Psychiatry is the medical specialty devoted to the diagnosis, prevention, and treatment of deleterious mental conditions . These include various matters related to mood, behaviour, cognition , perceptions , and emotions.
129-484: The Research Diagnostic Criteria ( RDC ) are a collection of influential psychiatric diagnostic criteria published in late 1970s under auspices of Statistics Section NY Psychiatric Institute, authors were Spitzer, R L; Endicott J; Robins E. PMID 1153649. As psychiatric diagnoses widely varied especially between the US and Europe, the purpose of the criteria was to allow diagnoses to be consistent in psychiatric research. Some of
258-415: A multi-layered network of cooperating, distinct, or even competing social groups – from families and peer groups to corporations and political states . As such, social interactions between humans have established a wide variety of values, social norms , languages , and traditions (collectively termed institutions ), each of which bolsters human society . Humans are also highly curious , with
387-402: 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
516-668: A theory of mind . The human mind is capable of introspection , private thought , imagination , volition , and forming views on existence . This has allowed great technological advancements and complex tool development through complex reasoning and the transmission of knowledge to subsequent generations through language . Humans have had a dramatic effect on the environment . They are apex predators , being rarely preyed upon by other species. Human population growth , industrialization, land development, overconsumption and combustion of fossil fuels have led to environmental destruction and pollution that significantly contributes to
645-522: A brain scan might be used to rule out other medical illnesses, but at this time relying on brain scans alone cannot accurately diagnose a mental illness or tell the risk of getting a mental illness in the future. Some clinicians are beginning to utilize genetics and automated speech assessment during the diagnostic process but on the whole these remain research topics. In 2018, the American Psychological Association commissioned
774-443: A consequence of better nutrition, healthcare, and living conditions. The average mass of an adult human is 59 kg (130 lb) for females and 77 kg (170 lb) for males. Like many other conditions, body weight and body type are influenced by both genetic susceptibility and environment and varies greatly among individuals. Humans have a far faster and more accurate throw than other animals. Humans are also among
903-419: A few other places), saw the emergence of agriculture and permanent human settlement ; in turn, this led to the development of civilization and kickstarted a period of continuous (and ongoing) population growth and rapid technological change . Since then, a number of civilizations have risen and fallen, while a number of sociocultural and technological developments have resulted in significant changes to
1032-463: A great capacity for altering their habitats by means of technology, irrigation , urban planning , construction, deforestation and desertification . Human settlements continue to be vulnerable to natural disasters , especially those placed in hazardous locations and with low quality of construction. Grouping and deliberate habitat alteration is often done with the goals of providing protection, accumulating comforts or material wealth, expanding
1161-612: A higher body fat percentage. At puberty , humans develop secondary sex characteristics . Females are capable of pregnancy , usually between puberty, at around 12 years old, and menopause , around the age of 50. As omnivorous creatures, they are capable of consuming a wide variety of plant and animal material, and have used fire and other forms of heat to prepare and cook food since the time of Homo erectus . Humans can survive for up to eight weeks without food and several days without water . Humans are generally diurnal , sleeping on average seven to nine hours per day. Childbirth
1290-512: 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
1419-475: A human can lose personhood (such as by going into a persistent vegetative state ). Humans are apes ( superfamily Hominoidea ). The lineage of apes that eventually gave rise to humans first split from gibbons (family Hylobatidae) and orangutans (genus Pongo ), then gorillas (genus Gorilla ), and finally, chimpanzees and bonobos (genus Pan ). The last split, between the human and chimpanzee–bonobo lineages, took place around 8–4 million years ago, in
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#17328526785321548-406: 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
1677-581: A more barrel-shaped chests in contrast to the funnel shape of other apes, an adaptation for bipedal respiration. Apart from bipedalism and brain size, humans differ from chimpanzees mostly in smelling , hearing and digesting proteins . While humans have a density of hair follicles comparable to other apes, it is predominantly vellus hair , most of which is so short and wispy as to be practically invisible. Humans have about 2 million sweat glands spread over their entire bodies, many more than chimpanzees, whose sweat glands are scarce and are mainly located on
1806-499: A much clearer picture of life at the time. Between the 8th and 6th century BCE, Europe entered the classical antiquity age, a period when ancient Greece and ancient Rome flourished. Around this time other civilizations also came to prominence. The Maya civilization started to build cities and create complex calendars . In Africa, the Kingdom of Aksum overtook the declining Kingdom of Kush and facilitated trade between India and
1935-418: A narrative which tries to incorporate symptoms into a meaningful life history and to frame them as responses to external conditions. Both approaches are important in the field of psychiatry but have not sufficiently reconciled to settle controversy over either the selection of a psychiatric paradigm or the specification of psychopathology . The notion of a " biopsychosocial model " is often used to underline
