Christian Jonathan Haverkampf M.D.
Psychiatry is the medical specialty devoted to the diagnosis, prevention, study, and treatment of mental disorders. These include various abnormalities related to mood, behaviour, cognition, and perceptions. Working on internal and external communication is a central focus in psychiatric treatment.
Keywords: psychiatry, psychotherapy, communication, medicine
Biological and Social Science. 5
Medication and Psychotherapy. 10
The question what psychiatry is begins with the definition of the term ‘psyche’. The term “psychiatry” was first coined by the German physician Johann Christian Reil in 1808. The ancient Greek term ‘psyche’ is often translated as ‘soul’. However, it can also mean ‘butterfly’. While psychiatry was up until about a century ago more an occult art than a science, this has changed dramatically in the twentieth century. Within the last century, psychiatry began to make its terms, observations and inquiry much more structured and ‘scientific’.
Psychiatric illnesses all have in common that communication with others and the own person is disturbed. (Haverkampf, 2010b) These maladaptive communication patterns lead to the symptoms which are commonly observed. For example, in a case of schizophrenia the source of incoming information can no longer be correctly attributed to the outside world or the inside, and in a case of anxiety emotional signals are no longer correctly identified and processed. Communication, the transmission of messages, adheres to rules like any other natural phenomena and is relied on in nature from information carried in a beam of light to cells exchanging DNA. Humans can observe and reflect on these flows of information, also on information flows within themselves. The sense of self and the attribution of a mind to someone or oneself is a result of the ability to observe these flows of information, and as such of the communication one has with oneself or the world around.
Psychiatry refers to a field of medicine focused specifically on the mind, aiming to study, prevent, and treat mental disorders in humans. It is devoted to the diagnosis, prevention, study, and treatment of mental disorders. These include various abnormalities related to mood, behaviour, cognition, and perceptions. Psychiatry focuses on the interaction between patients and therapists in a way, which no other medical specialty does. While it is true that psychiatry has become more biologically based over the last century, it has also begun to look at the finer details of information transmission in the neuronal networks of the brain. Fortunately, gone are the times of lobotomies, where parts of the brain were removed, to make way for much more specific and finer treatment interventions, whether with psychotherapy or medication that works on specific neurotransmitter receptors or mimics certain neurotransmitters. The elaboration of the information transmission at the synaptic level has given us clues on how psychiatric illness is maintained, and medication works, within the larger system of an individual’s neuronal network.
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 linked up with neurology and neuropsychiatry. Sigmund Freud, who early in his career searched intensively for explanations of psychiatric phenomena on a neuronal level, initiated the development of psychoanalysis, which shifted the emphasis on communication as an important instrument in the healing process. The psychoanalytic theory became popular among psychiatrists because it allowed the patients to be treated in private practices at a time when effective psychiatric medication was still in its infancy.
Psychopharmacology became an integral part of psychiatry starting with Otto Loewi’s discovery of the neuromodulatory properties of acetylcholine, which became the first neurotransmitter to be described. The discovery of chlorpromazine’s effectiveness in treating schizophrenia in 1952 revolutionized treatment of the disorder, as did lithium carbonate’s ability to stabilize mood highs and lows in bipolar disorder in 1948. Neuroimaging became an investigatory tool in psychiatry in the 1980s.
Psychopharmacological changes in the neurotransmission systems, the information interfaces where electrical signals are translated into chemical signals, and back again, affect how and what information is being transmitted. This in turn has an effect on a person’s internal communication and his or her communication with the external world, which are also the target of psychotherapy. (Haverkampf, 2010a, 2017c) Medication and psychotherapy can thus work together synergistically.
Unlike physicians in other medical specialties, psychiatrists specialize in the doctor–patient relationship and should be trained extensively in the use of psychotherapy and other therapeutic communication techniques. Unfortunately, this is not always the case, which can reduce the effectiveness in treating a mental health condition significantly, because treatment of a mental health condition implies working with and understanding communication on different levels. The patient uses communication with other people and the self-talk with him or herself to meat own needs, values, wishes, desires and aspirations, requiring a holistic approach to the communication patterns and mechanisms a patient uses.
Since communication plays such a central role in psychiatric treatment, the author has developed communication-focused therapy (CFT), which focuses on internal and external communication patterns to relieve the symptoms of a wide variety of mental health conditions (Haverkampf, 2017a, 2018c).
Biological and Social Science
Psychiatry is the most multidisciplinary medical specialty using research in the field of neuroscience, psychology, medicine, biology, biochemistry, even physics, and pharmacology. Since psychiatry looks at the patient who is interacting with the larger world around, the social and communication sciences, including even behavioural economics, and the humanities can make important contributions to the field of psychiatry. If one considers psychiatry as a specialty that focuses on improving meaningful communication within wider information systems, the biological and social viewpoints merely represent looking at the same processes with different magnifications.
