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Archives

Index /Archive 1: Jun 2001 - Dec 2005 /Archive 2: Jan 2006 - Feb 2006 /Archive 3: Feb 2006 - May 2006 /Archive 4: Jul 2006 - Mar 2007 /Archive 5: Mar 2007 - Apr 2007 /Archive 6: Apr 2007 - Oct 2007 /Archive 7: Oct 2007 - Feb 2008

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)[reply]

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)[reply]

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)[reply]

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)[reply]

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

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 (talk • contribs) 12:10, 27 May 2008 (UTC)[reply]

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)[reply]

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)[reply]

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)[reply]

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)[reply]

O-kay...which do you think need to go and which to remain then? Cheers, Casliber (talk · contribs) 02:29, 11 June 2008 (UTC)[reply]

...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)[reply]

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)[reply]

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)[reply]

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)[reply]

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)[reply]

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)[reply]

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)[reply]

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)[reply]

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)[reply]

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)[reply]

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)[reply]

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)[reply]

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)[reply]

Yea, that would be awesome. Chupper (talk) 21:49, 15 July 2008 (UTC)[reply]

I was musing the same thing - our beds certainly look nothing like that. Cheers, Casliber (talk · contribs) 04:35, 20 July 2008 (UTC)[reply]

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)[reply]

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)[reply]

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)[reply]

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)[reply]

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)[reply]

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)[reply]

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)[reply]

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)[reply]

"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)[reply]

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

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)[reply]

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)[reply]

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)[reply]

Yes, that's a much better suggestion. Martinevans123 (talk) 07:52, 21 July 2008 (UTC)[reply]

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)[reply]

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)[reply]

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)[reply]

We don't really need a reference for a caption do we? But tell us anyway. Anonymaus (talk) 09:37, 22 July 2008 (UTC)[reply]

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)[reply]

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)[reply]

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)[reply]