2064-427: A natural dualist (i.e., non-spiritual) revision of the biopsychosocial view, reflecting the efforts of Australian psychiatrist Niall McLaren to bring the discipline into scientific maturity in accordance with the paradigmatic standards of philosopher Thomas Kuhn . Once a medical professional diagnoses a patient there are numerous ways that they could choose to treat the patient. Often psychiatrists will develop
2193-479: 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. A major reason for this change was the advent of managed care insurance plans, 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
2322-415: A priority on improving mental health and achieving equity in mental health for all people worldwide, although some scholars consider it to be a neo-colonial, culturally insensitive project. Liaison psychiatry is the branch of psychiatry that specializes in the interface between other medical specialties and psychiatry. Military psychiatry covers special aspects of psychiatry and mental disorders within
2451-560: 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
2580-493: 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
2709-562: A psychiatry residency. There are several reasons for this surge, including the intriguing nature of the field, growing interest in genetic biomarkers involved in psychiatric diagnoses, and newer pharmaceuticals on the drug market to treat psychiatric illnesses. 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: Additional psychiatry subspecialties, for which
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#17328526785322838-447: A result, humans are a cosmopolitan species found in almost all regions of the world, including tropical rainforest , arid desert , extremely cold arctic regions , and heavily polluted cities; in comparison, most other species are confined to a few geographical areas by their limited adaptability. The human population is not, however, uniformly distributed on the Earth 's surface, because
2967-556: A review to reach a consensus on whether modern clinical MRI / fMRI will be able to be used in the diagnosis of mental health disorders. The criteria presented by the APA stated that the biomarkers used in diagnosis should: The review concluded that although neuroimaging diagnosis may technically be feasible, very large studies are needed to evaluate specific biomarkers which were not available. Three main diagnostic manuals used to classify mental health conditions are in use today. The ICD-11
3096-403: A significant shortage of psychiatrists in the United States and elsewhere. Strategies to address this shortfall have included the use of short 'taster' placements early in the medical school curriculum and attempts to extend psychiatry services further using telemedicine technologies and other methods. Recently, however, there has been an increase in the number of medical students entering into
3225-632: A similar species. Migrating out of Africa , they gradually replaced and interbred with local populations of archaic humans. Multiple hypotheses for the extinction of archaic human species such as Neanderthals include competition, violence , interbreeding with Homo sapiens , or inability to adapt to climate change . Humans began exhibiting behavioral modernity about 160,000–60,000 years ago. For most of their history, humans were nomadic hunter-gatherers. The Neolithic Revolution , which began in Southwest Asia around 13,000 years ago (and separately in
3354-515: A simple linear or branched progression but involved interbreeding between related species . Genomic research has shown that hybridization between substantially diverged lineages was common in human evolution. DNA evidence suggests that several genes of Neanderthal origin are present among all non sub-Saharan-African populations, and Neanderthals and other hominins, such as Denisovans , may have contributed up to 6% of their genome to present-day non sub-Saharan-African humans. Human evolution
3483-574: A single board, the American Board of Psychiatry and Neurology, one of the member boards of the American Board of Medical Specialties. 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. Psychiatrists also differ from psychologists in that they are physicians and have post-graduate training called residency (usually four to five years) in psychiatry;
3612-451: A successful labor increased significantly during the 20th century in wealthier countries with the advent of new medical technologies. In contrast, pregnancy and natural childbirth remain hazardous ordeals in developing regions of the world, with maternal death rates approximately 100 times greater than in developed countries. Both the mother and the father provide care for human offspring, in contrast to other primates, where parental care
3741-588: 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. The earliest known texts on mental disorders are from ancient India and include the Ayurvedic text, Charaka Samhita . The first hospitals for curing mental illness were established in India during
3870-438: 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. Behaviorism
3999-406: A wide variety of plant and animal material. Human groups have adopted a range of diets from purely vegan to primarily carnivorous . In some cases, dietary restrictions in humans can lead to deficiency diseases ; however, stable human groups have adapted to many dietary patterns through both genetic specialization and cultural conventions to use nutritionally balanced food sources. The human diet
Research Diagnostic Criteria - Misplaced Pages Continue
4128-569: A wide variety of settings and are performed by many different health professionals . Therefore, the diagnostic procedure may vary greatly based upon these factors. Typically, though, a psychiatric diagnosis utilizes a differential diagnosis procedure where a mental status examination and physical examination is conducted, with pathological , psychopathological or psychosocial histories obtained, and sometimes neuroimages or other neurophysiological measurements are taken, or personality tests or cognitive tests administered. In some cases,