Psychiatry addresses internal and external communication issues, which are usually multifactorial in their aetiology. Compliance and the effects of medication and psychotherapy depend on the interactions between the patient and the environment. There are branches of psychiatry which look at different environments and how they influence the mental well-being of a patient. Unfortunately, psychiatric hospitals and various public health clinics have been notoriously slow at implementing any recommendations from this research.
Psychiatric illnesses can be conceptualized in several different ways. The biomedical approach examines signs and symptoms and compares them with diagnostic criteria. However, unlike the other fields of medicine, psychiatric diagnoses say little about underlying causes on a biological level but are mostly groupings of symptoms which seem to appear together. This is not to say that such groupings are not helpful. They can make it easier to describe conditions and often make it easier to pick specific therapeutic approaches and types of medication. However, since individual symptoms overlap and due to the complexity of the neural networks, it is usually not possible to follow a group of symptoms back to a specific biological variation. Since the brain is highly plastic, synapses rearrange their connections with each other all the time and assign varying weights to them. This means that a symptom of anxiety, for example, can be triggered by information stored over millions of nerve cells, and merely understanding how a biological component, such as a receptor, works does not help in understanding or treating the symptom.
Software and Hardware
Psychiatry is both ‘software’ and ‘hardware’ oriented, where ‘software’ refers to the information stored in the neural network and ‘hardware’ to the cellular network on a biological level. In the latter, there is an overlap with neurology and other medical sciences. What sets psychiatry apart is particularly the concern with information, the flows of information and how information is processed. New diagnostic systems and schemata have been developed on the psychotherapy side, which pay greater attention to the information dynamics. These models and systems can provide additional information to an experienced clinician who can then integrate these additional aspects with the diagnostic systems from the traditional medico-psychiatric side.
The biopsychosocial Model
The biopsychosocial model is commonly used to describe the three factors that play a role in the development and maintenance of a psychiatric condition:
- Environment (social)
What is striking about these three domains is that all consist of the transmission of information in one way or another. Some describe more the internal communication (biology, neuroscience, psychology), while others describe the external communication (psychology, sociology, economics and others), but all work in parallel all of the time. Psychiatry thus works with very complex systems, which are much more elaborate than in any other field of medicine. This may also be the reasons why psychiatry was the field within medicine to develop rather late, because it uses the insight gained in several other fields.
Psychiatric diagnoses take place in 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, 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. A few psychiatrists are beginning to utilize genetics during the diagnostic process but on the whole, this remains a research topic.
The problem with most diagnostic systems in psychiatry is that they do not address the underlying causes of an illness but focus instead on bundles of symptoms. As a descriptive system this makes sense in many instances. However, from a treatment perspective this is often unhelpful. Since medication works on underlying neurotransmission system within a vast network of interconnected neurons, a system that makes diagnosis based on properties within that system and on the individual neuronal level would be more helpful. From a psychotherapeutic perspective, a focus on internal and external communication would be helpful. Both perspectives could lead to systems that would be compatible with each other or even to one system that combines features of the two.
Three main diagnostic manuals used to classify mental health conditions are in use today. The International Classification of Diseases (ICD-10) 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 (DSM-V), produced and published by the American Psychiatric Association, is primarily focused on mental health conditions and is the main classification tool in the United States, although the ICD-10 has official status there as well. It is currently in its fifth revised edition and is also used worldwide. As already mentioned, the diagnostic systems are based on bundles of symptoms. Psychiatry has “a syndrome-based disease classification, which is not based on mechanisms and does not guide treatment, which largely depends on trial and error” (Stephan et al., 2016). The author of this article would not go so far. Greater clarity about a diagnosis or several diagnoses, even if we do not understand fully the underlying biological and psychological mechanisms, can be an important tool in formulating a treatment plan, which often also includes medication (Haverkampf, 2018a)
The diagnostic manuals overlap to a significant degree. One reason is that they describe groups of symptoms which are often seen together, and over time the use of their diagnostic terms has made it easier to provide treatment and conduct research. However, both suffer from the critiques mentioned above. They can give a rough idea of the symptoms, a suitable therapy and the prognosis. However, since the diagnostic systems say nothing about the underlying causes, the actual therapy needs to be individualized and its success depends on several factors inside the person and in the environment. Looking at the patient’s internal and external communication can help individualize the therapy. (Haverkampf, 2010b, 2012, 2013a, 2013b)
It is important to keep in mind the purpose served by diagnosis. It is ultimately to help a patient and raise his or her quality of life. While there may be other uses of it for forensic, insurance or other purposes, they should not lead to a different interpretation of what a diagnosis is for in a treatment context. Diagnoses can at least help to raise the probability that a specific medication or group of medication will alleviate certain symptoms (Haverkampf, 2018a, 2018f).
The first step in treatment is traditionally assessment. 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.
However, especially in psychotherapeutic treatment, assessment can still take place after the therapy has commenced. While it is important to have a working hypothesis for the condition, it is important to remain open to any new insights gained from observing and interacting with the patient over time. For this, it is important to be in the interaction with the patient, yet also to be able to take a step outside of the interaction and reflect on the communication dynamics.
