Psychiatry refers to the branch of clinical medicine that studies mental disorders and also treats the soul using methods of diagnosis, prevention and treatment. Also, this term implies and includes the totality of accredited non-governmental and state institutions having the right to compulsory isolation of potentially dangerous persons.
The German psychiatrist V. Griesinger has gained widespread recognition due to a more precise definition of the concept of psychiatry as a teaching on the treatment and recognition of mental illness. Treatment includes therapy, organization of psychiatric care, rehabilitation, prevention, social aspects of psychiatry. Recognition includes diagnosis, investigation of pathogenesis, etiology, course, and also the outcome of mental disorders. According to a common definition, a mental illness refers to a change in consciousness that goes beyond the norm. The boundary conditions between pathology and norm are studied by clinical psychology. This direction is widely developing in the USA.
Psychiatry is divided into private and general.
In private psychiatry, individual diseases are the subject of study, and in general psychiatry, the general patterns of mental disorder are the subject of study. General psychiatry also includes general psychopathology, as well as pathopsychology. Private psychiatry is sometimes called private psychopathology. Signs of mental disorders are the subject of psychiatric semiotics. The symptoms of mental illness, the biological nature, manifestations of pathological changes in the body leading to a mental disorder are studied by clinical psychiatry, and modern psychiatry examines the etiology, clinic, pathogenesis, diagnosis, prevention, treatment, examination and rehabilitation of mental disorders.
Expertise in psychiatry is divided into military psychiatric, forensic psychiatric, medical and social (labor). The main method of psychiatric examination is a clinical study. A psychiatric diagnosis is established after clinical and laboratory research methods are obtained.
For several centuries to the present, there has been a discussion: psychiatry is a science or art. Critics say that there is no real evidence of the scientific nature of psychiatry and the effectiveness of its methods.
Psychiatry of the late XIX - early XX century was distinguished by two schools. The first included psychoanalysis, where Sigmund Freud laid the foundation for his work on the theory of the unconscious. According to his theory, the human brain isolates the area of animal instincts. Freud believed that “It” is opposed to the personal “I”, and “Super-I” is opposed to the dictates of society, which leads the personality and imposes certain standards of behavior. The unconscious, Freud believed, is a prison for forbidden desires, for example - erotic, squeezed out of it by consciousness. Due to the impossibility of the final destruction of desire, consciousness offers a sublimation mechanism - substitution through the realization of creativity or religion.
At the same time, a nervous breakdown represents a program malfunction in the sublimation mechanism, and the forbidden patient spills out through a painful reaction. The restoration of a person’s normal functioning is carried out through a technique called psychoanalysis. This method involves returning the patient to childhood memories, as well as resolving the problem.
Emil Kraepelin opposed Freud with his school of positivistic medicine. Kraepelin attributed progressive paralysis to the basis of the theory of mental disorder, and developed a new form of studying the disease as a process that develops over time and then breaks down to certain stages, with certain symptoms. Positivist medicine provides an explanation for mental disorder as a destruction of brain tissue, a biological disorder caused by multiple causes.
However, none of the theories could claim to be substantiated by evidence. Freud built the theory of children's sex drive on the psychoanalysis of adults, explaining that it is impossible to confirm it in children because of fear of a forbidden topic. Opponents reproached Kraepelin that in fact the theory of organic damage leads to madness and emotional as well as mental degradation. The cure of the sick at that time was considered impossible, and the professional activity of the doctor was reduced to supervision, as well as stopping possible aggression. In addition, the positivist theory found it difficult to explain the numerous cases of mental disorders.
Mental disorders are divided into two levels: psychotic and neurotic. This boundary is conditional and it is assumed that pronounced gross symptomatology is a sign of psychosis. And the softness and smoothness of symptoms is characteristic of neurotic disorders.
Psychiatry is a field of human knowledge that deals with the study of the pathology of human mental activity. What is a pathology of mental activity? It is impossible to answer this question exactly. Where the norm is not defined, there can be no talk of pathology. At the same time, the manifestation of mental activity is indisputable, which can be regarded as abnormal. This means a manifestation of a mental disorder, which at the same time appears to a large extent, counteracting, and sustainable. These include obsessions, delusions, phobias, mood pathology (affect and manic states), perceptual disorders (illusions, hallucinations, senestopathies).
To date, effective methods of therapy that are used by psychiatrists include blocking the brain (antipsychotics), pharmacotherapy - antipsychotics, brain destruction (electroshock - electroconvulsive therapy, lobotomy-psychosurgery).