Talk:Psychiatry/Archive 8

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Psychiatry as Preventative Medicine

This article is very well-written and comprehensive. I wanted however to bring up some discussion of the first line:

Psychiatry is the medical specialty devoted to the study and treatment of mental disorders—which include various affective, behavioural, cognitive and perceptual disorders.

Should Wikipedia as a community also emphasize the nature of mental health as preventative medicine, and the role of psychiatry as a mainainer of regular mental health? We treat mental disorders. We also try to steer our patients away from them and prevent them. Naples Psychiatrist (talk) 15:43, 7 August 2010 (UTC).

psychiatry has a poor record when it comes to preventative approaches. The health promotion disciplines are more active in issues of addressing the precursors of mental health and at times the psychiatric profession has failed to consider early detection as a legitimate activity - (in my opinion) mainly due to underlying assumptions that mental health is a biological illness (and therefore unpreventable). Good idea to add examples of preventative psychiatry - I would be interested in this, although I doubt whether it is a core activity. cheers Earlypsychosis (talk) 21:38, 7 August 2010 (UTC)

Misuse of sources

This article has been edited by a user who is known to have misused sources to unduly promote certain views (see WP:Jagged 85 cleanup). Examination of the sources used by this editor often reveals that the sources have been selectively interpreted or blatantly misrepresented, going beyond any reasonable interpretation of the authors' intent.

Please help by viewing the entry for this article shown at the cleanup page, and check the edits to ensure that any claims are valid, and that any references do in fact verify what is claimed. Tobby72 (talk) 13:19, 4 September 2010 (UTC)

Recentism and hype

The hype on genetics with "decade of..." is rather lame. We've heard this every decade. A more significant progress was the introduction of effective medication for psychosis and mania. I can think of any number of fields, e.g. cancer, where genetics was declared to have solutions just around the corner. Tijfo098 (talk) 21:27, 20 October 2010 (UTC)

Agreed and removed. Removed recentism tag also.FiachraByrne (talk) 18:54, 7 February 2011 (UTC)

Sources for History of Psychiatry

I think there's an over-reliance on Shorter for the history of psychiatry. He's a good historian, but he has a particular point of view. Also, not all citations of Shorter bear a strong relationship to either the facts or arguments used in his text. Treatment of psychoanalysis is bizarre on the 20th century section. It was very dominant, particularly in the US.

There's a book by Elkes and Thorpe called 'A Summary of Psychiatry' which is cited a number of times. This book was written in 1967 and is very much out of date. Better sources should be used here. FiachraByrne (talk) 18:50, 7 February 2011 (UTC)

I have taken a first (small) step to addressing this, and am currently reading three current relevant RS histories to do more. That these histories read so differently from this article is, yet so similar to one another, in itself indicates a need for improvement (same comment applies to associated psych history related Wiki articles). ParkSehJik (talk) 23:21, 30 November 2012 (UTC)

Underweight of Rosenhan experiment

I think that esposition of the Rosenhan experiment (and more even the issue of the the reliability of the psychiatry) is underweighted in this article. Why talking about it only in the "History" section (in a subsection with criptic title "Transinstitutionalization and the aftermath")? shouldn't this epistemology issue be dealt also whereever reliability of psychiatry is delt or is important, maybe even in lead section? --79.16.163.8 (talk) 06:22, 11 May 2011 (UTC)

Creation of a History of psychiatry article

I think this article would benefit from a focus on present day practices and issues. Therefore I propose creating a History of psychiatry article and moving most of the content on the history of the discipline currently to the new page where it could be expanded. There is already a History of psychiatric institutions (which needs a lot of work). However, rather than focus only on institutional issues, the History of psychiatry should focus on the history of the discipline treating of such topics as professionalisation, the development of disease concepts and taxonomies, theories of mental illness, and therapeutic practices (see for example History of psychology). If there's no reply in a week I'll assume assent and go ahead with the proposal. Thanks FiachraByrne (talk) 16:22, 14 August 2011 (UTC)

I'm going to put together a draft on my user page User:FiachraByrne/History of psychiatry. Any input there is welcome. As I'm currently working on some other articles this will take a while (about a month?). FiachraByrne (talk) 09:14, 1 September 2011 (UTC)

RfC request at Neuro-Linguistic Programming

I think the article Neuro-linguistic_programming has gone downhill since it was nominated as a featured article and am trolling for those interested to come and fix it. Talk:Neuro-linguistic_programming#RfC_request Please copy or forward this request to more appropriate places. Thanks, htom (talk) 20:45, 3 January 2012 (UTC)

Deletion

At 01:17 on 27 January 2012,‎ user Literaturegeek has deleted from the article “Psychiatry” 72,388 bytes of its text based on various and numerous medical articles and books by physicians in accordance with WP:RS. I disagree with Literaturegeek, but would like other users to decide whether the text, deleted by Literaturegeek, should be restored or not. The more detailed version of the article “Psychiatry,” in which very important controversies over psychiatry have been described, is here. --Psychiatrick (talk) 02:59, 27 January 2012 (UTC)

I have not been watching that article, but looking over the diffs, I have to agree with LG that the edits took the article far out of the realm of MEDRS-compatibility, not to mention NPOV-compatibility. Looie496 (talk) 03:31, 27 January 2012 (UTC)

Agree with removal of recent additions, which clearly violate NPOV. Yobol (talk) 05:07, 27 January 2012 (UTC)

In Psychiatrick's recent reinsertion of removed material, the editor wrote 'removing information, taken from the scientific journal “World Psychiatry” of World Psychiatric Association, constitutes vandalism'. Literaturegeek is an editor in good standing, and accusations of vandalism should be avoided when there is another potential explanation. The source may have been given undue weight, for example, and Literaturegeek should have the opportunity to explain before being reverted as a vandal. References to reliable sources are not irremovable, especially in an article as broad as Psychiatry, where fringe viewpoints may deserve mention, but not multiple paragraphs. Dialectric (talk) 18:18, 27 January 2012 (UTC)

I do not know what is vandalism, if it’s not the deletion of text added to an article and based on a reliable source. In this way, I'm afraid that anyone can delete or spoil everything in Wikipedia. I am also an editor in good standing, and the scientific journal “World Psychiatry” of the World Psychiatric Association is a reliable source. Dialectric, why have you reverted the added text based on it? Please restore the text. --Psychiatrick (talk) 19:21, 27 January 2012 (UTC)

POV tag

I notice in the section above, "Underweight of Rosenhan experiment", that an editor is arguing for more weight and prominence to be given to this famous study. And I agree. But now all mention of it has been removed from the article.