Assessment with a focus on the internal and external communication can identify problems which are leading to the symptoms. This information is then helpful to make better decisions with respect to medication and psychotherapy. Communication-Focused Therapy, as developed by the author, focuses on communication patterns an individual uses, whether in everyday life or in a therapeutic setting (Haverkampf, 2010b, 2017a). Rather than looking primarily at the content of what is being communicated, the how it is communicated assumes an additional particularly important role. Since people, and all other living organisms, meet their needs and aspirations through the exchange of information withing themselves and with the world, it is important to encourage awareness, reflection and experimentation with communication to make it more efficient and satisfying for the individual. As life aligns more with the basic parameters, the needs, values and aspirations, as a result of better communication, the symptoms of a mental health condition often receded (Haverkampf, 2017f, 2017b, 2017d) .
Psychiatric medication represents a very heterogenous group of substances, which are among the most widely prescribe in the world. Psychiatric medication was usually available before one had an understanding for its effects on a cellular or neural network level. However, in all cases it has been shown that psychiatric medication affects the information transmission in the brain. This is a point where psychotherapy and medication could go well with each other hand in hand (Haverkampf, 2018f).
The efficacy of medication can often very significantly among individuals. One antidepressant from the most popular group of antidepressants, the selective serotonin reuptake inhibitor (SSRI), for example, may help against the symptoms of depression and anxiety, while another from the same group does not work in the same patient. The outcome is not always easy to predict, although one can have a sense of the medication that is most likely to work. It requires a proper assessment in the first place, but also a solid understanding of the desired changes and the expectations of the patient.
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, and thyroid function. Electroconvulsive therapy (ECT) is sometimes administered for severe and disabling conditions, such as those unresponsive to medication. Although the literature reports on successes in treatment-resistant cases, its use remains controversial. Often, the available treatment options with medication and psychotherapy have not been fully exhausted when considering ECT.
To summarize, one may say that the support available form medication can be life-changing in some cases and increase the quality of life significantly. In contrast, in others, it may do little or lead to side effects, or there can be both positive and negative effects side by side. Several parameters have been studied to shape the recommendations of the professional. For example, in a study on the variables that could predict a successful treatment outcome in depression, chronic depression, older age, and lower intelligence, each predicted relatively weak response across psychotherapy and medication. On the other hand, marriage, unemployment, and having experienced a higher number of recent life events each predicted superior response to cognitive therapy relative to antidepressant medications (Fournier et al., 2009).
As already mentioned, 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. 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 is required for the appointment. For example, most psychiatrists schedule three or four follow-up appointments per hour, as opposed to seeing one patient per hour in the traditional psychotherapy model. 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.
However, this approach is short-sighted. It may be easier to prescribe medication, which is a concept familiar to most patients, than to explain how psychotherapy works, whose basic premises, tools and approaches are less well known. Psychotherapy often delivers a lasting effect in the long-term in cases of anxiety, mild to moderate depression and several other conditions, which goes beyond the ongoing support medication can offer (Haverkampf, 2017a). The reason is that changes in the internal and external communications usually bring about changes in a patient’s symptoms (Haverkampf, 2018d). While medication also has an effect on these communication patterns and, through learning effects, it can even last for some time after the drug is discontinued, the changes are usually less specifically tailored to the needs and personal history of the patient.
Medication and Psychotherapy
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. Today, people receiving psychiatric treatment are more likely to be seen as outpatients. In many cases, a combination of psychotherapy and medication can prevent relapse longer than either treatment type on its own. (Haverkampf, 2018f, 2018e) There is a substantial synergism between the two. Medication can provide the support which facilitates psychotherapy, while psychotherapy can increase the compliance with medication.
Most unethical treatments in psychiatry have been a result of neglecting the importance of communication in treatment and seeing properties of interactions as being localized in a particular area of the brain rather than occurring in a network internally and through interactions with the world externally. Much unethical behaviour in psychiatry can be summarised by saying that the physician failed to interact, communicate and understand a patient in any meaningful way. When knowledge about psychiatric conditions is seen separate from the interaction with the patient, it becomes akin to playing the lottery of sorts. Treatment requires a focus on how the patient communicates internally and externally and how the world responds to these messages.
When a psychiatrist is connected on emotional and cognitive levels with himself or herself as well as the patient and has healthy boundaries in place, ethical lapses become less likely. However, this often requires substantial experience and skills in a psychotherapeutic technique that focuses on insight. It requires an interest in and experience with human communication.
