref>

* [[Child and adolescent psychiatry]]

* [[Clinical neurophysiology]]

* [[Liaison psychiatry|Consultation-liaison psychiatry]]<ref>{{cite web|url=https://www.abpn.com/become-certified/taking-a-subspecialty-exam/psychosomatic-medicine/|title=Psychosomatic Medicine|website=American Board of Psychiatry and Neurology|access-date=2017-08-20|archive-date=2017-08-20|archive-url=https://web.archive.org/web/20170820203107/https://www.abpn.com/become-certified/taking-a-subspecialty-exam/psychosomatic-medicine/|url-status=live}}</ref>

*[[Forensic psychiatry]]

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Additional psychiatry subspecialties, for which the ABPN does not provide formal certification, include:<ref name=UKReq>{{cite web|website=The Royal College of Psychiatrists|date=2005|title=Careers info for School leavers|access-date=March 25, 2007|url=http://www.rcpsych.ac.uk/training/careersinpsychiatry/careerbooklet.aspx|archive-date=9 July 2007|archive-url=https://web.archive.org/web/20070709051515/http://www.rcpsych.ac.uk/training/careersinpsychiatry/careerbooklet.aspx}}</ref>

* [[Biological psychiatry]]

* [[Cognition|Cognitive]] diseases, as in various forms of [[dementia]]

* [[Community mental health service|Community psychiatry]]

* [[Cross-cultural psychiatry]]

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* [[Neurodevelopmental disorder]]s

* [[Neuropsychiatry]]

* [[Interventional psychiatry|Interventional Psychiatry]]

* [[Social psychiatry]]

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Inpatient psychiatric wards may be secure (for those thought to have a particular risk of violence or self-harm) or unlocked/open. Some wards are mixed-sex whilst same-sex wards are increasingly favored to protect women inpatients. Once in the care of a hospital, people are [[psychiatric assessment|assessed]], monitored, and often given medication and care from a multidisciplinary team, which may include physicians, pharmacists, psychiatric nurse practitioners, [[psychiatric and mental health nursing|psychiatric nurses]], clinical psychologists, psychotherapists, psychiatric social workers, occupational therapists and social workers. If a person receiving treatment in a psychiatric hospital is assessed as at particular risk of harming themselves or others, they may be put on constant or intermittent one-to-one supervision and may be put in physical restraints or medicated. People on inpatient wards may be allowed leave for periods of time, either accompanied or on their own.<ref>{{cite book|title=Acute inpatient psychiatric care: A source book|publisher=World Health Organization|location=Darlinghurst, Australia|year=2003|isbn=978-0-9578073-1-0|oclc=223935527|author=Treatment Protocol Project}}</ref>

In many developed countries there has been a massive reduction in psychiatric beds since the mid 20th century, with the growth of community care. Italy has been a pioneer in psychiatric reform, particularly through the no-restraint initiative that began nearly fifty years ago. The Italian movement, heavily influenced by Franco Basaglia, emphasizes ethical treatment and the elimination of physical restraints in psychiatric care. A study examining the application of these principles in Italy found that 14 general hospital psychiatric units reported zero restraint incidents in 2022.<ref>{{Cite journal |last1=Pocobello |first1=Raffaella |last2=Camilli |first2=Francesca |last3=Rossi |first3=Giovanni |last4=Davì |first4=Maurizio |last5=Corbascio |first5=Caterina |last6=Tancredi |first6=Domenico |last7=Oretti |first7=Alessandra |last8=Bonavigo |first8=Tommaso |last9=Galeazzi |first9=Gian Maria |last10=Wegenberger |first10=Oliver |last11=el Sehity |first11=Tarek |date=January 2024 |title=No-Restraint Committed General Hospital Psychiatric Units (SPDCs) in Italy—A Descriptive Organizational Study |journal=Healthcare |language=en |volume=12 |issue=11 |pages=1104 |doi=10.3390/healthcare12111104 |doi-access=free |pmid=38891179 |issn=2227-9032|pmc=11171828 }}</ref>