Issues such as the DSM are described in glowing terms with no mention of the controversy surrounding this issue. Again, there is a lack of balance here.

And the lead section gives no indication of the criticism and controversy that surrounds psychiatry, and so is not in accordance with WP:Lead.

So I'm adding a POV tag to the article. Johnfos (talk) 15:06, 6 August 2012 (UTC)

I have put back the paragraph on the Rosenhan study that was removed by Yobol a short time ago -- it's true that this was just a single study, but it was very influential and extensively cited. I have also removed the POV tag -- I'll be happy to continue discussion of additional changes, but there is no need to deface the article with an ugly tag on top. Looie496 (talk) 15:50, 6 August 2012 (UTC)

Fine, and I have added some other material, to bring balance to the article. Johnfos (talk) 22:27, 6 August 2012 (UTC)

It would be a lot easier to support that new paragraph if it cited any sources. Looie496 (talk) 23:10, 6 August 2012 (UTC)

There are two new paragraphs. The one without sources is the last para of the lead of Diagnostic and Statistical Manual of Mental Disorders, which I have linked at the start of the section. So presumably sources are in that article, per normal practice. Johnfos (talk) 23:26, 6 August 2012 (UTC)

In future if you copy material from one article to another, please indicate in the edit summary that you are doing so. The copyright rules actually require this; but even ignoring the legalisms it's very helpful for people trying to figure out where the material came from. (I'm ducking for the moment the question whether the material needs a reference here -- I think probably it does, as the lead of an article is generally treated differently from the body.) Looie496 (talk) 23:45, 6 August 2012 (UTC)

A discussion of the Rosenhan experiment is probably out of weight on this top level article; there have been thousands of experiments done in this field, there is probably no good reason to include this one unless it had a profound impact on the field; a search on google books in books about the history of psychiatry such as here, here and here do not even mention the experiment once, but we have an entire paragraph about it? At the very least, I have cut down the amount of material about it and moved it back to the history section. Yobol (talk) 01:22, 7 August 2012 (UTC)

Interesting. For me, a Google Books search for "Rosenhan psychiatry" yields dozens of hits, many of them highly reputable, such as the Oxford Textbook of Psychopathology. I first learned about the study in my undergraduate Psychology textbook, and I've seen it discussed many times since. Looie496 (talk) 02:45, 7 August 2012 (UTC)

It's a matter of weight. I have no doubt that it is an "important" study, but I'm sure there are many of those. Why does this one, and only this one, get mentioned here? For an example, the "Oxford Textbook of Psychopathology" has exactly one paragraph, in 800 pages of text on this study. Why would we also have one paragraph about it in this top level overview article that is supposed to talk about the broadest and most important aspects of psychiatry? I'm sure that book has many other studies mentioned too, why does that one study go in and the others not? Yobol (talk) 03:09, 7 August 2012 (UTC)

The impact of the Rosenhan experiment is most pertinent to the development of the DSM III and it should be mentioned principally in that context rather than as a commentary on present day diagnosis and diagnostic categories. The change since then, whether viewed positively or negatively, has been profound. The books cited on the history of psychiatry above are, with the exception, perhaps, of Shorter, not particularly authoritative within the history of medicine/psychiatry. On a second take, this one contains articles by Gilman, Tomes, and Grob. Shorter's text, which is well written and worth a read, is generally not reflective of the field. FiachraByrne (talk) 09:22, 27 November 2012 (UTC)

Differentiation issues - psychiatry and other mental health disciplines

Comments: Scope of practice: Psychiatrists also differ from psychologists in that they are physicians and only their residency training (usually 3 to 4 years) is in psychiatry, and their graduate medical training is identical to all other physicians. – the difference between psychologists and psychiatrists in not well presented, it’s written that “only” the residency is what differentiates them, which is not the case. Also, psychiatry, in Canada and some European countries, is a 5 year residency.

Practitioners: …but it is their training as physicians that differentiates them from other mental health professionals. – This article is about psychiatry, not about mental health, besides, it is not only the core medical training that differentiates them from other mental health professionals, but also extensive training in psychiatry, which other mental health professionals do not have.

Diagnostic systems: Psychiatric diagnoses take place in a wide variety of settings and are performed by many different health professionals. – In this context, a psychiatric diagnosis is made by a qualified psychiatrist.

General considerations: They may come under the care of a psychiatric physician or other psychiatric practitioners by various paths – A psychiatric physician is called a psychiatrist. I am not aware that there are psychiatric practitioners other than psychiatrists; e.g. psychiatric nurses practice nursing, not psychiatry.

Inpatient treatment: Once in 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. – Multidisciplinary team, which may include psychiatrists, other physicians, pharmacists…

Outpatient treatment: psychiatrists are limiting their practices to psychopharmacology (prescribing medications) with little or no time devoted to psychotherapy or "talk" therapies, or behavior modification. – Maybe this is the case in the United States, which also probably does not represent the majority of psychiatrists, but there is no need for generalization for the entire profession. --Twokidneys (talk) 23:12, 19 October 2012 (UTC)

Significant controversies

Per WP:MOS (lede) - "summarize the most important points—including any prominent controversies", I made this edit[1]. Please discuss, add more reliable sources, and suggest similar material to add to the article body.ParkSehJik (talk) 22:26, 26 November 2012 (UTC)

This edit] removes dubious tags from unsourced statements, removes the POV tag from the entire article, removes all controversy from the lede in violation of WP:MOS (lede) as cited above, and removed RS content with a completely unsourced declaration of WP:UNDUE, in violation of WP:MOS (lede) as to significant controversy. ParkSehJik (talk) 23:17, 26 November 2012 (UTC)

I have reverted your edits again. It's clear that you are trying to push an anti-psychiatry point of view into the article, and that won't do. Looie496 (talk) 23:39, 26 November 2012 (UTC)

How is that "clear"? Any addition of MOS (lede) controversy required RS material falls into your category. What is your justification for reverting construction tags, dubious tags on unsourced (and false per the RS I added, violating WP:MEDRS) statements, and failing MOS (lede)? ParkSehJik (talk) 23:45, 26 November 2012 (UTC)

POV tag is far too strong. I don't think any problem is anywhere near big enough to warrant that tag. Let's wait and see if any other users also thinks that there is a problem.

