Psychiatry

Psychiatry

Occupation
Names	Physician
Activity sectors	Medicine
Description
Education required	Doctor of Medicine (MD) Doctor of Osteopathic Medicine (DO) Bachelor of Medicine, Bachelor of Surgery (MBBS/MBChB) Bachelor of Science in Clinical Medicine (Psychiatry) Higher Diploma in Clinical Medicine and Surgery (Psychiatry) Diploma in Clinical Medicine and Surgery Diploma in Clinical Psychiatry
Related jobs	Medical specialties Clinical psychology

Psychiatry is the medical specialty devoted to the diagnosis, prevention, and treatment of deleterious mental conditions.^[1][2] These include various matters related to mood, behaviour, cognition, perceptions, and emotions.

Initial psychiatric assessment of a person begins with creating a

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

Theory and focus

Psychiatry refers to a field of medicine focused specifically on the mind, aiming to study, prevent, and treat mental disorders in humans.^[10][11][12] It has been described as an intermediary between the world from a social context and the world from the perspective of those who are mentally ill.^[13]

People who specialize in psychiatry often differ from most other mental health professionals and physicians in that they must be familiar with both the social and biological sciences.^[11] The discipline studies the operations of different organs and body systems as classified by the patient's subjective experiences and the objective physiology of the patient. ^[14] Psychiatry treats mental disorders, which are conventionally divided into three general categories: mental illnesses, severe learning disabilities, and personality disorders.^[15] Although the focus of psychiatry has changed little over time, the diagnostic and treatment processes have evolved dramatically and continue to do so. Since the late 20th century, the field of psychiatry has continued to become more biological and less conceptually isolated from other medical fields.^[16]

Scope of practice

Though the medical specialty of psychiatry uses research in the field of neuroscience, psychology, medicine, biology, biochemistry, and pharmacology,^[17] it has generally been considered a middle ground between neurology and psychology.^[18] 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.^[19] 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.^[18] 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.^[20] Psychiatrists can therefore counsel patients, prescribe medication, order laboratory tests, order neuroimaging, and conduct physical examinations.^[3]

Ethics

The World Psychiatric Association issues an ethical code to govern the conduct of psychiatrists (like other purveyors of professional ethics). The psychiatric code of ethics, first set forth through the Declaration of Hawaii in 1977 has been expanded through a 1983 Vienna update and in the broader Madrid Declaration in 1996. The code was further revised during the organization's general assemblies in 1999, 2002, 2005, and 2011.^[21]

The World Psychiatric Association code covers such matters as confidentiality, the death penalty, ethnic or cultural discrimination,^[21] euthanasia, genetics, the human dignity of incapacitated patients, media relations, organ transplantation, patient assessment, research ethics, sex selection,^[22] torture,^[23][24] and up-to-date knowledge.

In establishing such ethical codes, the profession has responded to a number of controversies about the practice of psychiatry, for example, surrounding the use of lobotomy and electroconvulsive therapy.

Discredited psychiatrists who operated outside the norms of medical ethics include Harry Bailey, Donald Ewen Cameron, Samuel A. Cartwright, Henry Cotton, and Andrei Snezhnevsky.^{[25][page needed]}

Approaches

Psychiatric illnesses can be conceptualised in a number of different ways. The

Once a medical professional diagnoses a patient there are numerous ways that they could choose to treat the patient. Often psychiatrists will develop a treatment strategy that incorporates different facets of different approaches into one. Drug prescriptions are very commonly written to be regimented to patients along with any therapy they receive. There are three major pillars of psychotherapy that treatment strategies are most regularly drawn from. Humanistic psychology attempts to put the "whole" of the patient in perspective; it also focuses on self exploration.^[30] Behaviorism is a therapeutic school of thought that elects to focus solely on real and observable events, rather than mining the unconscious or subconscious. Psychoanalysis, on the other hand, concentrates its dealings on early childhood, irrational drives, the unconscious, and conflict between conscious and unconscious streams.^[31]

Practitioners

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All

The field of psychiatry has many subspecialties that require additional training and certification by the American Board of Psychiatry and Neurology (ABPN). Such subspecialties include:^[36]

• Addiction psychiatry, addiction medicine
• Brain injury medicine^[37][38]
• Child and adolescent psychiatry
• Clinical neurophysiology
• Consultation-liaison psychiatry^[39]
• Forensic psychiatry
• Geriatric psychiatry
• Hospice and palliative medicine
• Sleep medicine^[40]

Wikibooks has a book on the topic of: Psychiatry

Wikiquote has quotations related to Psychiatry.

Look up psychiatry in Wiktionary, the free dictionary.