In many developed countries there has been a massive reduction in psychiatric beds since the mid 20th century, with the growth of community care. Standards of inpatient care remain a challenge in some public and private facilities, due to levels of funding, and facilities in developing countries are typically grossly inadequate for the same reason. Even in developed countries, programs in public hospitals vary widely. Some may offer structured activities and therapies offered from many perspectives while others may only have the funding for medicating and monitoring patients. This may be problematic in that the maximum amount of therapeutic work might not actually take place in the hospital setting. This is why hospitals are increasingly used in limited situations and moments of crisis where patients are a direct threat to themselves or others. Alternatives to psychiatric hospitals that may actively offer more therapeutic approaches include rehabilitation centers or "rehab" as popularly termed.{{citation needed|date=August 2008}}▼

▲~~In many developed countries there has been a massive reduction in psychiatric beds since the mid 20th century, with the growth of community care.~~ Standards of inpatient care remain a challenge in some public and private facilities, due to levels of funding, and facilities in developing countries are typically grossly inadequate for the same reason. Even in developed countries, programs in public hospitals vary widely. Some may offer structured activities and therapies offered from many perspectives while others may only have the funding for medicating and monitoring patients. This may be problematic in that the maximum amount of therapeutic work might not actually take place in the hospital setting. This is why hospitals are increasingly used in limited situations and moments of crisis where patients are a direct threat to themselves or others. Alternatives to psychiatric hospitals that may actively offer more therapeutic approaches include rehabilitation centers or "rehab" as popularly termed.{{citation needed|date=August 2008}}

===Outpatient treatment===

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Greek philosophers, including [[Thales]], [[Plato]], and [[Aristotle]] (especially in his ''[[On the Soul|De Anima]]'' treatise), also addressed the workings of the mind. As early as the 4th century BC, the Greek physician [[Hippocrates]] theorized that [[mental disorder]]s had physical rather than supernatural causes. In 387 BCE, Plato suggested that the brain is where mental processes take place. In 4th to 5th century B.C. Greece, Hippocrates wrote that he visited [[Democritus]] and found him in his garden cutting open animals. Democritus explained that he was attempting to discover the cause of madness and melancholy. Hippocrates praised his work. Democritus had with him a book on madness and melancholy.<ref>{{cite book| vauthors = Burton R |title=The Anatomy of Melancholy: What it is with All the Kinds, Causes, Symptoms, Prognostics, and Several Cures of it: in Three Partitions, with Their Several Sections, Members and Subsections Philosophically, Medicinally, Historically Opened and Cut Up|date=1881|publisher=Chatto & Windus|location=London|ol=3149647W|pages=[https://books.google.com/books?id=DAIGAAAAQAAJ&pg=PA22 22], [https://books.google.com/books?id=DAIGAAAAQAAJ&pg=PA24 24]}}</ref> During the 5th century BCE, mental disorders, especially those with [[psychosis|psychotic]] traits, were considered [[supernatural]] in origin,<ref name=Elkes13>{{cite book| vauthors = Elkes A, Thorpe JG |date=1967|title=A Summary of Psychiatry|location=London|publisher=Faber & Faber|page=13|oclc=4687317}}</ref> a view which existed throughout [[ancient Greece]] and [[ancient Rome|Rome]],<ref name=Elkes13/> as well as Egyptian regions.<ref>{{cite book| vauthors = Dumont F |date=2010|title=A history of personality psychology: Theory, science and research from Hellenism to the twenty-first century|location=New York|publisher=Cambridge University Press|oclc=761231096|isbn=978-0-521-11632-9}}</ref>{{Page needed|date=August 2017}} [[Alcmaeon of Croton|Alcmaeon]], believed the [[brain]], not the [[heart]], was the "organ of thought". He tracked the ascending sensory nerves from the body to the brain, theorizing that mental activity originated in the [[Central nervous system|CNS]] and that the cause of [[mental illness]] resided within the brain. He applied this understanding to classify mental diseases and treatments.<ref name="Pietrini" /><ref>{{Cite journal |last1=Janssen |first1=Diederik F. |last2=Hubbard |first2=Thomas K. |date=May 2021 |title=Psychology: Early print uses of the term by Pier Nicola Castellani (1525) and Gerhard Synellius (1525). |journal=History of Psychology |volume=24 |issue=2 |pages=182–187 |doi=10.1037/hop0000187 |pmid=34081519 |s2cid=235334263 |issn=1939-0610}}</ref> Religious leaders often turned to versions of [[exorcism]] to treat mental disorders often utilizing methods that many consider to be cruel or barbaric methods. Trepanning was one of these methods used throughout history.<ref name=Elkes13/>