Give me a little bit and I can find sources for those claims you tagged as dubious. --Harizotoh9 (talk) 23:46, 26 November 2012 (UTC)

Dubious tags after RS is found, not before. ParkSehJik (talk) 00:06, 27 November 2012 (UTC)

Also, I am not completely against a few sentences discussing controversies. It would have to be written by several people and reached via consensus however. What you wrote was simply far too strong. --Harizotoh9 (talk) 23:48, 26 November 2012 (UTC)

"It would have to be written by several people " is not a WP policy or guideline. This is not an alternative medicine article, and there should not be such strong emotional attachment to any position. "Too strong", describing the exact wording (rearranged) of a RS, is an unsourced opinion, not a basis for removing content you do not like from the controversy section per MOS (lede). ParkSehJik (talk) 00:01, 27 November 2012 (UTC)

I agree with that. The article has a long section on ethical and legal issues, and it would be reasonable for the lead to summarize that. But it needs to be done from a neutral point of view. Looie496 (talk) 23:53, 26 November 2012 (UTC)

I used the exact language from the NPOV RS source I cited, rearranged to avoid copyright concerns. So I can't be any more NPOV. ParkSehJik (talk) 00:01, 27 November 2012 (UTC)

"NPOV RS" source is not quite right. That's a diatribe published in a very obscure journal. Since the year 2000 it has been cited a rousing total of 11 times. According to Google Scholar, the most widely cited paper ever published by the journal (which has existed at least since 1994) gets a total of 92 academic citations, which is laughable. Looie496 (talk) 00:33, 27 November 2012 (UTC)

"It would have to be written by several people " is not a WP policy or guideline.

WP:Consensus is a policy, especially for potentially controversial edits and articles. I believe that such a section in the lede discussing controversies should be reached via consensus.

"Too strong", describing the exact wording (rearranged) of a RS, is an unsourced opinion, not a basis for removing content you do not like from the controversy section per MOS (lede).

Sources questioning whether psychiatry is a science are a minority opinion, so I cite WP:UNDUE. "Giving due weight and avoiding giving undue weight means that articles should not give minority views as much of, or as detailed, a description as more widely held views." Also, I am not against having a controversies section in the lede. But it should summarize what is already in the controversies section, and not introduce new information, and be worded differently. The way it was phrased originally made all of it simply statements of facts.

What is your source that it is a minority opinion, and where does "minority opinion" appeare in WO:MOS (lede) re controversies? ParkSehJik (talk) 04:33, 27 November 2012 (UTC)

I used the exact language from the NPOV RS source I cited, rearranged to avoid copyright concerns.

I am not sure if that was enough to avoid copyright concerns. It would have to be written from scratch. --Harizotoh9 (talk) 00:34, 27 November 2012 (UTC)

I did write it from scratch (memory), but all of content words were in the article. My edit was limke an abstract of the article's abstract. (Please don't emotionally react to my edits at forensic psychiatry. The offensive content wording is from the very title of highly respected sources. I am just editing per what the RS say.) ParkSehJik (talk) 00:56, 27 November 2012 (UTC)

• Wikipedia:Neutral_point_of_view/Noticeboard#NPOV_dispute_at_Psychiatry_and_Forensic_Psychiatry

I have requested commentary at the NPOV Notice board on this issue. --Harizotoh9 (talk) 09:07, 27 November 2012 (UTC)

I would have thought that most of the issues which ParkSehJik raises at least in relation to scientific validity, are covered in a neutral fashion in the last paragraph of the section on Diagnostic manuals. FiachraByrne (talk) 09:37, 27 November 2012 (UTC)

Image

Why is the top image a butterfly? There should be a much more useful image out there for psychiatry right? --Harizotoh9 (talk) 02:16, 27 November 2012 (UTC)

Exactly what I thought upon first arriving here. ParkSehJik (talk) 03:04, 27 November 2012 (UTC)

In Anatomy of Melancholy (1621) (image below) there is a story about how Hipocrates went to visit Democritus and found him in his garden with a bunch of animals laying about, all cut open. Democritus explained that he was attempting to discover the cause of madness and melancholy[2]. ParkSehJik (talk) 04:03, 27 November 2012 (UTC)

Psychiatrists treat disorders with pills

Ritalin Pill

Prozac

Pristiq

Lexapro

Happy pill

In 1932, Brave New World portrayed a distopia in which everyone was on medications to stablize their mood and behavior for more uniformity, and make them feel as if they were happy

A person dispensing pills prescribed by the psychiatrists who were hired to help out at Guantanamo, or whatever psychiatrists with the MD they got after making their hyppocratic oath do there.

The Anatomy of Melancholy, What it is: With all the Kinds, Causes, Symptomes, Prognostickes, and Several Cures of it (1621)

Thank you for the suggestions. I have added an image from elsewhere in the article. It's more use than a butterfly. I may use some of these images elsewhere in the article.