Wikiversity has learning resources about Psychiatry

Wikimedia Commons has media related to Psychiatry.

Additional psychiatry subspecialties, for which the ABPN does not provide formal certification, include:^[41]

• Biological psychiatry
• Cognitive diseases, as in various forms of dementia
• Community psychiatry
• Cross-cultural psychiatry
• Emergency psychiatry
• Evolutionary psychiatry
• Global mental health
• Learning disabilities
• Military psychiatry
• Neurodevelopmental disorders
• Neuropsychiatry
• Social psychiatry

In larger healthcare organizations, psychiatrists often serve in senior management roles, where they are responsible for the efficient and effective delivery of mental health services for the organization's constituents. For example, the Chief of Mental Health Services at most VA medical centers is usually a psychiatrist, although psychologists occasionally are selected for the position as well.^[citation needed]

In the United States, psychiatry is one of the few specialties which qualify for further education and board-certification in pain medicine, palliative medicine, and sleep medicine.

Research

Psychiatric research is, by its very nature, interdisciplinary; combining social, biological and psychological perspectives in attempt to understand the nature and treatment of mental disorders.^[48] Clinical and research psychiatrists study basic and clinical psychiatric topics at research institutions and publish articles in journals.^{[17][49][50][51]} Under the supervision of institutional review boards, psychiatric clinical researchers look at topics such as neuroimaging, genetics, and psychopharmacology in order to enhance diagnostic validity and reliability, to discover new treatment methods, and to classify new mental disorders.^{[52][page needed]}

Clinical application

Diagnostic systems

The review concluded that although neuroimaging diagnosis may technically be feasible, very large studies are needed to evaluate specific biomarkers which were not available.^[63]

Diagnostic manuals

Three main diagnostic manuals used to classify mental health conditions are in use today. The ICD-11 is produced and published by the World Health Organization, includes a section on psychiatric conditions, and is used worldwide.^[64] The Diagnostic and Statistical Manual of Mental Disorders, produced and published by the American Psychiatric Association (APA), is primarily focused on mental health conditions and is the main classification tool in the United States.^[65] It is currently in its fifth revised edition and is also used worldwide.^[65] The Chinese Society of Psychiatry has also produced a diagnostic manual, the Chinese Classification of Mental Disorders.^[66]

The stated intention of diagnostic manuals is typically to develop replicable and clinically useful categories and criteria, to facilitate consensus and agreed upon standards, whilst being atheoretical as regards etiology.^[65][67] However, the categories are nevertheless based on particular psychiatric theories and data; they are broad and often specified by numerous possible combinations of symptoms, and many of the categories overlap in symptomology or typically occur together.^[68] While originally intended only as a guide for experienced clinicians trained in its use, the nomenclature is now widely used by clinicians, administrators and insurance companies in many countries.^[69]

The DSM has attracted praise for standardizing psychiatric diagnostic categories and criteria. It has also attracted controversy and criticism. Some critics argue that the DSM represents an

Individuals receiving psychiatric treatment are commonly referred to as

.

A psychiatrist or medical provider evaluates people through a psychiatric assessment for their mental and physical condition. This usually involves interviewing the person and often obtaining information from other sources such as other health and social care professionals, relatives, associates, law enforcement personnel, emergency medical personnel, and psychiatric rating scales. A mental status examination is carried out, and a physical examination is usually performed to establish or exclude other illnesses that may be contributing to the alleged psychiatric problems. A physical examination may also serve to identify any signs of self-harm; this examination is often performed by someone other than the psychiatrist, especially if blood tests and medical imaging are performed.

Like most medications, psychiatric medications can cause

full blood counts, serum drug levels, renal function, liver function or thyroid function. Electroconvulsive therapy (ECT) is sometimes administered for serious conditions, such as those unresponsive to medication. The efficacy^[74][75]

and adverse effects of psychiatric drugs may vary from patient to patient.

Inpatient treatment

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Psychiatric treatments have changed over the past several decades. In the past, psychiatric patients were often hospitalized

for six months or more, with some cases involving hospitalization for many years.

Average inpatient psychiatric treatment stay has decreased significantly since the 1960s, a trend known as

physical restraints, strapped to their beds for periods of weeks or months.^[81][82]

Psychiatric inpatients are people admitted to a hospital or clinic to receive psychiatric care. Some are admitted involuntarily, perhaps committed to a secure hospital, or in some jurisdictions to a facility within the prison system. In many countries including the United States and Canada, the criteria for involuntary admission vary with local jurisdiction. They may be as broad as having a mental health condition, or as narrow as being an immediate danger to themselves or others. Bed availability is often the real determinant of admission decisions to hard pressed public facilities.