In the 6th century AD, [[Lin Xie]] carried out an early [[Experimental psychology|psychological experiment]], in which he asked people to draw a square with one hand and at the same time draw a circle with the other (ostensibly to test people's vulnerability to distraction). It has been cited that this was an early ~~psychatric~~psychiatric experiment.<ref name=":1">{{Cite journal |last1=Janssen |first1=Diederik F. |last2=Hubbard |first2=Thomas K. |date=May 2021 |title=Psychology: Early print uses of the term by Pier Nicola Castellani (1525) and Gerhard Synellius (1525). |journal=History of Psychology |volume=24 |issue=2 |pages=182–187 |doi=10.1037/hop0000187 |pmid=34081519 |s2cid=235334263 |issn=1939-0610}}</ref>

The [[Islamic Golden Age]] fostered early studies in [[Islamic psychology]] and psychiatry, with many scholars writing about mental disorders. The Persian physician [[Muhammad ibn Zakariya al-Razi]], also known as "Rhazes", wrote texts about psychiatric conditions in the 9th century.<ref name="WaelMohamed">{{cite web| vauthors = Mohamed WM |date=August 2008|title=History of Neuroscience: Arab and Muslim Contributions to Modern Neuroscience|website=International Brain Research Organization|url=http://ibro.info/wp-content/uploads/2012/12/Arab-and-Muslim-Contributions-to-Modern-Neuroscience.pdf|archive-date=10 June 2014|archive-url=https://web.archive.org/web/20140610082740/http://ibro.info/wp-content/uploads/2012/12/Arab-and-Muslim-Contributions-to-Modern-Neuroscience.pdf}}</ref> As chief physician of a hospital in Baghdad, he was also the director of one of the first [[bimaristan]]s in the world.<ref name="WaelMohamed" />

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The modern era of institutionalized provision for the care of the mentally ill, began in the early 19th century with a large state-led effort. In England, the [[Lunacy Act 1845]] was an important landmark in the treatment of the mentally ill, as it explicitly changed the status of [[mental illness|mentally ill]] people to [[patients]] who required treatment. All asylums were required to have written regulations and to have a resident qualified [[physician]].<ref name="Wright, 1999">Wright, David: "Mental Health Timeline", 1999</ref>{{full citation needed|date=November 2014}} In 1838, France enacted a law to regulate both the admissions into asylums and asylum services across the country.

In the United States, the erection of state asylums began with the first law for the creation of one in New York, passed in 1842. The [[Utica State Hospital]] was opened around 1850. Many state hospitals in the United States were built in the 1850s and 1860s on the [[Kirkbride Plan]], an architectural style meant to have curative effect.<ref>{{cite book| vauthors = Yanni C |title=The Architecture of Madness: Insane Asylums in the United States|publisher=Minnesota University Press |location=Minneapolis |year=2007 |url=https://books.google.com/books?id=fJOC_rSW1kgC |isbn=978-0-8166-4939-6|via=Google Books}}</ref>{{Page needed|date=August 2017}}

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* {{cite book | vauthors = Guze SB |year=1992|title=Why Psychiatry Is a Branch of Medicine|location=New York|publisher=Oxford University Press|isbn=978-0-19-507420-8|oclc=25315637}}

* {{cite book | vauthors = Lyness JM |year=1997|title=Psychiatric Pearls|location=Philadelphia|publisher=F.A. Davis Company |isbn=978-0-8036-0280-9|oclc=807453406}}

* {{cite book | ~~vauthors~~ last= Shorter |first=E |year=1998|orig-date=1997|title=A History of Psychiatry: From the Era of the Asylum to the Age of Prozac|url=https://archive.org/details/historyofpsychia0000shor|url-access=registration|location=New York|publisher=John Wiley & Sons, Inc.|isbn=978-0-471-24531-5|oclc=60169541}}