4257-511: Is 38 weeks, but a normal pregnancy can vary by up to 37 days. Embryonic development in the human covers the first eight weeks of development; at the beginning of the ninth week the embryo is termed a fetus . Humans are able to induce early labor or perform a caesarean section if the child needs to be born earlier for medical reasons. In developed countries, infants are typically 3–4 kg (7–9 lb) in weight and 47–53 cm (19–21 in) in height at birth. However, low birth weight
4386-428: Is a branch of telemedicine . 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. Research also suggests comparable therapeutic factors, such as changes in problematic thinking or behaviour. It can improve access to mental health services for some but might also represent a barrier for those lacking access to
4515-485: Is a mixture of the two parental sets. Among the 23 pairs of chromosomes, there are 22 pairs of autosomes and one pair of sex chromosomes . Like other mammals, humans have an XY sex-determination system , so that females have the sex chromosomes XX and males have XY. Genes and environment influence human biological variation in visible characteristics, physiology, disease susceptibility and mental abilities. The exact influence of genes and environment on certain traits
4644-424: Is a population decline in the winter months of this realm. Humans established nation-states in the other seven realms, such as South Africa , India , Russia , Australia , Fiji , United States and Brazil (each located in a different biogeographical realm). By using advanced tools and clothing , humans have been able to extend their tolerance to a wide variety of temperatures, humidities , and altitudes. As
4773-881: 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. All physicians can diagnose mental disorders and prescribe treatments utilizing principles of psychiatry. Psychiatrists are trained physicians who specialize in psychiatry and are certified to treat mental illness . They may treat outpatients, inpatients, or both; they may practice as solo practitioners or as members of groups; they may be self-employed, be members of partnerships, or be employees of governmental, academic, nonprofit, or for-profit entities; employees of hospitals; they may treat military personnel as civilians or as members of
4902-627: Is also used worldwide. The Chinese Society of Psychiatry has also produced a diagnostic manual, the Chinese Classification of Mental Disorders . 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. 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
5031-402: Is characterized by a number of morphological , developmental , physiological , and behavioral changes that have taken place since the split between the last common ancestor of humans and chimpanzees . The most significant of these adaptations are hairlessness , obligate bipedalism, increased brain size and decreased sexual dimorphism ( neoteny ). The relationship between all these changes
5160-456: Is common in developing countries, and contributes to the high levels of infant mortality in these regions. Compared with other species, human childbirth is dangerous, with a much higher risk of complications and death. The size of the fetus's head is more closely matched to the pelvis than in other primates. The reason for this is not completely understood, but it contributes to a painful labor that can last 24 hours or more. The chances of
5289-421: Is dangerous, with a high risk of complications and death . Often, both the mother and the father provide care for their children, who are helpless at birth . Humans have a large, highly developed, and complex prefrontal cortex , the region of the brain associated with higher cognition. Humans are highly intelligent and capable of episodic memory ; they have flexible facial expressions, self-awareness , and
Research Diagnostic Criteria - Misplaced Pages Continue
5418-472: Is generally aging, with the median age around 40 years. In the developing world , the median age is between 15 and 20 years. While one in five Europeans is 60 years of age or older, only one in twenty Africans is 60 years of age or older. In 2012, the United Nations estimated that there were 316,600 living centenarians (humans of age 100 or older) worldwide. Humans are omnivorous , capable of consuming
5547-443: Is inherited only from the mother, geneticists have concluded that the last female common ancestor whose genetic marker is found in all modern humans, the so-called mitochondrial Eve , must have lived around 90,000 to 200,000 years ago. Most human reproduction takes place by internal fertilization via sexual intercourse , but can also occur through assisted reproductive technology procedures. The average gestation period
5676-408: Is mostly done by the mother. Helpless at birth , humans continue to grow for some years, typically reaching sexual maturity at 15 to 17 years of age. The human life span has been split into various stages ranging from three to twelve. Common stages include infancy , childhood , adolescence , adulthood and old age . The lengths of these stages have varied across cultures and time periods but
5805-513: Is not well understood. While no humans – not even monozygotic twins – are genetically identical, two humans on average will have a genetic similarity of 99.5%-99.9%. This makes them more homogeneous than other great apes, including chimpanzees. This small variation in human DNA compared to many other species suggests a population bottleneck during the Late Pleistocene (around 100,000 years ago), in which
5934-467: 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
6063-503: 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. 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
6192-619: Is produced and published by the World Health Organization , includes a section on psychiatric conditions, and is used worldwide. 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 . It is currently in its fifth revised edition and
6321-476: Is required for the appointment. 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. 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
6450-475: Is sometimes administered for serious conditions, such as those unresponsive to medication. The efficacy and adverse effects of psychiatric drugs may vary from patient to patient. 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