Is there any place to put the information I removed? It seems like mildly interesting trivia, but doesn't seem very relevant. --Harizotoh9 (talk) 04:08, 27 November 2012 (UTC)

I've restored the image. Seems there are some problems here understanding NPOV, OR, and MEDRS. --Ronz (talk) 18:12, 27 November 2012 (UTC)

An MRI scan of the brain: manymental disorders are thought to be associated with neurobiological abnormalities

Have never used an MRI to diagnoses a psychiatric condition. All psych diagnosis are done by ruling out other conditions and based on what the person says / how they behave. We could state that psychiatric illnesses are associated with normal MRI scans but I do not think that should be in the lead. Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:11, 27 November 2012 (UTC)

WP:IMAGE LEAD doesn't have any clear solutions for us. In this case, something representing the brain would probably be most appropriate. --Ronz (talk) 20:23, 27 November 2012 (UTC)

Doc James is talking very good sense here. Quite agree with what he says. Martinevans123 (talk) 22:25, 27 November 2012 (UTC)

Can we move on to discussing what is appropriate? The image we decide upon doesn't have to be related to diagnosis methods at all, as long as we ensure it doesn't mislead readers to the contrary. --Ronz (talk) 01:20, 28 November 2012 (UTC)

I propose the Prozac image. Prozak is as highly used in the practice as anything else. Prokak is also iconic of the field as it is now practiced. The Guantanamo pic should go in the criticism section, since advising on how to administer "discomforts", then "treating" the induced rational hopelessness as bipolar depression, is not medicine, as defined in the Wiki article. The image of Anatomy of Melancholy should be appropriately to the history section. ParkSehJik (talk) 03:05, 28 November 2012 (UTC)

Such an image would be highly misleading, if not an outright misrepresentation. --Ronz (talk) 04:36, 28 November 2012 (UTC)

Why would it be misleading? ParkSehJik (talk) 18:13, 28 November 2012 (UTC)

Risks seeming to reduce the entire discipline to a single approach, even a single pill, from a single manufacturer? Surely a little unhealthy, for any reader and/or patient? Martinevans123 (talk) 17:28, 29 November 2012 (UTC)

Would a tag cloud from the article itself, or a reliable source, be an acceptable image? Psychiatry, by its nature, is inextricably linked to language. A couch would be a cliché, and medications are only aspect of the specialty. There are many reasons a tag cloud would be inappropriate for other WP articles - I've never suggested one before - but I think this could be a reasonable exception. -- Scray (talk) 05:22, 28 November 2012 (UTC)

Interesting suggestion. Do any good or featured articles take this approach? --Ronz (talk) 17:34, 28 November 2012 (UTC)

None of which I am aware - but change can be a good thing, and this article obviously has particular challenges regarding lead image. -- Scray (talk) 23:55, 30 November 2012 (UTC)

I'm intrigued by the tag-cloud suggestion. Would it be possible to get a preview? FiachraByrne (talk) 13:46, 29 November 2012 (UTC)

Tag cloud of Psychiatry article (as of 29 Nov 2012)

See example at right. Obviously, we could replace text, font, arrangement, colors - the question is whether a word cloud is appropriate. I do like the idea as no more biased than our own article. I contemplated removing the words "psychiatry", "psychiatrist", etc as redundant, but I think they fit pretty well. -- Scray (talk) 23:05, 30 November 2012 (UTC)

I like it - particularly the fact that it would change with editing of the article. Also, I'm in favour of anything that deviates from the usual visual clichés. FiachraByrne (talk) 00:47, 1 December 2012 (UTC)

Per Fiachra; and I like its disordered word saladness. (I know a schizophrenic whose art resembles this, too.) --Anthonyhcole (talk) 08:04, 1 December 2012 (UTC)

Proposal

There's no sort of international symbol of psychiatry, like the Rod of Asclepius for (generally physical) medicine? I went to Amazon and looked at the covers of a few dozen Psychiatry textbooks, and they were of absolutely no use. Almost all of them had nondescript abstract designs. I'd suggest a composite image made up of:

Images for composite

Medications

Doctor-patient relationship (not a great image for this but you get the idea)

Philippe Pinel

or the like. Zad68 18:19, 28 November 2012 (UTC)

• Please God no images of a man with his head in his hands. FiachraByrne (talk) 13:46, 29 November 2012 (UTC)
• I supoport Zad68's proposal. Sorry, FiachraByrne, but I especially like the image of the man with his head in his hands, followed by the Prozak image. These two images are quickly highly informative as to the current nature of the practice of psychiatry, and the image of the man with his head in his hands also indicates that, although the scientific basis and ontological status of all of psychiatry's objects are not as well based in scientific methodology and empiricism as in other fields of medicine, there are real psychiatric objects needing medical treatment (albeit not necessarily lifetime treatment).

- I would suggest this image instead of the two doc-patient and Pinel images. It is very fully of content - it contains info as to what psychiatrists look at when practiced as medicine, contains historical content, has the previously iconic couch, points to the doctor patient relationship, and humrously but vaguely points to persistent controversies not encountered in other medical practices. If other editors agree, I will look into getting permission for use. ParkSehJik (talk) 17:19, 29 November 2012 (UTC)

• nor woman? Martinevans123 (talk) 17:23, 29 November 2012 (UTC)

Do good or featured articles use such composite images? --Ronz (talk) 17:48, 29 November 2012 (UTC)

Bird does. But I don't care for the composite image solution: too cluttered; impractical for a small device. And please let's not have the head in the hands. --Anthonyhcole (talk) 06:02, 2 December 2012 (UTC)

Proposal for forensic psyhiatry section improvement, re recent deletion of dubious tags and RS and MEDRS content

• 10% of legal opinions (re forensic psychiatry) termed or compared expert witnesses to “hired guns”, “whores”, or “prostitutes”. (source - Journal of the American Academy of Psychiatry and the Law, 27:414 –25, 1999 – 2). Prosecutors made the plurality of the comments. This is not just a review of usage on the street, this is a review of legal opinions. 10% of legal opinions, the majority of which are by prosecutors, is significant per MOS (lede), and is in no way UNDUE. And that is just a citation of what is in the legal record, so it the very most conservative number on prevalence of opinion in the legal profession.

• There is also RS that such usage has a rational basis in the way the profession is currently practiced, of which I am compiling. Here are four of many RS on the topic - (1. “Hired guns,” “whores,” and “prostitutes”: case law references to clinicians of ill repute, D. Mossman, Journal of the American Academy of Psychiatry and the Law, 27:414 –25, 1999 – 2. Whores of the Court: The Fraud of Psychiatric Testimony and the Rape of American Justice, Hagen MA, New York: HarperCollins, 1997 – 3. Reel Forensic Experts: Forensic Psychiatrists as Portrayed on Screen, Susan Hatters Friedman, MD, Cathleen A. Cerny, MD, Sherif Soliman, MD, and Sara G. West, MD, J Am Acad Psychiatry Law 39:412–17, 2011.