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* {{cite book| veditors = Berrios GE, Porter R |date=1995|title=The History of Clinical Psychiatry|location=London|publisher=Athlone Press|oclc=1000559759|isbn=978-0-485-24211-9}}

* {{cite book|vauthors=Berrios GE|date=1996|title=History of Mental symptoms: The History of Descriptive Psychopathology since the 19th century|location=Cambridge|publisher=Cambridge University Press|oclc=668203298|isbn=978-0-511-52672-5}}

* {{cite journal|vauthors=Burke C|date=February 2000|title=Psychiatry: a "value-free" science?|journal=[[Linacre Quarterly]]|volume=67/1|pages=59–88|doi=10.1080/20508549.2000.11877569|s2cid=77216987|url=http://www.cormacburke.or.ke/node/369|access-date=2011-01-22|archive-date=2021-11-29|archive-url=https://web.archive.org/web/20211129195128/http://www.cormacburke.or.ke/node/369|url-status=live}}▼

* {{cite encyclopedia| vauthors = Ford-Martin PA | veditors = Longe JL, Blanchfield DS |date=2002 |title=Psychosis |encyclopedia=Gale Encyclopedia of Medicine |edition=2nd |volume=4 |location=Detroit |publisher=Gale Group |oclc=51166617}}

* [[Gavin Francis|Francis, Gavin]], "Changing Psychiatry's Mind" (review of [[Anne Harrington]], ''Mind Fixers: Psychiatry's Troubled Search for the Biology of Mental Illness'', Norton, 366 pp.; and [[Nathan Filer]], ''This Book Will Change Your Mind about Mental Health: A Journey into the Heartland of Psychiatry'', London, Faber and Faber, 248 pp.), ''[[The New York Review of Books]]'', vol. LXVIII, no. 1 (14 January 2021), pp. 26–29. "[M]ental disorders are different [from illnesses addressed by other medical specialties].... [T]o treat them as purely physical is to misunderstand their nature." "[C]are [needs to be] based on distress and [cognitive, emotional, and physical] need rather than [on psychiatric] diagnos[is]", which is often uncertain, erratic, and unreplicable. (p. 29.)

* [[Sue Halpern|Halpern, Sue]], "The Bull's-Eye on Your Thoughts" (review of [[Nita A. Farahany]], ''The Battle for Your Brain: Defending the Right to Think Freely in the Age of Neurotechnology'', St. Martin's, 2023, 277 pp.; and [[Daniel Barron]], ''Reading Our Minds: The Rise of Big Data Psychiatry'', Columbia Global Reports, 2023, 150 pp.), ''[[The New York Review of Books]]'', vol. LXX, no. 17 (2 November 2023), pp. 60–62. Psychiatrist [[Daniel Barron]] deplores psychiatry's reliance largely on subjective impressions of a patient's condition – on [[pattern recognition|behavioral-pattern recognition]] – whereas other medical specialties dispose of a more substantial armamentarium of objective diagnostic [[technologies]]. A psychiatric patient's [[diagnosis|diagnoses]] are arguably more in the eye of the physician: "An [[anti-psychotic]] 'works' if a [psychiatric] patient ''looks and feels'' less [[psychotic]]." Barron also posits that [[speech|talking]] – an important aspect of psychiatric [[diagnostics]] and treatment – involves vague, subjective [[language]] and therefore cannot reveal the [[brain]]'s objective workings. He trusts, though, that [[Big Data]] technologies will make psychiatric [[signs and symptoms]] more quantifiably objective. Sue Halpern cautions, however, that "When numbers have no agreed-upon, scientifically-derived, extrinsic meaning, quantification is unavailing." (p. 62.)