To have a definition of illness, one needs a definition of health. Psychiatry is not only concerned with psychiatric illness but largely also with the maintenance of mental health. Insight into the aetiology and pathogenesis of burnout, for example, helps to prevent it, (Haverkampf, 2013a, 2013c, 2017g, 2018b) which is not only good for the individual but society and the economy as a whole. (Haverkampf, 2013c) Knowledge about which work and communication environments are helpful in preventing a relapse of psychosis can help a person arrange life in ways which keep him or her mentally healthy for as long as possible. (Haverkampf, 2017e) Skills in connecting with oneself can help to understand the information contained in emotional signals underlying episodes of anxiety. (Haverkampf, 2012)
Into the Future
The biopsychosocial model reduces to the communication model. Internal communication and external communication are, to some extent, arbitrary distinctions because communication still adheres to the basic rules and laws of communication, whether it unfolds in a person or without. However, this requires an integrated and more universal view of mental health. What makes us all human are the mental processes which give us the ability to observe and reflect on these flows of information. Psychotherapy and medication are the tools to bring about change in these communication patterns, internal and external ones. Other supportive therapies, such as occupational therapy, meditation and various forms of bodywork, can provide crucial additional support towards a satisfied, content and happy life, one in which personal needs, values, wishes, desires and aspirations can be met.
Dr Jonathan Haverkampf, M.D. (Vienna) MLA (Harvard) LL.M. psychoanalytic psychotherapy (Zurich) trained in medicine, psychiatry and psychotherapy and works in private practice for psychotherapy, counselling and psychiatric medication in Dublin, Ireland. He is the author of several books and over a hundred articles. Dr Haverkampf has developed Communication-Focused Therapy® and written extensively about it. He also has advanced degrees in management and law. The author can be reached by email at jo****************@gm***.com or on the websites www.jonathanhaverkampf.ie and www.jonathanhaverkampf.com.
World Health Organisation (1992). The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. Geneva: World Health Organisation. ISBN 978-92-4-154422-1.
American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders (4th, text revision ed.). Washington, DC: American Psychiatric Publishing, Inc. ISBN 978-0-89042-025-6.
Chen, Yan-Fang (March–June 2002). “Chinese classification of mental disorders (CCMD-3): Towards integration in international classification”. Psychopathology. 35 (2–3): 171–5. PMID 12145505. doi:10.1159/000065140.
Essen-Möller, Eric (September 1961). “On classification of mental disorders”Paid subscription required. Acta Psychiatrica Scandinavica. 37 (2): 119–26. doi:10.1111/j.1600-0447.1961.tb06163.x.
Mezzich, Juan E. (February 1979). “Patterns and issues in multiaxial psychiatric diagnosis”. Psychological Medicine. 9 (1): 125–37. PMID 370861. doi:10.1017/S0033291700021632.
Guze, SB (June 1970). “The need for toughmindedness in psychiatric thinking”. Southern Medical Journal. 63 (6): 662–71. PMID 5446229. doi:10.1097/00007611-197006000-00012.
Dalal, PK; Sivakumar, T (October–December 2009). “Moving towards ICD-11 and DSM-5: Concept and evolution of psychiatric classification”. Indian Journal of Psychiatry. 51 (4): 310-9. PMC 2802383 Freely accessible. PMID 20048461. doi:10.4103/0019-5545.58302
Kendell, Robert; Jablensky, Assen (January 2003). “Distinguishing Between the Validity and Utility of Psychiatric Diagnoses”. American Journal of Psychiatry. 160 (1): 4–12. PMID 12505793. doi:10.1176/appi.ajp.160.1.4
Baca-Garcia E, Perez-Rodriguez MM, Basurte-Villamor I, Fernandez del Moral AL, Jimenez-Arriero MA, Gonzalez de Rivera JL, Saiz-Ruiz J, Oquendo MA (February 2007). “Diagnostic stability of psychiatric disorders in clinical practice”. The British Journal of Psychiatry. 190 (3): 210–6. PMID 17329740. doi:10.1192/bjp.bp.106.024026
Pincus HA, Zarin DA, First M (December 1998). “‘Clinical Significance’ and DSM-IV”Paid subscription required. Letters to the Editor. Archives of General Psychiatry. 55 (12): 1145. PMID 9862559. doi:10.1001/archpsyc.55.12.1145.
Greenberg, Gary (29 January 2012). “The D.S.M.’s Troubled Revision”. The Opinion Pages. The New York Times.
Moncrieff, Joanna; Wessely, Simon; Hardy, Rebecca (26 January 2004). “Active placebos versus antidepressants for depression”. Cochrane Database of Systematic Reviews (1): CD003012. PMID 14974002. doi:10.1002/14651858.CD003012.pub2.
Hopper, Kim; Wanderling, Joseph (January 2000). “Revisiting the developed versus developing country distinction in course and outcome in schizophrenia: results from ISoS, the WHO collaborative follow-up project. International Study of Schizophrenia” (PDF). Schizophrenia Bulletin. 26 (4): 835–46. PMID 11087016. doi:10.1093/oxfordjournals.schbul.a033498.
Unzicker, Rae E.; Wolters, Kate P.; Robinson, Debra (20 January 2000). “From Privileges to Rights: People Labeled with Psychiatric Disabilities Speak for Themselves”. National Council on Disability. Retrieved on 01-10-2017.