• Hagan criticized the methods of clinical assessment and psychological testing (in an evidence based and very reasoned and manner) and argued that mental health testimony is business rather than science, which is only a small part of the many bases of my placement of the Dubious tag on “medicine” re forensic psychiatry, and thereby on "all of psychiatry" being medicine. I was ridiculed as not being worthy of responding to re my arguments to keep the content I put in with MEDRS, with no sourcing for the ridicule, and simply because I put a dubious tag per the MEDRS and RS. This is not a good way to treat editors, nor is it a good basis for editing andarguing on talk, citing "common knowledge" to trump MEDRS sourced info.

• Samuel Gross (a Michigan Law School prof) writes “The contempt of lawyers and judges for experts is famous. They regularly describe expert witnesses as prostitutes.” This is RS for the use of “famous”, in addition to the source I provided describing “frequent” use of the expression. No wiki editor critical of my edits is citing any sources to base their opinions. The New York Times published similar remarks re being partisans rather than science based medical practitioners (In U.S., expert witnesses are partisan, Liptak A, New York Times. August 12, 2008, p A1).

• This is not just a “minority” “opinion”, and my recitation of what is in highly MEDRS and RS sources is not POV. It is citing sources. Deletions based on editors (likely as yet uninformed) opinions are not justified. I expect that in the end, these editors, likely deleting in good faith, will read the RS and MEDRS literature, and the material will gradually go into the article. In the meantime, editors should stop attacking me because they are uninformed as to what is in the MEDRS and RS sources, and is a prevalent, if not dominant, view in the legal, medical, and scientific community.— Preceding unsigned comment added by ParkSehJik (talk • contribs)

Hi ParkSehJik. The sources you are bringing here deal with the intersection of psychiatry and how it is (ab)used within the American legal system. What fraction of all the best reliable sources discussing psychiatry go into detail about the idea that psychiatrists are 'hired guns' and 'whores' for the courts? Can you give a ballpark figure, is it 30%? 10%? What fraction of a good, modern college-level textbook on psychiatry would cover this idea? Would it be 10 chapters devoted to it in a 30 chapter textbook? More? Less? Looking forward to your answers, cheers.... Zad68 19:59, 28 November 2012 (UTC)

- I do not have sources to answer to your question, but you apparently do or would not be asking it. What is the answer and what are your sources?

- If you have none and are trying to make a rhetorical point, that this talk page section is only about criticism of one part of psychiatry, that is correct. It is about that part which is praticed in the courts. So this talk page section would only apply to criticism sub-secion in the a corresponding section in this article on forensic psychiatry, with more specificity and greater detail given in the daughter article, forensic psychiatry. But all such information was summarily removed from that article[3] as "inherently unencyclopedic pov"[4].

- However, since such psychiatric practice is not medicine, as RS sourced above, and is at best related to a medical science, and as reliably sourced above, may not be science at all. Therefore, practice of psychiatry should be defined as including medicine in some of its practices, not as all of it being medince. ParkSehJik (talk) 06:10, 29 November 2012 (UTC)

Psychiatry is one of the oldest medical specialisms. It's designation as medical practice is a disciplinary/professional attribute that has little to do with the actual content of psychiatric knowledge or the nature of psychiatric practice. To establish this it is unnecessary to evaluate whether in any or all instances psychiatry adheres to the so-called "scientific method". The nature of psychiatric objects (diseases/syndromes/disorders) has, of course, been subject to much debate both within the without the discipline. Current DSM classification seems to represent an uneasy detente between clinical utility and scientific verifiability. I think those issues are covered in a neutral fashion in the DSM section of this article. There's an extensive literature on this topic, much of it philosophical, and it might be worthy of its own article.

Expert testimony of psychiatrists and interaction of the discipline with the law is somewhat relevant to the section on ethics. Personally, I think that this section of the article - which is unnecessarily vague - should be rewritten. The specific instances brought up here are mostly specific to the article on Forensic Psychiatry and should only be adverted to briefly here, if at all. Otherwise there are risks of WP:UNDUE. The sources ParkSehJik has posted would also be appropriate to the article on the Insanity defense (which needs a rewrite) and for an article on Psychiatry and the Law (broader article than forensic psychiatry). FiachraByrne (talk) 13:43, 29 November 2012 (UTC)

However,

I am in full agreeent with each assertion of FiachraByrne, especially re standards of UNDUE, re rewrite, and re the insanity defense article. I would add to improving the insanity defense article, that improvements be made to articles re "involuntary holds" (e.g., Section 5150), and if it does not already exist, an article on historic abuses of psychiatry by forced commitments (e.g., by organized crime bosses to get rid of troublesome wives threatening to tell all in divoirce proceedings), and feminist perspectives on the preposterous entities still sanctioned by the pscyiatric bosses for use, such as being designated to have penis envy. ParkSehJik (talk) 16:45, 29 November 2012 (UTC)

OK. Hi ParkSehJik. I wouldn't say our positions are equivalent so just to clarify ... My first statement above is a rebuttal of the use of a {{dubious}} tag at the end of the sentence: "Psychiatry is the medical specialty ..." My point is that the scientific status of psychiatry is irrelevant to whether it should be properly considered a medical specialism. Its status as a specialism has more to do with institutional and professional recognition, medical training in psychiatry, etc. It is not dependent on the theory or practice associated with the discipline. That is the same with any medical specialism.FiachraByrne (talk) 20:59, 29 November 2012 (UTC)