People may be admitted voluntarily if the treating doctor considers that safety is not compromised by this less restrictive option. For many years, controversy has surrounded the use of involuntary treatment and use of the term "lack of insight" in describing patients. Internationally, mental health laws vary significantly but in many cases, involuntary psychiatric treatment is permitted when there is deemed to be a significant risk to the patient or others due to the patient's illness. Involuntary treatment refers to treatment that occurs based on a treating physician's recommendations, without requiring consent from the patient.[83]

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 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.^[84]

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]

Outpatient treatment

Outpatient treatment involves periodic visits to a psychiatrist for consultation in his or her office, or at a community-based outpatient clinic. During initial appointments, a psychiatrist generally conducts a psychiatric assessment or evaluation of the patient. Follow-up appointments then focus on making medication adjustments, reviewing potential medication interactions, considering the impact of other medical disorders on the patient's mental and emotional functioning, and counseling patients regarding changes they might make to facilitate healing and remission of symptoms. The frequency with which a psychiatrist sees people in treatment varies widely, from once a week to twice a year, depending on the type, severity and stability of each person's condition, and depending on what the clinician and patient decide would be best.

Increasingly, psychiatrists are limiting their practices to psychopharmacology (prescribing medications), as opposed to previous practice in which a psychiatrist would provide traditional 50-minute psychotherapy sessions, of which psychopharmacology would be a part, but most of the consultation sessions consisted of "talk therapy". This shift began in the early 1980s and accelerated in the 1990s and 2000s.^[85] A major reason for this change was the advent of managed care insurance plans,^{[clarification needed]} which began to limit reimbursement for psychotherapy sessions provided by psychiatrists. The underlying assumption was that psychopharmacology was at least as effective as psychotherapy, and it could be delivered more efficiently because less time is required for the appointment.^{[86][87][88][89][90][91][a][excessive citations]} Because of this shift in practice patterns, psychiatrists often refer patients whom they think would benefit from psychotherapy to other mental health professionals, e.g., clinical social workers and psychologists.^[92]

Telepsychiatry

This section is an excerpt from Telepsychiatry.[edit]

Telepsychiatry or telemental health refers to the use of telecommunications technology (mostly videoconferencing and phone calls) to deliver psychiatric care remotely for people with mental health conditions. It is a branch of telemedicine.^[93][94]

Telepsychiatry can be effective in treating people with mental health conditions. In the short-term it can be as acceptable and effective as face-to-face care.^[95]

It can improve access to mental health services for some but might also represent a barrier for those lacking access to a suitable device, the internet or the necessary digital skills. Factors such as poverty that are associated with lack of internet access are also associated with greater risk of mental health problems, making digital exclusion an important problem of telemental health services.^[95]

During the COVID-19 pandemic mental health services were adapted to telemental health in high-income countries. It proved effective and acceptable for use in an emergency situation but there were concerns regarding its long-term implementation.^[96]

History

Main article: History of psychiatry

Earliest knowledge

The earliest known texts on mental disorders are from ancient India and include the Ayurvedic text, Charaka Samhita.^[97][98] The first hospitals for curing mental illness were established in India during the 3rd century BCE.^[99]

Greek philosophers, including

mental illness resided within the brain. He applied this understanding to classify mental diseases and treatments.^[17][103] 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.^[101]

In the 6th century AD,

Lin Xie carried out an early 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 experiment.^[104]

The

Muhammad ibn Zakariya al-Razi, also known as "Rhazes", wrote texts about psychiatric conditions in the 9th century.^[105] As chief physician of a hospital in Baghdad, he was also the director of one of the first bimaristans in the world.^[105]

The first bimaristan was founded in Baghdad in the 9th century, and several others of increasing complexity were created throughout the Arab world in the following centuries. Some of the bimaristans contained wards dedicated to the care of mentally ill patients.^[106] During the Middle Ages, Psychiatric hospitals and lunatic asylums were built and expanded throughout Europe. Specialist hospitals such as Bethlem Royal Hospital in London were built in medieval Europe from the 13th century to treat mental disorders, but were used only as custodial institutions and did not provide any type of treatment. It is the oldest extant psychiatric hospital in the world.^[107]

An ancient text known as

Qing Dynasty with the work of Western-educated Fang Yizhi (1611–1671), Liu Zhi (1660–1730), and Wang Qingren (1768–1831). Wang Qingren emphasized the importance of the brain as the center of the nervous system, linked mental disorder with brain diseases, investigated the causes of dreams, insomnia, psychosis, depression and epilepsy.^[104]