Jiang, H. Joanna; Barrett, Marguerite L.; Sheng, Minya (November 2014). Characteristics of Hospital Stays for Nonelderly Medicaid Super-Utilizers, 2012 (Healthcare Cost and Utilization Project (HCUP) Statistical Brief). Rockville, MD: Agency for Healthcare Research and Quality. 184.
Treatment Protocol Project (2003). Acute inpatient psychiatric care: A source book. Darlinghurst, Australia: World Health Organisation. ISBN 0-9578073-1-7. OCLC 223935527.
Mojtabai R, Olfson M (4 August 2008). “National trends in psychotherapy by office-based psychiatrists”. Archives of General Psychiatry. 65 (8): 962–70. PMID 18678801. doi:10.1001/archpsyc.65.8.962 Freely accessible.
Clemens, Norman A. (March 2010). “New parity, same old attitude towards psychotherapy?”. Journal of Psychiatric Practice. 16 (2): 115–9. PMID 20511735. doi:10.1097/01.pra.0000369972.10650.5a.
Mellman, Lisa A. (March 2006). “How endangered is dynamic psychiatry in residency training?”. The Journal of the American Academy of Psychoanalysis and Dynamic Psychiatry. 34 (1): 127–33. PMID 16548751. doi:10.1521/jaap.2006.34.1.127.
Stone, Alan A. (July 2001). “Psychotherapy in the managed care health market”. Journal of Psychiatric Practice. 7 (4): 238–43. PMID 15990529. doi:10.1097/00131746-200107000-00003.
Pasnau, Robert O. (March 2000). “Can the patient-physician relationship survive in the era of managed care?”. Journal of Psychiatric Practice. 6 (2): 91–6. PMID 15990478. doi:10.1097/00131746-200003000-00004.
Mojtabai R, Olfson M (January 2010). “National trends in psychotropic medication polypharmacy in office-based psychiatry”. Archives of General Psychiatry. 67 (1): 26–36. PMID 20048220. doi:10.1001/archgenpsychiatry.2009.175
Olfson M, Marcus SC, Druss B, Elinson L, Tanielian T, Pincus HA (9 January 2002). “National trends in the outpatient treatment of depression”. JAMA. 287 (2): 203–9. PMID 11779262. doi:10.1001/jama.287.2.203
Harris, Gardiner (March 5, 2011). “Talk Doesn’t Pay, So Psychiatry Turns to Drug Therapy”. The New York Times. Retrieved 01-10-2017.
Scull, Andrew, ed. (2014). Cultural Sociology of Mental Illness: An A-to-Z Guide. 1. Sage Publications. p. 386. ISBN 978-1-4833-4634-2. OCLC 955106253.
Levinson, David; Gaccione, Laura (1997). Health and Illness: A Cross-cultural Encyclopedia. Santa Barbara, CA: ABC-CLIO. p. 42. ISBN 978-0-87436-876-5. OCLC 916942828.
Koenig, Harold G. (2005). “History of Mental Health Care”. Faith and Mental Health: Religious Resources for Healing. West Conshohocken: Templeton Foundation Press. p. 36. ISBN 978-1-59947-078-8. OCLC 476009436.
Elkes, Alexander; Thorpe, James Geoffrey (1967). A Summary of Psychiatry. London: Faber & Faber. p. 13. OCLC 4687317.
Burton, Robert (1881). The Anatomy of Melancholy: What it is with All the Kinds, Causes, Symptoms, Prognostics, and Several Cures of it: in Three Partitions, with Their Several Sections, Members and Subsections Philosophically, Medicinally, Historically Opened and Cut Up. London: Chatto & Windus. pp. 22, 24. OL 3149647W.
Dumont, Frank (2010). A history of personality psychology: Theory, science and research from Hellenism to 21th century. New York: Cambridge University Press. ISBN 978-0-521-11632-9. OCLC 761231096.
Mohamed, Wael M.Y. (August 2008). “History of Neuroscience: Arab and Muslim Contributions to Modern Neuroscience” (PDF). International Brain Research Organization. Retrieved on 01-10-2017.
Fournier, J. C., DeRubeis, R. J., Shelton, R. C., Hollon, S. D., Amsterdam, J. D., & Gallop, R. (2009). Prediction of Response to Medication and Cognitive Therapy in the Treatment of Moderate to Severe Depression. Journal of Consulting and Clinical Psychology, 77(4), 775–787. https://doi.org/10.1037/a0015401
Haverkampf, C. J. (2010a). A Primer on Interpersonal Communication (3rd ed.). Dublin: Psychiatry Psychotherapy Communication Publishing Ltd.
Haverkampf, C. J. (2010b). Communication and Therapy (3rd ed.). Retrieved from https://www.jonathanhaverkampf.com
Haverkampf, C. J. (2012). A Case of Severe Anxiety. J Psychiatry Psychotherapy Communication, 1(2), 35–40.
Haverkampf, C. J. (2013a). A Case of Burnout. J Psychiatry Psychotherapy Communication, 2(3), 80–87.