The reason my position on this may seem odd is recent discussion of the definition in the first lede paragraph at alternative medicine. Editors with a marketing purpose in editing keep trying to define it as per what is practiced, in order to create an ambiguity, which they then use to imply by the definition of medicine being science based, to create an air of scientific respectability, the very definition of psyeudoscence for fraud. So it is important to adhere to strict MEDRS qualificiations to stop this in those articles. That is the upshot of recent discussions re the lede at alternative medicine. A suggestion to strt discussion on this is that "Psychiatry includes the practice of medicine to heal mental diseases and disorders, associated medical sciences (e.g. - not to be in the article - administration of "discomfort" at Guantanamo, and whatever psychiatrists do down there), applications of theories of the mind in an effort to heal, and taking partisan legal positions in legal disputes involving a person's mental state". This is not an official proposal, but is more close to MEDRS standards. ParkSehJik (talk) 21:51, 29 November 2012 (UTC)

When I refer to WP:UNDUE I'm referring to the proposed inclusion of material questioning, at least from the perspective of legal representatives, the neutrality of medical expert witnesses. I'm not sure that it's appropriate to include it in this article but that it may be more relevant to forensic psychiatry. I agree that some of those sources might be relevant to the insanity defense article but, to be honest, I haven't checked them out in any detail so I'm not sure if they're principally secondary sources or primary studies. The actual numbers which form the basis of one of the surveys appears to be quite low (re psychiatric expert witnesses as "prostitutes", etc) and it would be necessary to ascertain whether these findings have been replicated elsewhere and if those kind of views are specific to any particular jurisdiction or, indeed, if they're specific to psychiatric expert witnesses or the kind of opinions that lawyers hold of expert witnesses generally.

"An article on the historic abuses of psychiatry ..." There are articles on the Political abuse of psychiatry and the Political abuse of psychiatry in the Soviet Union. During the 1960s and 1970s there was a strong tendency to interpret psychiatry and psychiatric institutions as solely engaged in social control; the social control thesis was extremely crude and is no longer current, by and large, but you could look up deviance theory and all that. Abuses occur and charges of the confinement of the sane have been leveled at mad-doctors since the 18th century (Daniel Defoe, etc). By and large such committal by conspiracy is relatively rare.

Feminist perspectives on psychiatry and medicine are notable - even if the theses of figures such as Elaine Showalter, Phylis Chesler or Jane Ussher have largely been negated - but they're probably not directly relevant to this article. There are sufficient sources to create an article on feminism and psychiatry or feminist interpretations of psychiatry, should you wish to do so. Penis envy is a Freudian concept and wouldn't be mainstream at this point in time within psychiatry.

On a more general level, the purpose is to create an informative article about the discipline that is neutral in tone and content. The purpose is not to prosecute psychiatry or any other discipline. FiachraByrne (talk) 20:59, 29 November 2012 (UTC)

@FiachraByrne - Thanks for well reasoned comments. I see "Women, Madness and the Law: A Feminist Reader" in the survivors movement reference section linked to by your user page sandbox. I have off-Wiki personal information on this topic as it relates to Meyer Lansky and current activities by elements of the Chinese government re their American and German stock exchanges activity, and surprisingly, the Technological singularity, This is what brought me to awareness of things not typically known, and completely without sources, RS or not. Despite accusations of "obvious POV", my "position" is likely not anything like yours or anyone else, far from what my own was until recently, and likely far from anything that ever entered the mind of any editor. It is not represented in any way in my edits or talk page comments. I will likely soon go on a lengthy Wikibreak after seeing the consolidation of article topics at your user page, to read their sources, then return to this topic, and hopefully then edit in a manner that does not stimulate much talk page discussion or controversy. ParkSehJik (talk) 21:51, 29 November 2012 (UTC)

OK Park. Good Luck. :) FiachraByrne (talk) 23:04, 29 November 2012 (UTC)

Should the psychiatry, forensic psychiatry, and related articles be held to a lower MEDRS standard than alternative medicine and its related articles?

Discussion re uniform application of MEDRS standards to all WP articles is here[5].

Following discussion re MEDRS, ontologic status of psychiatric categories, and controversy re the scientific methodologies for attaching the term "disease", "disorder", and :lifetime" to the categories (if they really exist, e.g., Penis envy), in the psychiatry, forensic psychiatry, Bipolar disorder, and related article talk pages, FiachraByrne correctly wrote (bolfaced added by me for emphasis of most relevant part, and whose comment I may have distorted by excerpting just a part of it in order to raise the following issue) -

"Psychiatry is one of the oldest medical specialisms. It's designation as medical practice is a disciplinary/professional attribute that has little to do with the actual content of psychiatric knowledge or the nature of psychiatric practice. To establish this it is unnecessary to evaluate whether in any or all instances psychiatry adheres to the so-called 'scientific method'."

However, the designation of psychatry always being medicine, and not just some parts of it, with the associated implications of established efficacy in healing real diseases, at Wikipedia, is a WP:MEDRS issue, not just a matter of determining the common usage on the street. The part of FiachraByrne's comment quoted above raises issues being glossed over by other editors at those multiple talk pages, where it is declared to be "common knowledge" that psychiatry is for the most part evidence and science based, that its designated categories (eg., penis envy and bipolar disorder) are real, that the DSM designation of their being "disorders" estabishes with MEDRS that they are, and that they are lifetime, and questioning this violated WP:COMMONSENSE, and is WP:BATTLE because it is unquestionable, even with MEDRS and RS saying otherwise, all because Diagnostic and Statistical Manual of Mental Disorders (DSM), the self-proclaimed "bible" for practitioners, is always unque3stionably MEDRS. Furthermore, RS and MEDRS content is being totally deleted from any WP:MOS (lede) "controversy" paragraph as being UNDUE, by simply citing the declarations in DSM, even when contradicted by other MEDRS sources.

The same WP:MEDRS standards should be applied to psychiatry as to alternative medicine articles. Traditional Chinese Medicine (TCM) is also one of the oldest "medical" practices. There is rigorous enforcement by WP:MEDRS hawks (of which I am one) that assertions re TCM being healing "medicine", as defined in that article and by MEDRS standards. The only allowable edits are that TCM practitioners "claim" to heal. TCM uses supernatural etiological objects ("qi" flow blockage causing qi, not the heart, to propel the blood inadequately), and outright false statements about anatomies, developed without the "cutting" of the "tom" in "anatomy" (Greek "tom" means "cut", as in "a-tom" – meaning not further able to be cut, as atoms were thought to be), has also historically been designated "medicine". MEDRS has different standards than accepted common usage, and for good reasons well argued in setting up the policy.