Medical specialty

The beginning of psychiatry as a medical specialty is dated to the middle of the nineteenth century,

Louis XIV of France created a public system of hospitals for those with mental disorders, but as in England, no real treatment was applied.^[110]

During the Enlightenment, attitudes towards the mentally ill began to change. It came to be viewed as a disorder that required compassionate treatment. In 1758, English physician William Battie wrote his Treatise on Madness on the management of mental disorder. It was a critique aimed particularly at the Bethlem Royal Hospital, where a conservative regime continued to use barbaric custodial treatment. Battie argued for a tailored management of patients entailing cleanliness, good food, fresh air, and distraction from friends and family. He argued that mental disorder originated from dysfunction of the material brain and body rather than the internal workings of the mind.^[111][112]

The introduction of moral treatment was initiated independently by the French doctor

Jean Esquirol (1772–1840), went on to help establish 10 new mental hospitals that operated on the same principles.^[113]

Although Tuke, Pinel and others had tried to do away with physical restraint, it remained widespread into the 19th century. At the Lincoln Asylum in England, Robert Gardiner Hill, with the support of Edward Parker Charlesworth, pioneered a mode of treatment that suited "all types" of patients, so that mechanical restraints and coercion could be dispensed with—a situation he finally achieved in 1838. In 1839, Sergeant John Adams and Dr. John Conolly were impressed by the work of Hill, and introduced the method into their Hanwell Asylum, by then the largest in the country.^{[114][115][page needed]}

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

patients who required treatment. All asylums were required to have written regulations and to have a resident qualified physician.^{[116][full citation needed}

] 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.^{[117][page needed}

]

At the turn of the century, England and France combined had only a few hundred individuals in asylums.[118] By the late 1890s and early 1900s, this number had risen to the hundreds of thousands. However, the idea that mental illness could be ameliorated through institutionalization ran into difficulties.^[119] Psychiatrists were pressured by an ever-increasing patient population,^[119] and asylums again became almost indistinguishable from custodial institutions.^[120]

In the early 1800s, psychiatry made advances in the diagnosis of mental illness by broadening the category of mental disease to include mood disorders, in addition to disease level delusion or irrationality.^[121] The 20th century introduced a new psychiatry into the world, with different perspectives of looking at mental disorders. For Emil Kraepelin, the initial ideas behind biological psychiatry, stating that the different mental disorders are all biological in nature, evolved into a new concept of "nerves", and psychiatry became a rough approximation of neurology and neuropsychiatry.^[122] Following Sigmund Freud's pioneering work, ideas stemming from psychoanalytic theory also began to take root in psychiatry.^[123] The psychoanalytic theory became popular among psychiatrists because it allowed the patients to be treated in private practices instead of warehoused in asylums.^[123]

By the 1970s, however, the psychoanalytic school of thought became marginalized within the field.^[123] Biological psychiatry reemerged during this time. Psychopharmacology and neurochemistry became the integral parts of psychiatry starting with Otto Loewi's discovery of the neuromodulatory properties of acetylcholine; thus identifying it as the first-known neurotransmitter. Subsequently, it has been shown that different neurotransmitters have different and multiple functions in regulation of behaviour. In a wide range of studies in neurochemistry using human and animal samples, individual differences in neurotransmitters' production, reuptake, receptors' density and locations were linked to differences in dispositions for specific psychiatric disorders. For example, the discovery of chlorpromazine's effectiveness in treating schizophrenia in 1952 revolutionized treatment of the disorder,^[124] as did lithium carbonate's ability to stabilize mood highs and lows in bipolar disorder in 1948.^[125] Psychotherapy was still utilized, but as a treatment for psychosocial issues.^[126] This proved the idea of neurochemical nature of many psychiatric disorders.

Another approach to look for biomarkers of psychiatric disorders is ^[127] Neuroimaging that was first utilized as a tool for psychiatry in the 1980s.^[128]

In 1963, US president John F. Kennedy introduced legislation delegating the National Institute of Mental Health to administer Community Mental Health Centers for those being discharged from state psychiatric hospitals.^[129] Later, though, the Community Mental Health Centers focus shifted to providing psychotherapy for those with acute but less serious mental disorders.^[129] Ultimately there were no arrangements made for actively following and treating severely mentally ill patients who were being discharged from hospitals, resulting in a large population of chronically homeless people with mental illness.^[129]

Controversy and criticism

Main article:

Controversy surrounding psychiatry

The institution of psychiatry has attracted controversy since its inception.

critical psychiatry

group in the UK.