* {{cite journal|vauthors=Hirschfeld RM, Lewis L, Vornik LA|title=Perceptions and impact of bipolar disorder: how far have we really come? Results of the national depressive and manic-depressive association 2000 survey of individuals with bipolar disorder|journal=The Journal of Clinical Psychiatry|volume=64|issue=2|pages=161–74|date=February 2003|pmid=12633125|doi=10.4088/JCP.v64n0209}}

* {{cite journal| vauthors = Hiruta G | veditors = Beveridge A |title=Japanese psychiatry in the Edo period (1600-1868)|journal=History of Psychiatry|volume=13|issue=50|pages=131–51|date=June 2002|doi=10.1177/0957154X0201305002|s2cid=143377079}}▼

* {{cite journal|vauthors=Krieke LV, Jeronimus BF, Blaauw FJ, Wanders RB, Emerencia AC, Schenk HM, Vos SD, Snippe E, Wichers M, Wigman JT, Bos EH, Wardenaar KJ, Jonge PD|title=HowNutsAreTheDutch (HoeGekIsNL): A crowdsourcing study of mental symptoms and strengths|journal=International Journal of Methods in Psychiatric Research|volume=25|issue=2|pages=123–44|date=June 2016|pmid=26395198|doi=10.1002/mpr.1495|pmc=6877205|hdl=11370/060326b0-0c6a-4df3-94cf-3468f2b2dbd6|url=https://pure.rug.nl/ws/files/30435764/2015_Van_der_Krieke_Jeronimus_HowNutsAreTheDutch_A_Crowdsourcing_Study_of_Mental_Symptoms_and_Strengths.pdf|access-date=2019-12-06|archive-date=2019-08-02|archive-url=https://web.archive.org/web/20190802163143/https://pure.rug.nl/ws/files/30435764/2015_Van_der_Krieke_Jeronimus_HowNutsAreTheDutch_A_Crowdsourcing_Study_of_Mental_Symptoms_and_Strengths.pdf}}

* {{cite journal|vauthors=McGorry PD, Mihalopoulos C, Henry L, Dakis J, Jackson HJ, Flaum M, Harrigan S, McKenzie D, Kulkarni J, Karoly R|title=Spurious precision: procedural validity of diagnostic assessment in psychotic disorders|journal=The American Journal of Psychiatry|volume=152|issue=2|pages=220–3|date=February 1995|pmid=7840355|doi=10.1176/ajp.152.2.220|citeseerx=10.1.1.469.3360}}

* {{cite journal|vauthors=Moncrieff J, Cohen D|title=Rethinking models of psychotropic drug action|journal=Psychotherapy and Psychosomatics|volume=74|issue=3|pages=145–53|year=2005|pmid=15832065|doi=10.1159/000083999|s2cid=6917144}}