• Should the psychiatry, forensic psychiatry, Bipolar disorder, and related articles be held to a lower WP:MEDRS standard than alternative medicine and its related articles, as to its designation as a healing "medicine", with implications to claims of efficacy and intent of all areas of its practice (e.g., forensic psychiatry, or psychiatry practiced under the color of being "medicine" at Guantanamo), when there are substantial MEDRS sourced content that at, least part of psychiatry, is not based on science at all, and other parts are not intended to heal anything?

• Should Diagnostic and Statistical Manual of Mental Disorders V be continued to be unquestioned as MEDRS, and citec as "common knowledge" which, if questioned with MEDRS or RS, is claimed to be WP:BATTLE and violate WP:COMMON SENSE, as was DSM IV, especially in light of comments such as that of Allen Frances, chair of the DSM-IV Task Force - "DSM 5 will accept diagnoses that achieve reliabilities as unbelievably low as 0.2-0.4 (barely beating the level of chance agreement two monkeys could achieve throwing darts at a diagnostic board"[6].

Discussion is here[7].

ParkSehJik (talk) 19:44, 29 November 2012 (UTC)

Note, I moved the discussion to MEDRS following this exchange ParkSehJik (talk) 19:44, 29 November 2012 (UTC)

This is not a venue for such discussions. --Ronz (talk) 17:52, 29 November 2012 (UTC)

@Ronz - When another group of editors (not me), multiply posted similar related discussion at other talk pages (NPOV noticeboard and WikiProject Medicine without noticing me), editors said such discussion should go here on this talk page. I think it belongs at the talk page of MEDRS and will move it there if you agree it is more appropriate, but I expect it to be referred back here as it was at Wikiproject Medicine. Where do you suggest putting the discussion topic, and I will move it there? ParkSehJik (talk) 18:06, 29 November 2012 (UTC)

I am moving the discussion to MEDRS per Ronz comment. ParkSehJik (talk) 19:42, 29 November 2012 (UTC)

Proposed content for criticism section

I am proposing a criticism section and here is a first stab at the crticism section's lede paragraph -

See also the Diagnostic manuals section of this article.

There has been controversy regarding some areas of psychiatry, including over-prescription of medications, the ease with which declarations of disease categories and diagnoses can be made, the inability to refute some diagnoses of mental illnesses once made, vagueness and ambiguities of descriptions of mental states upon which important medical and other decisions are based, concerns about the validity of the scientific methodology used to base some of its diagnoses and treatments, that mental categories asserted by some psychiatrists to exist are entirely fictitious, that some mental states are declared to be diseases or disorders when they are not, but are instead either entirely fictitious or based on assigning deviation from a norm by an arbitrary amount to be a disorder or disease, and criticisms specific to the Diagnostic and Statistical Manual of Mental Disorders. Forensic psychiatry, the formation of opinion on a diagnosis of mental state for use in a partisan legal dispute, has been highly criticized as using these deficiencies in areas of psychiatry for motives other than medical, including basing diagnosis on financial or political motives.

I believe it will not be difficult to find RS for each of these points, but want to first see if there may be general objections before spending time doing so. ParkSehJik (talk) 01:05, 30 November 2012 (UTC)

Not only do we need sources to verify the information, we need sources to demonstrate it is proper to give such weight to the information. I've yet to seen in any of the many such discussions any hint of the latter, nor an understanding that they are required. --Ronz (talk) 01:18, 30 November 2012 (UTC)

Generally separate criticism sections are not recommended as they function as point-of-view forks. It's better to structure articles thematically and integrate any criticism in the applicable article section if supported by reliable sources and not undue. The text above is not neutral or balanced - it is a prosecutor's case and inappropriate for inclusion in an encyclopedia article. FiachraByrne (talk) 13:03, 30 November 2012 (UTC)

I generally agree with FiachraByrne point re integration vs. a criticism section, as the latter promotes kooky POV pushing. The point would nota apply to the lede, however, which is too short and general for such interation, especially as I am proposing only a single sentence, with elaboration in the article body.

Elaboration would include re “concerns about the validity of the scientific methodology used to base some of its diagnoses and treatments”, one of many examples. The Journal of Psychiatry and Neuroscience published[8] results of a meta-analysis of use of SSRIs re suicide. Meta-analyses of Randomized controlled trials (RTCs) indicated that SSRIs may reduce suicidal ideation in some patients. So it would appear established that SSRIs have efficacy for treatment. Here lies the crux of the problem, non-empirically (unscientific) linking the symptoms (SI) with disease (suicide) - from the abstract, “These same RCTs, however, revealed an excess of suicidal acts on active treatments compared with placebo, with an odds ratio of 2.4 (95; confidence interval 1.6–3.7). I had assumed editors working on psychiatry and related articles were familiar with the plethora of similar literature all over the field of psychiatry, and of the massive philosophy of science literature on the controversies, especially as it has made it into the mainstream popular science media. ParkSehJik (talk) 17:53, 30 November 2012 (UTC)

The general procedure is to edit the body of the text first and only then make changes to the lede if warranted. The specific source you cite above relates to an apparent increase in suicidal acts amongst those prescribed SSRIs. However, currently the article has no section on psychiatric medication - it has a "general considerations" section (for some reason) with two subsections on inpatient and outpatient treatment. There's also an empty section on "treatment settings" which should probably be deleted. I think the inclusion of the material on SSRIs would require a section on psychiatric medication in the article (perhaps as a subsection of a section called "psychiatric treatment" which would include various therapies). This is probably justifiable but I'd be interested in the opinion of other editors.

There is an article called Psychiatric medication and, according to Wikipedia conventions, the parent article (i.e. this article on Psychiatry) should reflect and accurately summarise the contents of the child article on Psychiatric medication and link to it. However, having looked at the article - which isn't far off a list - I'd argue against that and only include the most significant and frequently prescribed medications or classes of medications.