6579-433: Is the clinical application of psychiatry in emergency settings. Forensic psychiatry utilizes medical science generally, and psychiatric knowledge and assessment methods in particular, to help answer legal questions. Geriatric psychiatry is a branch of psychiatry dealing with the study, prevention, and treatment of mental disorders in the elderly . Global mental health is an area of study, research and practice that places
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#17328526785326708-445: Is the subject of ongoing debate. Hylobatidae ( gibbons ) Pongo abelii Pongo tapanuliensis Pongo pygmaeus Gorilla gorilla Gorilla beringei Pan troglodytes Pan paniscus Homo sapiens (humans) Until about 12,000 years ago, all humans lived as hunter-gatherers . The Neolithic Revolution (the invention of agriculture ) first took place in Southwest Asia and spread through large parts of
6837-654: Is typified by an unusually rapid growth spurt during adolescence. Human females undergo menopause and become infertile at around the age of 50. It has been proposed that menopause increases a woman's overall reproductive success by allowing her to invest more time and resources in her existing offspring, and in turn their children (the grandmother hypothesis ), rather than by continuing to bear children into old age. The life span of an individual depends on two major factors, genetics and lifestyle choices. For various reasons, including biological/genetic causes, women live on average about four years longer than men. As of 2018 ,
6966-626: 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 adverse effects in patients, and some require ongoing therapeutic drug monitoring , for instance full blood counts , serum drug levels, renal function, liver function or thyroid function. Electroconvulsive therapy (ECT)
7095-976: The International Classification of Diseases (ICD), 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. Treatment may include psychotropics (psychiatric medicines), interventional approaches and psychotherapy , and also other modalities such as assertive community treatment , community reinforcement , substance-abuse treatment , and supported employment . Treatment may be delivered on an inpatient or outpatient basis, depending on
7224-534: The British Empire expanded to become the world's largest empire . A tenuous balance of power among European nations collapsed in 1914 with the outbreak of the First World War , one of the deadliest conflicts in history. In the 1930s, a worldwide economic crisis led to the rise of authoritarian regimes and a Second World War , involving almost all of the world's countries . The war's destruction led to
7353-568: The Caral–Supe civilization is the oldest complex civilization in the Americas. Astronomy and mathematics were also developed and the Great Pyramid of Giza was built. There is evidence of a severe drought lasting about a hundred years that may have caused the decline of these civilizations, with new ones appearing in the aftermath. Babylonians came to dominate Mesopotamia while others, such as
7482-501: The Church would provide centralized authority and education. In the Middle East, Islam became the prominent religion and expanded into North Africa. It led to an Islamic Golden Age , inspiring achievements in architecture , the revival of old advances in science and technology, and the formation of a distinct way of life. The Christian and Islamic worlds would eventually clash, with
7611-470: The Homo genus. The name " Homo sapiens " means 'wise man' or 'knowledgeable man'. There is disagreement if certain extinct members of the genus, namely Neanderthals , should be included as a separate species of humans or as a subspecies of H. sapiens . Human is a loanword of Middle English from Old French humain , ultimately from Latin hūmānus , the adjectival form of homō ('man' – in
7740-566: The Kingdom of England , the Kingdom of France and the Holy Roman Empire declaring a series of holy wars to regain control of the Holy Land from Muslims . In the Americas, between 200 and 900 CE Mesoamerica was in its Classic Period , while further north, complex Mississippian societies would arise starting around 800 CE. The Mongol Empire would conquer much of Eurasia in the 13th and 14th centuries. Over this same time period,
7869-819: The Mali Empire in Africa grew to be the largest empire on the continent, stretching from Senegambia to Ivory Coast . Oceania would see the rise of the Tuʻi Tonga Empire which expanded across many islands in the South Pacific. By the late 15th century, the Aztecs and Inca had become the dominant power in Mesoamerica and the Andes , respectively. The early modern period in Europe and
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#17328526785327998-596: 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. An ancient text known as The Yellow Emperor's Classic of Internal Medicine identifies
8127-572: The Old World over the following millennia. It also occurred independently in Mesoamerica (about 6,000 years ago), China, Papua New Guinea , and the Sahel and West Savanna regions of Africa. Access to food surplus led to the formation of permanent human settlements , the domestication of animals and the use of metal tools for the first time in history. Agriculture and sedentary lifestyle led to
8256-629: The Poverty Point culture , Minoans and the Shang dynasty , rose to prominence in new areas. The Late Bronze Age collapse around 1200 BCE resulted in the disappearance of a number of civilizations and the beginning of the Greek Dark Ages . During this period iron started replacing bronze, leading to the Iron Age . In the 5th century BCE, history started being recorded as a discipline , which provided
8385-766: The colonization of the Americas and the Columbian Exchange . This expansion led to the Atlantic slave trade and the genocide of Native American peoples . This period also marked the Scientific Revolution , with great advances in mathematics , mechanics , astronomy and physiology . The late modern period (1800–present) saw the Technological and Industrial Revolution bring such discoveries as imaging technology , major innovations in transport and energy development . Influenced by Enlightenment ideals,