Haverkampf, C. J. (2013b). A Case of Depression. J Psychiatry Psychotherapy Communication, 2(3), 88–90.
Haverkampf, C. J. (2013c). Economic Costs of Burnout. J Psychiatry Psychotherapy Communication, 2(3), 88–94.
Haverkampf, C. J. (2017a). Communication-Focused Therapy (CFT) (2nd ed.). Dublin: Psychiatry Psychotherapy Communication Publishing Ltd.
Haverkampf, C. J. (2017b). Communication-Focused Therapy (CFT) for ADHD. J Psychiatry Psychotherapy Communication, 6(4), 110–115.
Haverkampf, C. J. (2017c). Communication-Focused Therapy (CFT) for Bipolar Disorder. J Psychiatry Psychotherapy Communication, 6(4), 125–129.
Haverkampf, C. J. (2017d). Communication-Focused Therapy (CFT) for Depression. J Psychiatry Psychotherapy Communication, 6(4), 101–104.
Haverkampf, C. J. (2017e). Communication-Focused Therapy (CFT) for Psychosis. J Psychiatry Psychotherapy Communication, 6(4), 116–119.
Haverkampf, C. J. (2017f). Communication-Focused Therapy (CFT) for Social Anxiety and Shyness. J Psychiatry Psychotherapy Communication, 6(4), 107–109.
Haverkampf, C. J. (2017g). Healing Burnout.
Haverkampf, C. J. (2018a). An Overview of Psychiatric Medication (3rd ed.). Dublin: Psychiatry Psychotherapy Communication Publishing Ltd.
Haverkampf, C. J. (2018b). Burnout and Happiness at the Workplace (2nd ed.). Dublin: Psychiatry Psychotherapy Communication Publishing Ltd.
Haverkampf, C. J. (2018c). Communication-Focused Therapy (CFT) – Specific Diagnoses (Vol II) (2nd ed.). Dublin: Psychiatry Psychotherapy Communication Publishing Ltd.
Haverkampf, C. J. (2018d). Communication Patterns and Structures.
Haverkampf, C. J. (2018e). Psychiatric Conditions, Psychotherapy and Medication (1st ed.). Dublin: Psychiatry Psychotherapy Communication Publishing Ltd.
Haverkampf, C. J. (2018f). Psychiatric Medication and Psychotherapy (1st ed.). Psychiatry Psychotherapy Communication Publishing Ltd.
Stephan, K. E., Bach, D. R., Fletcher, P. C., Flint, J., Frank, M. J., Friston, K. J., … Breakspear, M. (2016, January 1). Charting the landscape of priority problems in psychiatry, part 1: Classification and diagnosis. The Lancet Psychiatry, Vol. 3, pp. 77–83. https://doi.org/10.1016/S2215-0366(15)00361-2
Haque, Amber (December 2004). “Psychology from Islamic Perspective: Contributions of Early Muslim Scholars and Challenges to Contemporary Muslim Psychologists”. Journal of Religion and Health. 43 (4): 357–377 . doi:10.1007/s10943-004-4302-z.
Verhagen, Peter; Van Praag, Herman M.; López-Ibor, Juan José, Jr.; Cox, John; Moussaoui, Driss, eds. (2010). Religion and Psychiatry: Beyond Boundaries. World Psychiatric Association. Chichester: John Wiley & Sons. p. 202. ISBN 978-0-470-69471-8. OCLC 761549866.
Laffey, Paul (November 2003). “Psychiatric therapy in Georgian Britain”Paid subscription required. Psychological Medicine. 33: 1285–97. PMID 14580082. doi:10.1017/S0033291703008109.
Gerard, Donald L. (September 1997). “Chiarugi and Pinel considered: Soul’s brain/person’s mind”Paid subscription required. Journal of the History of the Behavioral Sciences. 33 (4): 381–403. doi:10.1002/(SICI)1520-6696(199723)33:4<381::AID-JHBS3>3.0.CO;2-S.
Suzuki, Akihito (January 1995). “The politics and ideology of non-restraint: the case of the Hanwell Asylum”. Medical History. London: Wellcome Institute. 39 (1): 1–17. PMC 1036935 Freely accessible. PMID 7877402. doi:10.1017/s0025727300059457.
Bynum, W.F.; Porter, Roy; Shepherd, Michael, eds. (1988). The Asylum and its psychiatry. The Anatomy of Madness: Essays in the history of psychiatry. 3. London: Routledge. ISBN 978-0-415-00859-4. OCLC 538062123.
Yanni, Carla (2007). The Architecture of Madness: Insane Asylums in the United States. Minneapolis: Minnesota University Press. ISBN 978-0-8166-4939-6.
Rothman, D.J. (1990). The Discovery of the Asylum: Social Order and Disorder in the New Republic. Boston: Little Brown. p. 239. ISBN 978-0-316-75745-4.
