Transcript Introduction to Psychiatry for Pre

Introduction to Psychiatry for
Holy Spirit – 10th Grade
Marisa A. Giggie, MD, MPAff
Assistant Professor, Psychiatry and Behavioral
Medicine
University of Alabama School of Medicine, Tuscaloosa
Campus
GOALS OF PRESENTATION
• REVIEW DEFINITION OF PSYCHIATRY
• REVIEW DEFINITION OF MENTAL ILLNESS
• REVIEW TRAINING REQUIREMENTS TO BE A
PSYCHIATRIST
• INTRODUCE BASIC TREATMENT MODALITIES
WHAT IS PSYCHIATRY?
DEFINITION OF
PSYCHIATRY
The medical specialty
concerned with the
prevention, diagnosis, and
treatment of mental illness.
DEFINITION OF MENTAL ILLNESS
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A mental disorder or mental illness:
psychological or behavioral pattern that occurs in an
individual
Causes distress or disability that is not part of normal
development or culture.
The recognition and understanding of mental health
conditions has changed over time and across cultures, and
there are still variations in the definition, assessment, and
classification of mental disorders, although standard
guideline criteria are widely accepted.
Over a third of people in most countries report meeting
criteria for the major categories at some point in their life.
SERIOUS MENTAL ILLNESS (SMI)
• Disorder of thought, mood, perception,
orientation or memory
• Examples: schizophrenia, schizoaffective
disorder, psychotic conditions not otherwise
specified, bipolar disorder, and severe
depressive disorders.
• Excludes personality disorders & substance
abuse disorders
DSM-V
PSYCHIATRY VS PSYCHOLOGY
PSYCHIATRY IS A
MEDICAL FIELD
PSYCHIATRISTS GO
TO MEDICAL SCHOOL
PSYCHIATRISTS TRAIN
AS LONG AS
SURGEONS
PSYCHIATRISTS
PRESCRIBE
MEDICATION AND DO
PSYCHOTHERAPY
PSYCHIATRISTS ARE
NOT PSYCHOLOGISTS
PSYCHOLOGISTS ARE NOT PHYSICIANS
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"Psychologist" is an academic, occupational or professional title[1] used by individuals who are
either:
Social scientists conducting psychological research or teaching psychology in a college or university;
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employed by the government in psychology positions;
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professionals who apply psychological research, theories and techniques to "real-world" problems,
questions and issues, most typically in health and mental health care services, or in business and
industry.
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There are many different types of psychologists, as is reflected by the 56 different divisions of the
American Psychological Association (APA). Psychologists are generally described as being either
"applied" or "research-oriented". The common terms used to describe this central division in
psychology are "scientists" or "scholars" (those who conduct research) and "practitioners" or
"professionals" (those who apply psychological knowledge). The training models endorsed by the
APA require that applied psychologists be trained as both researchers and practitioners, and that
they possess advanced degrees.
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Most typically, people encounter psychologists and think of the discipline as involving the work of
clinical or counseling psychologists. While counseling and psychotherapy are common activities for
psychologists, these applied fields are just one branch in the larger domain of psychology.
Psychologists do NOT prescribe
medication. Only a Physician can.
WHAT IS A PSYCHIATRIST?
• A physician – MD or DO
– who completes
medical school, then a
four-year residency in
psychiatry.
• Subspecialties: Child &
Adolescent, Forensic,
Geriatric, C&L,
Substance Abuse
TRAINING IN PSYCHIATRY RESIDENCY
• Note: All MS3 do psychiatry rotation
• YEAR 1: Internship/neurology/IM/ER
• YEAR 2: Mostly inpatient, C&L, subspecialty
rotations, start psychotherapy caseload
• YEAR 3: OUTPATIENT
• YEAR 4: JR. ATTENDING ROLE ON SERVICES &
ELECTIVE/RESEARCH TIME
• Call is worst in year 1 then gets better
WHO ARE THERAPISTS?
DEFINITION OF A PSYCHOTHERAPIST
• Psychotherapy or personal counseling with a psychotherapist, is an
intentional interpersonal relationship used by trained
psychotherapists to aid a client or patient in problems of living.
• It aims to increase the individual's sense of their own well-being.
Psychotherapists employ a range of techniques based on
experiential relationship building, dialogue, communication and
behavior change and that are designed to improve the mental
health of a client or patient, or to improve group relationships (such
as in a family).
• Psychotherapy may also be performed by practitioners with a
number of different qualifications, including psychiatry, clinical
psychology, counseling psychology, mental health counseling,
clinical social work, marriage and family therapy, rehabilitation
counseling, music therapy, occupational therapy, psychiatric
nursing, psychoanalysis and others.
FREUD WAS A PSYCHIATRIST WHO
POPULARIZED PSYCHOANALYSIS
DIAGNOSIS OF MENTAL ILLNESS
• Can be diagnosed by a psychiatrist, a
psychologist, or a psychotherapist.
• Psychiatric Evaluation is not the same as a
Psychological Evaluation is not the same as a
therapy evaluation.
• ARE YOU CONFUSED YET?
PSYCHIATRIC EVALUATION FOR
MENTAL ILLNESS
• Assess symptoms of major psychiatric
disorders
• Past psychiatric history, past medical history,
medications, allergies, family medical history,
developmental history, educational history,
work history, social history
• Mental Status Examination/Sometimes
Physical Examination
• Assessment and Plan
MAJOR CATEGORIES OF MENTAL
ILLNESS
• DISORDERS OF INFANCY,
CHILDHOOD, AND
ADOLESCENCE (ADHD,
Oppositional Defiant Disorder,
Conduct Disorder, Autism,
Mental Retardation, etc)
• DELIRIUM, DEMENTIA,
AMNESTIC DISORDERS
• SUBSTANCE-RELATED
DISORDERS (Alcohol…)
• MENTAL DISORDERS DUE TO A
GENERAL MEDICAL
CONDITION
• MOOD DISORDER
• SCHIZOPHRENIA AND OTHER
PSYCHOTIC DISORDERS
• FACTITIOUS DISORDERS
• DISSOCIATIVE DISORDERS
• SEXUAL AND GENDER
IDENTITY DISORDERS
• EATING DISORDERS
• SLEEP DISORDERS
• IMPULSE CONTROL
DISORDERS
• ADJUSTMENT DISORDERS
• PERSONALITY DISORDERS
TREATMENTS FOR MENTAL ILLNESS
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MEDICATIONS
PSYCHOTHERAPY
ELECTROCONVULSIVE THERAPY (ECT)
TRANSMAGNETIC STIMULATION (TMS)
MEDICATIONS
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ANTIDEPRESSANTS
ANTIPSYCHOTICS
ANXIOLYTICS
MOOD STABILIZERS
STIMULANTS
HYPNOTICS
WHY STUDY PSYCHIATRY?
• It is seen in all specialties.
• Approx. 30-50% of primary care visits deal
with psychiatric issues directly or involve the
psychological aspect of disease.
• The brain is the last great frontier in medicine.
• It’s never boring – always interesting.
• Intellectually stimulating and diverse.
• It’s fun!!!