8514-414: The death penalty , ethnic or cultural discrimination, euthanasia , genetics, the human dignity of incapacitated patients, media relations, organ transplantation, patient assessment, research ethics, sex selection, torture , 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
8643-521: 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 CNS and that the cause of mental illness resided within the brain. He applied this understanding to classify mental diseases and treatments. 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
8772-423: The 'medical treatment of the soul ' ( ψυχή psych- 'soul' from Ancient Greek psykhē 'soul'; -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 ). "Psychiatry, more than any other branch of medicine, forces its practitioners to wrestle with
8901-606: The 1960s, a trend known as deinstitutionalization . Today in most countries, people receiving psychiatric treatment are more likely to be seen as outpatients . If hospitalization is required, the average hospital stay is around one to two weeks, with only a small number receiving long-term hospitalization. However, in Japan psychiatric hospitals continue to keep patients for long periods, sometimes even keeping them in physical restraints , strapped to their beds for periods of weeks or months. Psychiatric inpatients are people admitted to
9030-608: The 3rd century BCE. Greek philosophers, including Thales , Plato , and Aristotle (especially in his De Anima treatise), also addressed the workings of the mind. As early as the 4th century BC, the Greek physician Hippocrates theorized that mental disorders 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
9159-560: The 9th century. As chief physician of a hospital in Baghdad, he was also the director of one of the first bimaristans in the world. 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. During
9288-464: The ABPN does not provide formal certification, include: Addiction psychiatry focuses on evaluation and treatment of individuals with alcohol, drug, or other substance-related disorders, and of individuals with dual diagnosis of substance-related and other psychiatric disorders. Biological psychiatry is an approach to psychiatry that aims to understand mental disorders in terms of the biological function of
9417-510: The Americas and Europe experienced a period of political revolutions known as the Age of Revolution . The Napoleonic Wars raged through Europe in the early 1800s, Spain lost most of its colonies in the New World , while Europeans continued expansion into Africa – where European control went from 10% to almost 90% in less than 50 years – and Oceania. In the 19th century,
9546-438: The DSM represents an unscientific system that enshrines the opinions of a few powerful psychiatrists. There are ongoing issues concerning the validity and reliability of the diagnostic categories; the reliance on superficial symptoms ; the use of artificial dividing lines between categories and from ' normality '; possible cultural bias; medicalization of human distress and financial conflicts of interest , including with
9675-728: The Mediterranean. In West Asia, the Achaemenid Empire 's system of centralized governance became the precursor to many later empires, while the Gupta Empire in India and the Han dynasty in China have been described as golden ages in their respective regions. Following the fall of the Western Roman Empire in 476, Europe entered the Middle Ages . During this period, Christianity and
9804-792: The Near East ( c. 1450 –1800) began with the final defeat of the Byzantine Empire , and the rise of the Ottoman Empire . Meanwhile, Japan entered the Edo period , the Qing dynasty rose in China and the Mughal Empire ruled much of India. Europe underwent the Renaissance , starting in the 15th century, and the Age of Discovery began with the exploring and colonizing of new regions. This included
9933-572: The application of these principles in Italy found that 14 general hospital psychiatric units reported zero restraint incidents in 2022. 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
10062-473: The available food, improving aesthetics , increasing knowledge or enhancing the exchange of resources. Humans are one of the most adaptable species, despite having a low or narrow tolerance for many of the earth's extreme environments. Currently the species is present in all eight biogeographical realms , although their presence in the Antarctic realm is very limited to research stations and annually there
10191-561: The best long-distance runners in the animal kingdom, but slower over short distances. Humans' thinner body hair and more productive sweat glands help avoid heat exhaustion while running for long distances. Compared to other apes, the human heart produces greater stroke volume and cardiac output and the aorta is proportionately larger. Like most animals, humans are a diploid and eukaryotic species. Each somatic cell has two sets of 23 chromosomes , each set received from one parent; gametes have only one set of chromosomes, which
10320-460: The brain as the nexus of wisdom and sensation, includes theories of personality based on yin–yang balance, and analyzes mental disorder in terms of physiological and social disequilibria. Chinese scholarship that focused on the brain advanced during the Qing Dynasty with the work of Western-educated Fang Yizhi (1611–1671), Liu Zhi (1660–1730), and Wang Qingren (1768–1831). Wang Qingren emphasized
10449-730: The care of a hospital, people are assessed , monitored, and often given medication and care from a multidisciplinary team, which may include physicians, pharmacists, psychiatric nurse practitioners, 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. In many developed countries there has been
10578-483: The care of a psychiatric physician or other psychiatric practitioners by various paths, the two most common being self- referral or referral by a primary care physician . Alternatively, a person may be referred by hospital medical staff, by court order , involuntary commitment , or, in countries such as the UK and Australia, by sectioning under a mental health law . A psychiatrist or medical provider evaluates people through
