PSYCHIATRY

the branch of medicine that is concerned with the diagnosis, treatment, and prevention of mental disorders. The term psychiatry is derived from two Greek words meaning mind healing. Until the 18th century, mental illness or disorder was most often seen as demonic possession, but it gradually came to be considered as a sickness requiring treatment. Many judge that modern psychiatry was born with the efforts of Philippe Pinel in France and J. Connolly in England, who both advocated a more humane approach to mental illness. By the 19th century, research, classification, and treatment of disorders had gained momentum. Psychotherapy evolved from its origins in spiritual healing. The psychoanalytic theory of Sigmund Freud and his followers dominated the field for many years and did not receive a serious theoretical challenge until behaviour therapy and therapies deriving from humanistic psychology were developed in the mid-20th century. Insight therapies such as psychoanalysis, which pursue greater awareness of the patient's internal conflicts, continue to be dominant in psychiatric practice. The trained psychiatrist, who has completed medical school and a psychiatric residency, commonly employs medical treatments in addition to psychotherapy. Lobotomy, or leucotomy, whereby nerve fibres running to the front of the brain are severed, is today used only in severe cases and has generally lost favour as a treatment. Shock therapy (also called electroshock, or electroconvulsive, therapy) continues to be used for severe depressions and certain forms of psychosis. The medical technique that is by far the most widely used is drug therapy. The advent in the 1950s of psychotropic (mind-altering) drugs revolutionized treatment of the mental patient. Like the other medical techniques, drug therapy has sometimes been abused in pursuit of patient management; used properly, however, it can enhance a patient's outlook for recovery and return to the community. The contemporary psychiatrist frequently functions as a member of a mental-health team that includes clinical psychologists and social workers. As the therapeutic roles of these three professionals are not necessarily clearly delineated, an uneasy balance in orientation and division of skills may exist.