Introduction to Psychiatry for Holy Spirit – 10th Grade Marisa A. Giggie, MD, MPAff Assistant Professor, Psychiatry and Behavioral Medicine University of Alabama School of Medicine, Tuscaloosa Campus

GOALS OF PRESENTATION REVIEW DEFINITION OF PSYCHIATRY REVIEW DEFINITION OF MENTAL ILLNESS REVIEW TRAINING REQUIREMENTS TO BE A PSYCHIATRIST INTRODUCE BASIC TREATMENT MODALITIES

WHAT IS PSYCHIATRY?

DEFINITION OF PSYCHIATRY The medical specialty concerned with the prevention, diagnosis, and treatment of mental illness.

DEFINITION OF MENTAL ILLNESS A mental disorder or mental illness: psychological or behavioral pattern that occurs in an individual Causes distress or disability that is not part of normal development or culture. The recognition and understanding of mental health conditions has changed over time and across cultures, and there are still variations in the definition, assessment, and classification of mental disorders, although standard guideline criteria are widely accepted. Over a third of people in most countries report meeting criteria for the major categories at some point in their life.

SERIOUS MENTAL ILLNESS (SMI) Disorder of thought, mood, perception, orientation or memory Examples: schizophrenia, schizoaffective disorder, psychotic conditions not otherwise specified, bipolar disorder, and severe depressive disorders. Excludes personality disorders & substance abuse disorders

DSM-V

PSYCHIATRY VS PSYCHOLOGY PSYCHIATRY IS A MEDICAL FIELD PSYCHIATRISTS GO TO MEDICAL SCHOOL PSYCHIATRISTS TRAIN AS LONG AS SURGEONS PSYCHIATRISTS PRESCRIBE MEDICATION AND DO PSYCHOTHERAPY PSYCHIATRISTS ARE NOT PSYCHOLOGISTS

PSYCHOLOGISTS ARE NOT PHYSICIANS "Psychologist" is an academic, occupational or professional title[1] used by individuals who are either: Social scientists conducting psychological research or teaching psychology in a college or university; employed by the government in psychology positions; professionals who apply psychological research, theories and techniques to "real-world" problems, questions and issues, most typically in health and mental health care services, or in business and industry. There are many different types of psychologists, as is reflected by the 56 different divisions of the American Psychological Association (APA). Psychologists are generally described as being either "applied" or "research-oriented". The common terms used to describe this central division in psychology are "scientists" or "scholars" (those who conduct research) and "practitioners" or "professionals" (those who apply psychological knowledge). The training models endorsed by the APA require that applied psychologists be trained as both researchers and practitioners, and that they possess advanced degrees. Most typically, people encounter psychologists and think of the discipline as involving the work of clinical or counseling psychologists. While counseling and psychotherapy are common activities for psychologists, these applied fields are just one branch in the larger domain of psychology.

Psychologists do NOT prescribe medication. Only a Physician can.

WHAT IS A PSYCHIATRIST? A physician – MD or DO – who completes medical school, then a four-year residency in psychiatry. Subspecialties: Child & Adolescent, Forensic, Geriatric, C&L, Substance Abuse

TRAINING IN PSYCHIATRY RESIDENCY Note: All MS3 do psychiatry rotation YEAR 1: Internship/neurology/IM/ER YEAR 2: Mostly inpatient, C&L, subspecialty rotations, start psychotherapy caseload YEAR 3: OUTPATIENT YEAR 4: JR. ATTENDING ROLE ON SERVICES & ELECTIVE/RESEARCH TIME Call is worst in year 1 then gets better

WHO ARE THERAPISTS?

DEFINITION OF A PSYCHOTHERAPIST Psychotherapy or personal counseling with a psychotherapist, is an intentional interpersonal relationship used by trained psychotherapists to aid a client or patient in problems of living. It aims to increase the individual's sense of their own well-being. Psychotherapists employ a range of techniques based on experiential relationship building, dialogue, communication and behavior change and that are designed to improve the mental health of a client or patient, or to improve group relationships (such as in a family). Psychotherapy may also be performed by practitioners with a number of different qualifications, including psychiatry, clinical psychology, counseling psychology, mental health counseling, clinical social work, marriage and family therapy, rehabilitation counseling, music therapy, occupational therapy, psychiatric nursing, psychoanalysis and others.

FREUD WAS A PSYCHIATRIST WHO POPULARIZED PSYCHOANALYSIS

DIAGNOSIS OF MENTAL ILLNESS Can be diagnosed by a psychiatrist, a psychologist, or a psychotherapist. Psychiatric Evaluation is not the same as a Psychological Evaluation is not the same as a therapy evaluation. ARE YOU CONFUSED YET?

PSYCHIATRIC EVALUATION FOR MENTAL ILLNESS Assess symptoms of major psychiatric disorders Past psychiatric history, past medical history, medications, allergies, family medical history, developmental history, educational history, work history, social history Mental Status Examination/Sometimes Physical Examination Assessment and Plan

MAJOR CATEGORIES OF MENTAL ILLNESS DISORDERS OF INFANCY, CHILDHOOD, AND ADOLESCENCE (ADHD, Oppositional Defiant Disorder, Conduct Disorder, Autism, Mental Retardation, etc) DELIRIUM, DEMENTIA, AMNESTIC DISORDERS SUBSTANCE-RELATED DISORDERS (Alcohol…) MENTAL DISORDERS DUE TO A GENERAL MEDICAL CONDITION MOOD DISORDER SCHIZOPHRENIA AND OTHER PSYCHOTIC DISORDERS FACTITIOUS DISORDERS DISSOCIATIVE DISORDERS SEXUAL AND GENDER IDENTITY DISORDERS EATING DISORDERS SLEEP DISORDERS IMPULSE CONTROL DISORDERS ADJUSTMENT DISORDERS PERSONALITY DISORDERS

TREATMENTS FOR MENTAL ILLNESS MEDICATIONS PSYCHOTHERAPY ELECTROCONVULSIVE THERAPY (ECT) TRANSMAGNETIC STIMULATION (TMS)

MEDICATIONS ANTIDEPRESSANTS ANTIPSYCHOTICS ANXIOLYTICS MOOD STABILIZERS STIMULANTS HYPNOTICS

WHY STUDY PSYCHIATRY? It is seen in all specialties. Approx. 30-50% of primary care visits deal with psychiatric issues directly or involve the psychological aspect of disease. The brain is the last great frontier in medicine. It’s never boring – always interesting. Intellectually stimulating and diverse. It’s fun!!!