10707-437: The categories overlap in symptomology or typically occur together. 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. The DSM has attracted praise for standardizing psychiatric diagnostic categories and criteria. It has also attracted controversy and criticism. Some critics argue that
10836-585: The collapse of most global empires, leading to widespread decolonization. Following the conclusion of the Second World War in 1945, the United States and the USSR emerged as the remaining global superpowers . This led to a Cold War that saw a struggle for global influence, including a nuclear arms race and a space race , ending in the collapse of the Soviet Union. The current Information Age , spurred by
10965-771: The combined eastern and western Roman Empire in the 4th century AD. Bubonic plagues , first recorded in the 6th century AD, reduced the population by 50%, with the Black Death killing 75–200 million people in Eurasia and North Africa alone. Human population is believed to have reached one billion in 1800. It has since then increased exponentially, reaching two billion in 1930 and three billion in 1960, four in 1975, five in 1987 and six billion in 1999. It passed seven billion in 2011 and passed eight billion in November 2022. It took over two million years of human prehistory and history for
11094-504: 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. The World Psychiatric Association code covers such matters as confidentiality ,
11223-474: The continent, gradually replacing or interbreeding with local populations of archaic humans. Humans began exhibiting behavioral modernity about 160,000–70,000 years ago, and possibly earlier. This development was likely selected amidst natural climate change in Middle to Late Pleistocene Africa. The "out of Africa" migration took place in at least two waves, the first around 130,000 to 100,000 years ago,
11352-510: The criteria were based on the earlier Feighner Criteria , although many new disorders were included; "The historical record shows that the small group of individuals who created the Feighner criteria instigated a paradigm shift that has had profound effects on the course of American and, ultimately, world psychiatry." The RDC is important in the history of psychiatric diagnostic criteria as the DSM-III
11481-423: The desire to understand and influence phenomena having motivated humanity's development of science , technology , philosophy , mythology , religion , and other frameworks of knowledge ; humans also study themselves through such domains as anthropology , social science , history , psychology , and medicine . There are estimated to be more than eight billion living humans . Although some scientists equate
11610-511: The development of the Internet and Artificial Intelligence systems, sees the world becoming increasingly globalized and interconnected. Early human settlements were dependent on proximity to water and – depending on the lifestyle – other natural resources used for subsistence , such as populations of animal prey for hunting and arable land for growing crops and grazing livestock. Modern humans, however, have
11739-623: The early 20th century, there has been continuous human presence in Antarctica through research stations and, since 2000, in space through habitation on the International Space Station . All modern humans are classified into the species Homo sapiens , coined by Carl Linnaeus in his 1735 work Systema Naturae . The generic name " Homo " is a learned 18th-century derivation from Latin homō , which refers to humans of either sex. The word human can refer to all members of
11868-667: 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. 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 . Psychiatric research is, by its very nature, interdisciplinary; combining social, biological and psychological perspectives in attempt to understand
11997-668: The emergence of early civilizations . An urban revolution took place in the 4th millennium BCE with the development of city-states , particularly Sumerian cities located in Mesopotamia . It was in these cities that the earliest known form of writing, cuneiform script , appeared around 3000 BCE. Other major civilizations to develop around this time were Ancient Egypt and the Indus Valley Civilisation . They eventually traded with each other and invented technology such as wheels, plows and sails. Emerging by 3000 BCE,
12126-530: 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. Outpatient treatment involves periodic visits to
12255-561: The genomes of 1,184 individuals from 11 populations and identified 1.6 million single nucleotide polymorphisms . African populations harbor the highest number of private genetic variants. While many of the common variants found in populations outside of Africa are also found on the African continent, there are still large numbers that are private to these regions, especially Oceania and the Americas . By 2010 estimates, humans have approximately 22,000 genes. By comparing mitochondrial DNA , which
12384-580: The global average life expectancy at birth of a girl is estimated to be 74.9 years compared to 70.4 for a boy. There are significant geographical variations in human life expectancy, mostly correlated with economic development – for example, life expectancy at birth in Hong Kong is 87.6 years for girls and 81.8 for boys, while in the Central African Republic , it is 55.0 years for girls and 50.6 for boys. The developed world
12513-443: The human lifestyle. Genes and the environment influence human biological variation in visible characteristics, physiology , disease susceptibility, mental abilities, body size, and life span. Though humans vary in many traits, humans are among the least genetically diverse species. Any two humans are at least 99.5% genetically similar. Humans are sexually dimorphic : generally, males have greater body strength and females have
12642-550: The human population to reach one billion and only 207 years more to grow to 7 billion. The combined biomass of the carbon of all the humans on Earth in 2018 was estimated at 60 million tons, about 10 times larger than that of all non-domesticated mammals. In 2018, 4.2 billion humans (55%) lived in urban areas, up from 751 million in 1950. The most urbanized regions are Northern America (82%), Latin America (81%), Europe (74%) and Oceania (68%), with Africa and Asia having nearly 90% of