Borch-Jacobsen, Mikkel (7 October 2010). “Which came first, the condition or the drug?”. London Review of Books. 32 (19): 31–33.
Turner, Trevor (2007). “Chlorpromazine: Unlocking psychosis”. BMJ. 334 (suppl): s7. PMID 17204765. doi:10.1136/bmj.39034.609074.94
Cade, JFJ (3 September 1949). “Lithium salts in the treatment of psychotic excitement”. Medical Journal of Australia. 2 (10): 349–52. PMID 18142718.
Burns, Tom (2006). Psychiatry: A very short introduction. Oxford: Oxford University Press. ISBN 978-0-19-280727-4. OCLC 706088927.
Backes, Katherine A.; Borges, Nicole J.; Binder, S. Bruce; Roman, Brenda (2013), “First-year medical student objective structured clinical exam performance and specialty choice”, International Journal of Medical Education, 4: 38–40, doi:10.5116/ijme.5103.b037
Alarcón, Renato D. (2016), “Psychiatry and Its Dichotomies”, Psychiatric Times, 33 (5): 1
“Information about Mental Illness and the Brain (Page 3 of 3)”. The Science of Mental Illness. National Institute of Mental Health. January 31, 2006. Retrieved 01-10-20172007.
Kupfer DJ, Regier DA (2010). “Why all of medicine should care about DSM-5”. JAMA. 303 (19): 1974–1975. PMID 20483976. doi:10.1001/jama.2010.646.
Gabbard GO (2007). “Psychotherapy in psychiatry”. International Review of Psychiatry. 19 (1): 5–12. PMID 17365154. doi:10.1080/09540260601080813.
James, F.E. (July 1991). “Psyche”. Psychiatric Bulletin. 15 (7): 429–31. doi:10.1192/pb.15.7.429
Storrow, Hugh A. (1969). Outline of Clinical Psychiatry. New York: Appleton-Century-Crofts. p. 1. ISBN 978-0-390-85075-1. OCLC 599349242.
Pietrini, Pietrini (November 2003). “Toward a Biochemistry of Mind?”. Editorial. American Journal of Psychiatry. 160 (11): 1907–8. PMID 14594732. doi:10.1176/appi.ajp.160.11.1907.
“Madrid Declaration on Ethical Standards for Psychiatric Practice”. World Psychiatric Association. Retrieved 01-10-2017.
López-Muñoz F, Alamo C, Dudley M, Rubio G, García-García P, Molina JD, Okasha A (9 May 2007). Cecilio Alamoa, Michael Dudleyb, Gabriel Rubioc, Pilar García-Garcíaa, Juan D. Molinad and Ahmed Okasha. “Progress in Neuro-Psychopharmacology and Biological Psychiatry: Psychiatry and political–institutional abuse from the historical perspective: The ethical lessons of the Nuremberg Trial on their 60th anniversary”. Progress in Neuro-Psychopharmacology and Biological Psychiatry. 31 (4): 791–806. PMID 17223241. doi:10.1016/j.pnpbp.2006.12.007.
Gluzman, Semyon F. (December 1991). “Abuse of psychiatry: analysis of the guilt of medical personnel”. Journal of Medical Ethics. 17 (Suppl): 19–20. PMC 1378165 Freely accessible. PMID 1795363. doi:10.1136/jme.17.Suppl.19
Debreu, Gerard (1988). “Introduction”. In Corillon, Carol. Science and Human Rights. The National Academies Press. p. 21. doi:10.17226/9733 Freely accessible. Retrieved 01-10-2017.
Kirk, Stuart A.; Gomory, Tomi; Cohen, David (2013). Mad Science: Psychiatric Coercion, Diagnosis, and Drugs. New Brunswick, NJ: Transaction Publishers. ISBN 978-1-4128-4976-0. OCLC 935892629.
Verhulst J, Tucker G (May 1995). “Medical and narrative approaches in psychiatry”. Psychiatric Services. 46 (5): 513–4. PMID 7627683. doi:10.1176/ps.46.5.513
McLaren, N (February 1998). “A critical review of the biopsychosocial model”. The Australian and New Zealand Journal of Psychiatry. 32 (1): 86–96. PMID 9565189. doi:10.1046/j.1440-1614.1998.00343.x.
McLaren, Niall (2007). Humanizing Madness. Ann Arbor, MI: Loving Healing Press. ISBN 1-932690-39-5.
McLaren, Niall (2009). Humanizing Psychiatry. Ann Arbor, MI: Loving Healing Press. ISBN 1-61599-011-9.
Hurst, Michael. “Humanistic Therapy”. CRC Health Group. Retrieved 01-10-2016.
McLeod, Saul (2014). “Psychoanalysis”. Simply Psychology. Retrieved 01-10-2016.
Cherry, Kendra (9 June 2017). “What’s the Difference Between a Psychologist and a Psychiatrist?”. VeryWell. Dotdash.