* Singh, Manvir, "Read the Label: How psychiatric diagnoses create identities", ''[[The New Yorker]]'', 13 May 2024, pp. 20-24. "[T]he ''[[Diagnostic and Statistical Manual of Mental Disorders]]'', or ''DSM'' [...] guides how Americans [...] understand and deal with [[mental illness]]. [...] The ''DSM'' as we know it appeared in 1980, with the publication of the ''DSM-III'' [which] favored more precise diagnostic criteria and a more scientific approach [than the first two ''DSM'' editions]. [H]owever, the emerging picture is of overlapping conditions, of categories that blur rather than stand apart. No disorder has been tied to a specific [[gene]] or set of genes. Nearly [p. 20] all genetic vulnerabilities implicated in mental illness have been associated with many conditions. [...] As the philosopher [[Ian Hacking]] observed, labelling people is very different from labelling [[quark]]s or [[microbe]]s. Quarks and microbes are indifferent to their labels; by contrast, human classifications change how 'individuals experience themselves – and may even lead people to evolve their feelings and behavior in part because they are so classified.' Hacking's best-known example is [[multiple personality disorder]] [now called [[dissociative identity disorder]]]. Between 1972 and 1986, the number of cases of patients with multiple personalities exploded from the double digits to an estimated six thousand. [...] [I]n 1955 [n]o such diagnosis [had] existed. [Similarly, o]ver the past twenty years, the prevalence of [[autism]] in the United States has quadrupled [...]. A major driver of this surge has been a broadening of the definition and a lowering of the diagnostic threshold. Among people diagnosed with autism [...] evidence of the [[psychological]] and [[neurological]] traits associated with the condition declined by up to eighty per cent between 2000 and 2015. [[Temple Grandin]] [has commented that] [p. 21] 'The spectrum is so broad it doesn't make much sense.' [Confusion has also surrounded the term "[[sociopathy]]", which] was dropped from the ''DSM-II'' with the arrival of '[[antisocial personality disorder]]' [...]. Some scholars associated sociopathy with remorseless and impulsive behavior caused by a brain injury. Other people associated it with an antisocial personality. [T]he psychologist [[Martha Stout]] used it to mean a lack of [[conscience]]." (p. 22.) Yet another confusing [[nosological]] entity is [[borderline personality disorder]], "defined by sudden swings in [[Mood (psychology)|mood]], [[self-image]], and perceptions of others. [...] The concept is generally attributed to the psychoanalyst [[Adolph Stern]], who used it in 1937 to describe patients who were neither [[neurosis|neurotic]] nor [[psychotic]] and thus [were] 'borderline.' [It has been noted that] key symptoms such as [[identity disturbance]], outbursts of [[anger]], and unstable interpersonal relations also feature in [[narcissistic personality disorder|narcissistic]] and [[histrionic personality disorder]]s. [Medical sociologist] [[Allan Horwitz]] [...] asks why the ''DSM'' still treats B.P.D. as a [[personality disorder|disorder of personality]] rather than [[mood disorder|of mood]]. [p. 23.] [T]he process of labelling [[Reification (fallacy)|reifies]] categories [that is, endows them with a deceptive quality of "[[Wiktionary:thingness|thingness]]"], especially in the age of the [[Internet]]. [...] [P]eople everywhere encounter models of illness that they unconsciously embody. [...] In 2006, a [Mexican] student [...] developed devastating leg pain and had trouble walking; soon hundreds of classmates were afflicted." (p. 24.)

▲* {{cite journal|vauthors=Burke C|date=February 2000|title=Psychiatry: a "value-free" science?|journal=[[Linacre Quarterly]]|volume=67/1|pages=59–88|doi=10.1080/20508549.2000.11877569|s2cid=77216987|url=http://www.cormacburke.or.ke/node/369|access-date=2011-01-22|archive-date=2021-11-29|archive-url=https://web.archive.org/web/20211129195128/http://www.cormacburke.or.ke/node/369|url-status=live}}

* {{cite web|website=National Association of Cognitive-Behavioral Therapists|url=http://www.nacbt.org/whatiscbt.htm|title=What is Cognitive-Behavioral Therapy?|access-date=20 September 2006|archive-date=25 September 2006|archive-url=https://web.archive.org/web/20060925210024/http://www.nacbt.org/whatiscbt.htm|url-status=live}}

* {{cite journal|vauthors=Van Os J, Gilvarry C, Bale R, Van Horn E, Tattan T, White I, Murray R|title=A comparison of the utility of dimensional and categorical representations of psychosis. UK700 Group|journal=Psychological Medicine|volume=29|issue=3|pages=595–606|date=May 1999|pmid=10405080|doi=10.1017/s0033291798008162|s2cid=38854519 }}

* {{cite book|vauthors=Walker E, Young PD|date=1986|title=A Killing Cure|url=https://archive.org/details/killingcure00walk|url-access=registration|edition=1st|location=New York|publisher=H. Holt and Co.|oclc=12665467|isbn=978-0-03-069906-1}}

* {{cite journal|vauthors=Williams JB, Gibbon M, First MB, Spitzer RL, Davies M, Borus J, Howes MJ, Kane J, Pope HG, Rounsaville B|title=The Structured Clinical Interview for DSM-III-R (SCID). II. Multisite test-retest reliability|journal=Archives of General Psychiatry|volume=49|issue=8|pages=630–6|date=August 1992|pmid=1637253|doi=10.1001/archpsyc.1992.01820080038006}}

▲* {{cite journal| vauthors = Hiruta G | veditors = Beveridge A |title=Japanese psychiatry in the Edo period (1600-1868)|journal=History of Psychiatry|volume=13|issue=50|pages=131–51|date=June 2002|doi=10.1177/0957154X0201305002|s2cid=143377079}}