12771-505: The human population was reduced to a small number of breeding pairs. The forces of natural selection have continued to operate on human populations, with evidence that certain regions of the genome display directional selection in the past 15,000 years. The human genome was first sequenced in 2001 and by 2020 hundreds of thousands of genomes had been sequenced. In 2012 the International HapMap Project had compared
12900-425: 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 . The beginning of psychiatry as a medical specialty is dated to the middle of the nineteenth century, although its germination can be traced to the late eighteenth century. In the late 17th century, privately run asylums for
13029-521: The insane began to proliferate and expand in size. In 1713, the Bethel Hospital Norwich was opened, the first purpose-built asylum in England. In 1656, Louis XIV of France created a public system of hospitals for those with mental disorders, but as in England, no real treatment was applied. Human Humans ( Homo sapiens , meaning "thinking man" or "wise man") or modern humans are
13158-567: The late Miocene epoch. During this split, chromosome 2 was formed from the joining of two other chromosomes, leaving humans with only 23 pairs of chromosomes, compared to 24 for the other apes. Following their split with chimpanzees and bonobos, the hominins diversified into many species and at least two distinct genera. All but one of these lineages – representing the genus Homo and its sole extant species Homo sapiens – are now extinct. The genus Homo evolved from Australopithecus . Though fossils from
13287-400: The medical specialty of psychiatry uses research in the field of neuroscience , psychology , medicine , biology , biochemistry , and pharmacology , it has generally been considered a middle ground between neurology and psychology. Because psychiatry and neurology are deeply intertwined medical specialties, all certification for both specialties and for their subspecialties is offered by
13416-407: The military context. Neuropsychiatry is a branch of medicine dealing with mental disorders attributable to diseases of the nervous system. Social psychiatry is a branch of psychiatry that focuses on the interpersonal and cultural context of mental disorder and mental well-being. In larger healthcare organizations, psychiatrists often serve in senior management roles, where they are responsible for
13545-524: The military; and in any of these settings they may function as clinicians, researchers, teachers, or some combination of these. Although psychiatrists may also go through significant training to conduct psychotherapy , psychoanalysis or cognitive behavioral therapy , it is their training as physicians that differentiates them from other mental health professionals . Psychiatry was not a popular career choice among medical students, even though medical school placements are rated favorably. This has resulted in
13674-501: The most common and widespread species of primate , and the last surviving species of the genus Homo . They are great apes characterized by their hairlessness , bipedalism , and high intelligence . Humans have large brains , enabling more advanced cognitive skills that enable them to thrive and adapt in varied environments, develop highly complex tools , and form complex social structures and civilizations . Humans are highly social , with individual humans tending to belong to
13803-401: The multifactorial nature of clinical impairment. In this notion the word model is not used in a strictly scientific way though. Alternatively, a Niall McLaren acknowledges the physiological basis for the mind's existence but identifies cognition as an irreducible and independent realm in which disorder may occur. The biocognitive approach includes a mentalist etiology and provides
13932-520: The nature and treatment of mental disorders. Clinical and research psychiatrists study basic and clinical psychiatric topics at research institutions and publish articles in journals. 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. Psychiatric diagnoses take place in
14061-408: The nature of evidence, the validity of introspection, problems in communication, and other long-standing philosophical issues" ( Guze, 1992, p.4 ). Psychiatry refers to a field of medicine focused specifically on the mind , aiming to study , prevent , and treat mental disorders in humans . It has been described as an intermediary between the world from a social context and the world from
14190-470: The nervous system. Child and adolescent psychiatry is the branch of psychiatry that specializes in work with children, teenagers, and their families. Community psychiatry is an approach that reflects an inclusive public health perspective and is practiced in community mental health services . Cross-cultural psychiatry is a branch of psychiatry concerned with the cultural and ethnic context of mental disorder and psychiatric services. Emergency psychiatry
14319-555: The ongoing mass extinction of other forms of life. Within the last century, humans have explored challenging environments such as Antarctica , the deep sea , and outer space . Human habitation within these hostile environments is restrictive and expensive, typically limited in duration, and restricted to scientific , military , or industrial expeditions. Humans have visited the Moon and made their presence known on other celestial bodies through human-made robotic spacecraft . Since
14448-442: The only primates to have short, relatively flush canine teeth . Humans have characteristically crowded teeth, with gaps from lost teeth usually closing up quickly in young individuals. Humans are gradually losing their third molars , with some individuals having them congenitally absent. Humans share with chimpanzees a vestigial tail, appendix , flexible shoulder joints, grasping fingers and opposable thumbs . Humans also have
14577-474: The palm of the hand and on the soles of the feet. It is estimated that the worldwide average height for an adult human male is about 171 cm (5 ft 7 in), while the worldwide average height for adult human females is about 159 cm (5 ft 3 in). Shrinkage of stature may begin in middle age in some individuals but tends to be typical in the extremely aged . Throughout history, human populations have universally become taller, probably as