Brown, Menna; Barnes, Jacob; Silver, Katie; Williams, Nicholas; Newton, Philip M. (April 2016). “The Educational Impact of Exposure to Clinical Psychiatry Early in an Undergraduate Medical Curriculum”. Academic Psychiatry. 40 (2): 274–281. PMID 26077010. doi:10.1007/s40596-015-0358-1 – via SpringerLink.
Japsen, Bruce (15 September 2015). “Psychiatrist Shortage Worsens Amid ‘Mental Health Crisis’”. Forbes.
Thiele, Jonathan S.; Doarn, Charles R.; Shore, Jay H. (27 May 2015). “Locum Tenens and Telepsychiatry: Trends in Psychiatric Care”. Telemedicine Journal and e-Health. 21 (6): 510–3. PMID 25764147. doi:10.1089/tmj.2014.0159.
Hausman, Ken (6 December 2013). “Brain Injury Medicine Gains Subspecialty Status”. Psychiatric News. 48 (23): 10. doi:10.1176/appi.pn.2013.11b29.
Gandey, Allison (12 November 2010). “New Epilepsy and Emergency Medicine Subspecialties Launched”. Medscape Medical News. WebMD, LLC. Retrieved 2017-08-20.
“About AACP”. American Association of Community Psychiatrists. University of Pittsburgh School of Medicine, Department of Psychiatry. Retrieved 01-10-2017.
Patel, Vikram; Prince, Martin (19 May 2010). “Global mental health: A new global health field comes of age”. Commentary. JAMA. 303 (19): 1976–7. PMC 3432444 Freely accessible. PMID 20483977. doi:10.1001/jama.2010.616.
Mitchell, J.E.; Crosby, R.D.; Wonderlich, S.A.; Adson, D.E. (2000). Elements of Clinical Research in Psychiatry. Washington, DC: American Psychiatric Press. ISBN 978-0-88048-802-0. OCLC 632834662.
Meyendorf, R (1980). “Diagnose und Differentialdiagnose in der Psychiatrie und zur Frage der situationsbezogenen prognostischen Diagnose” [Diagnosis and differential diagnosis in psychiatry and the question of situation referred prognostic diagnosis]. Schweizer Archiv fur Neurologie, Neurochirurgie und Psychiatrie (in German). 126 (1): 121–34. PMID 7414302.
Leigh, Hoyle (1983). Psychiatry in the practice of medicine. Menlo Park, CA: Addison-Wesley. pp. 15,17,67. ISBN 978-0-201-05456-9. OCLC 869194520.
Hampel H, Teipel SJ, Kötter HU, Horwitz B, Pfluger T, Mager T, Möller HJ, Müller-Spahn F (May 1997). “Strukturelle Magnetresonanztomographie in der Diagnose und Erforschung der Demenz vom Alzheimer-Typ” [Structural magnetic resonance imaging in diagnosis and research of Alzheimer’s disease]. Der Nervenarzt (in German). 68 (5): 365–78. PMID 9280846.
Townsend, Brent A.; Petrella, Jeffrey R.; Doraiswamy, P. Murali (July 2002). “The role of neuroimaging in geriatric psychiatry”. Current Opinion in Psychiatry. 15 (4): 427–32. doi:10.1097/00001504-200207000-00014. (Subscription required (help)).
“Neuroimaging and Mental Illness: A Window Into the Brain”. National Institute of Mental Health. U.S. Department of Health and Human Services. 2009. Retrieved 01-10-2017.
Krebs, Marie-Odile (2005). “Future contributions on genetics”. World Journal of Biological Psychiatry. 6 (Sup 2): 49–55. PMID 16166024. doi:10.1080/15622970510030072.
Hensch, Tilman; Herold, Ulf; Brocke, Burkhard (August 2007). “An electrophysiological endophenotype of hypomanic and hyperthymic personality”. Journal of Affective Disorders. 101 (1–3): 13–26. PMID 17207536. doi:10.1016/j.jad.2006.11.018.
Vonk R, van der Schot AC, Kahn RS, Nolen WA, Drexhage HA (15 July 2007). “Is autoimmune thyroiditis part of the genetic vulnerability (or an endophenotype) for bipolar disorder?”. Biological Psychiatry. 62 (2): 135–140. PMID 17141745. doi:10.1016/j.biopsych.2006.08.041.
This article is solely a basis for academic discussion and no medical advice can be given in this article, nor should anything herein be construed as advice. Always consult a professional if you believe you might suffer from a physical or mental health condition. Neither author nor publisher can assume any responsibility for using the information herein.
Trademarks belong to their respective owners. Communication-Focused Therapy, the CFT logo with waves and leaves, Dr Jonathan Haverkampf, Journal of Psychiatry Psychotherapy and Communication, and Ask Dr Jonathan are registered trademarks.
This article has been registered with the U.S. Copyright Office. Unauthorized reproduction, distribution or publication in any form is prohibited. Copyright will be enforced.
© 2017-2020 Christian Jonathan Haverkampf. All Rights Reserved
Unauthorized reproduction, distribution and/or publication in any form is prohibited.