Double argues that most critical psychiatry is anti-reductionist. Rashed argues new mental health science has moved beyond this reductionist critique by seeking integrative and biopsychosocial models for conditions and that much of critical psychiatry now exists with orthodox psychiatry but notes that many critiques remain unaddressed^[131]: 237

The term

anti-psychiatry movement is that psychiatrists attempt to classify "normal" people as "deviant"; psychiatric treatments are ultimately more damaging than helpful to patients; and psychiatry's history involves (what may now be seen as) dangerous treatments, such as psychosurgery an example of this being the frontal lobectomy (commonly called a lobotomy).^[133]

The use of lobotomies largely disappeared by the late 1970s.

See also

• Glossary of psychiatry
• Medical psychology
• Biopsychiatry controversy
• Child and adolescent psychiatry
• Telepsychiatry
• Psychiatry Innovation Lab
• Anti-psychiatry
• Controversies about psychiatry

Notes

1. ^ This article does not enter into that debate or seek to summarize the comparative efficacy literature. It simply explains why managed care insurance companies stopped routinely reimbursing psychiatrists for traditional psychotherapy, without commenting on the validity of that rationale.

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Cited texts

• Gask L (2004). A Short Introduction to Psychiatry. London: SAGE Publications Ltd.
  OCLC 56009828
  .
• Guze SB (1992). Why Psychiatry Is a Branch of Medicine. New York: Oxford University Press.
  OCLC 25315637
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• Lyness JM (1997). Psychiatric Pearls. Philadelphia: F.A. Davis Company.
  OCLC 807453406
  .
• Shorter E (1998) [1997]. A History of Psychiatry: From the Era of the Asylum to the Age of Prozac. New York: John Wiley & Sons, Inc.
  OCLC 60169541
  .

Further reading

• Berrios GE, Porter R, eds. (1995). The History of Clinical Psychiatry. London: Athlone Press.
  OCLC 1000559759
  .
• Berrios GE (1996). History of Mental symptoms: The History of Descriptive Psychopathology since the 19th century. Cambridge: Cambridge University Press.
  OCLC 668203298
  .
• Ford-Martin PA (2002). "Psychosis". In Longe JL, Blanchfield DS (eds.). Gale Encyclopedia of Medicine. Vol. 4 (2nd ed.). Detroit: Gale Group.
  OCLC 51166617
  .
• 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.)
• 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.)
• Hirschfeld RM, Lewis L, Vornik LA (February 2003). "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". The Journal of Clinical Psychiatry. 64 (2): 161–74.
  PMID 12633125
  .
• 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 (June 2016). "HowNutsAreTheDutch (HoeGekIsNL): A crowdsourcing study of mental symptoms and strengths" (PDF). International Journal of Methods in Psychiatric Research. 25 (2): 123–44.
  PMID 26395198. Archived from the original
  (PDF) on 2019-08-02. Retrieved 2019-12-06.
• McGorry PD, Mihalopoulos C, Henry L, Dakis J, Jackson HJ, Flaum M, Harrigan S, McKenzie D, Kulkarni J, Karoly R (February 1995). "Spurious precision: procedural validity of diagnostic assessment in psychotic disorders". The American Journal of Psychiatry. 152 (2): 220–3.
  PMID 7840355
  .
• Moncrieff J, Cohen D (2005). "Rethinking models of psychotropic drug action". Psychotherapy and Psychosomatics. 74 (3): 145–53.
  S2CID 6917144
  .
• Burke C (February 2000). "Psychiatry: a "value-free" science?".
  S2CID 77216987. Archived
  from the original on 2021-11-29. Retrieved 2011-01-22.
• "What is Cognitive-Behavioral Therapy?". National Association of Cognitive-Behavioral Therapists. Archived from the original on 25 September 2006. Retrieved 20 September 2006.
• Van Os J, Gilvarry C, Bale R, Van Horn E, Tattan T, White I, Murray R (May 1999). "A comparison of the utility of dimensional and categorical representations of psychosis. UK700 Group". Psychological Medicine. 29 (3): 595–606.
  S2CID 38854519
  .
• Walker E, Young PD (1986). A Killing Cure (1st ed.). New York: H. Holt and Co.
  OCLC 12665467
  .
• Williams JB, Gibbon M, First MB, Spitzer RL, Davies M, Borus J, Howes MJ, Kane J, Pope HG, Rounsaville B (August 1992). "The Structured Clinical Interview for DSM-III-R (SCID). II. Multisite test-retest reliability". Archives of General Psychiatry. 49 (8): 630–6.
  PMID 1637253
  .
• Hiruta G (June 2002). Beveridge A (ed.). "Japanese psychiatry in the Edo period (1600-1868)". History of Psychiatry. 13 (50): 131–51.
  S2CID 143377079
  .