14706-506: The patient. Psychiatry treats mental disorders, which are conventionally divided into three general categories: mental illnesses , severe learning disabilities, and personality disorders . 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. Though
14835-403: The perspective of those who are mentally ill. 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 . The discipline studies the operations of different organs and body systems as classified by the patient's subjective experiences and the objective physiology of
14964-511: The population density varies from one region to another, and large stretches of surface are almost completely uninhabited, like Antarctica and vast swathes of the ocean. Most humans (61%) live in Asia; the remainder live in the Americas (14%), Africa (14%), Europe (11%), and Oceania (0.5%). Estimates of the population at the time agriculture emerged in around 10,000 BC have ranged between 1 million and 15 million. Around 50–60 million people lived in
15093-524: The practice of psychiatrists and with the pharmaceutical industry ; political controversies about the inclusion or exclusion of diagnoses from the manual, in general or in regard to specific issues; and the experience of those who are most directly affected by the manual by being diagnosed, including the consumer/survivor movement . Individuals receiving psychiatric treatment are commonly referred to as patients but may also be called clients , consumers , or service recipients . They may come under
15222-567: The quality and thoroughness of their graduate medical training is identical to that of all other physicians. Psychiatrists can therefore counsel patients, prescribe medication, order laboratory tests , order neuroimaging , and conduct physical examinations . 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 . The World Psychiatric Association issues an ethical code to govern
15351-404: The second ( Southern Dispersal ) around 70,000 to 50,000 years ago. H. sapiens proceeded to colonize all the continents and larger islands, arriving in Eurasia 125,000 years ago, Australia around 65,000 years ago, the Americas around 15,000 years ago, and remote islands such as Hawaii , Easter Island , Madagascar , and New Zealand in the years 300 to 1280 CE. Human evolution was not
15480-547: The sense of humanity). The native English term man can refer to the species generally (a synonym for humanity ) as well as to human males. It may also refer to individuals of either sex. Despite the fact that the word animal is colloquially used as an antonym for human , and contrary to a common biological misconception , humans are animals . The word person is often used interchangeably with human , but philosophical debate exists as to whether personhood applies to all humans or all sentient beings , and further if
15609-453: 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 , nurses , social workers , occupational therapists , and clinical psychologists . The term psychiatry was first coined by the German physician Johann Christian Reil in 1808 and literally means
15738-433: The term "humans" with all members of the genus Homo , in common usage it generally refers to Homo sapiens , the only extant member. All other members of the genus Homo , which are now extinct, are known as archaic humans , and the term "modern human" is used to distinguish Homo sapiens from archaic humans. Anatomically modern humans emerged around 300,000 years ago in Africa, evolving from Homo heidelbergensis or
15867-427: The transition are scarce, the earliest members of Homo share several key traits with Australopithecus . The earliest record of Homo is the 2.8 million-year-old specimen LD 350-1 from Ethiopia , and the earliest named species are Homo habilis and Homo rudolfensis which evolved by 2.3 million years ago. H. erectus (the African variant is sometimes called H. ergaster ) evolved 2 million years ago and
15996-475: 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 . Psychiatric illnesses can be conceptualised in a number of different ways. The biomedical approach examines signs and symptoms and compares them with diagnostic criteria. Mental illness can be assessed, conversely, through
16125-440: The world's 3.4 billion rural population. Problems for humans living in cities include various forms of pollution and crime , especially in inner city and suburban slums . Most aspects of human physiology are closely homologous to corresponding aspects of animal physiology. The dental formula of humans is: 2.1.2.3 2.1.2.3 . Humans have proportionately shorter palates and much smaller teeth than other primates. They are
16254-414: Was attempting to discover the cause of madness and melancholy. Hippocrates praised his work. Democritus had with him a book on madness and melancholy. During the 5th century BCE, mental disorders, especially those with psychotic traits, were considered supernatural in origin, a view which existed throughout ancient Greece and Rome , as well as Egyptian regions. Alcmaeon , believed the brain , not
16383-524: Was based on many of the RDC descriptions, head of DSM III Edition was R L Spitzer. Psychiatric Initial psychiatric assessment of a person begins with creating a case history and conducting a mental status examination . Physical examinations, psychological tests , and laboratory tests may be conducted. On occasion, neuroimaging or other neurophysiological studies are performed. Mental disorders are diagnosed in accordance with diagnostic manuals such as
16512-725: Was one of these methods used throughout history. 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 psychiatric experiment. 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
16641-402: Was the first archaic human species to leave Africa and disperse across Eurasia. H. erectus also was the first to evolve a characteristically human body plan . Homo sapiens emerged in Africa around 300,000 years ago from a species commonly designated as either H. heidelbergensis or H. rhodesiensis , the descendants of H. erectus that remained in Africa. H. sapiens migrated out of
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