The psychiatric medication article contains many child articles including one on antidepressants which in turn links to one on antidepressants and one on Fluoxetine (Prozac). This latter article does contain a section on suicide. Although you could argue that this effect is notable enough for ultimate inclusion in the parent article given that the risk of suicide is really very low I think that that might be hard to maintain. Probably more notable is the contention that SSRIs have little effect beyond placebos except for the most severely depressed patients.

Before you make such a section it would probably be advisable to post something on your intentions here on the talk page but that's up to you.

I would also advise you to read the conclusion of the study you cite carefully to make sure that the text that you propose to add to the article reflects the conclusions of the authors and not your own inferences from their data (lest you be accused of WP:OR.

Moreover, the study you cite does not support the statement you wish to make in the proposed change to the lede ("concerns about the validity of the scientific methodology used to base some of its diagnoses and treatments"). So far as I can determine there's no such statement in that article (admittedly I've looked at it only perfunctorily) and it would therefore appear to be your own inference from the study. FiachraByrne (talk) 00:35, 1 December 2012 (UTC)

Actually, there is an article on Treatment of mental disorders which could naturally form the basis for an subsection of this article on treatment. That article, however, needs a lot of work. FiachraByrne (talk) 01:00, 1 December 2012 (UTC)

Re deletion of "diagnosis", but not "treatment", with edit summary "redundant"

Re this reversion[9], on redundancy grounds. Your redundancy argument would also argue for removal of "treatment", if it is based on Diagnosis being contained in the link to the lede first sentence of medicine. If not, some areas of psychiatry cannot claim "treatment" per MEDRS, for example Freudian analysis. Please consistently explain why you want "tretment" and not "diagnosis", which "redundancy" does not address. ParkSehJik (talk) 02:40, 30 November 2012 (UTC)

I'm sorry, but you are not making much sense in light of the relevant policies and guidelines. Seems you're trying to inject your own point of view and original research into something that should simply summarize what medical definitions state, along with what is covered in the article. --Ronz (talk) 18:41, 30 November 2012 (UTC)

My personal POV is pro-evidence-based-psychiatry, , which includes the majority (in my unsourced opinion) of psychiatry, and about 50% or less of forensic psychaiatry (reasoning that there are two sides in every court case, many times both spurious in their reasoning. The sources I put in that article, which Ronz removed, support this POV). My pro-psychiatry POV and sttistical POV re forensic psychiatry is reinforced by multiple off wiki consultations in hospital emergency psych wards and review or direct involvement in hundreds of legal cases, including involving forced conservatorships, 1368 motions in Marden Motion context re People v Salazar case, opposition and support of extending 5150 holds to 5250 or beyond, etc. What is Ronz's basis for his anti-AGF attack on me aserting my POV withuot knowing it in the least? How have I injected this POV into the psychiatry article by adding "diagnosis" to the lede first sentence? The diagnosis aspect of psychiatry, without treatment, is as big a part of this nascent field of medicine. And you did not respond to my question, which makes perfect sense. How is it redundant? ParkSehJik (talk) 19:10, 30 November 2012 (UTC)

Sorry for offending you. I'd assumed by this point that you would have much more understanding of WP:NPOV and WP:OR. Instead you're taking references to these policies as personal attacks. Sorry for the confusion. --Ronz (talk) 19:13, 30 November 2012 (UTC)

You have not offended me. But your incessant baseless misstatment of my POV, and it driving my edits, violates AGF. My edits may add things from sources that I find missing from an article, and may be tilted to a POV only because I tend to edit as I read things, together with the fact that I tend to use WP:ENEMY reasoning off Wiki, and I thereby read things opposed to my own POV, in hopes of learning something new, whereby my POV changes. You said my insertion of "diagnosis" inserts my personal POV, and others have strted talk pages on me calling my edits an "anti-psychiatry rant". My POV is highly supportive of the aspects of psychiatry that are evidence based. My opinion is that this is the vast majority of the practice of psychiatry, and is based on anectdotl personal experience. It is the opposite of these incesant false assertions as to my POV, and it driving my edits. I have vast persaonal experience that work of psychiatrists in hospital emergency wards is gruelling to the point of being physically taxing, that the tools (usually chemical restraints or short term stabilizers) avaialable are not those the practitioner would select if he or she had more long term time to treat, and that the range of realistic long-term solutions is very narrow. I find such psychiatrists, often working in istitutions for small fractions of what they could make as forensic psychiatrists ($500/hr, with no one above checking the time clock), to be a category of people that I personally consider in the very highest esteem ethically, at a level of my esteem for volanteerism. And their general attempt to provide a science base to what is almost an impossible situation of specificity in a case, with tools handed them by industries marketing them with a dollar bottom line (which is the nature of being a business in a competitive market, and is not necessarily unethical, just not science driven) My POV is in no way presented in any of my edits, which simply add information from sources. Misstatement of my POV and intent in editing violates AGF, and is a personal attack. On what do you base your claim of knowing my personal POV at all? How have I injected my POV into the psychiatry article by adding "diagnosis" to the lede first sentence? You said it was redundant. How is it redundant? ParkSehJik (talk) 20:09, 30 November 2012 (UTC)

Sorry again. To be crystal clear, the edit changed the emphasis (hence the pov) without adding new sources or indicating what sources or current content indicated that such a changes was proper. Given that the next paragraph goes into diagnosis in some detail, it's quite redundant.

I've linked in Medical diagnosis to the second paragraph of the lede to ever so slightly increase it's emphasis. --Ronz (talk) 22:48, 30 November 2012 (UTC)

I would think "diagnosis, study, and treatment" - for almost any medical specialty that engages in all three. That's the order in which they generally occur (e.g. cardiologists diagnose people with heart problems, study the diagnostic and treatment modalities, and finally treat them when treatments have been refined beyond investigational phase. Putting "study" first does not makes sense to me, except from the historical or pedantic "-ology" perspective. -- Scray (talk) 23:50, 30 November 2012 (UTC)

I also don't see the logic in this deletion and how it relates to anyone's POV. I'd also support the suggestion of Scray as the best formulation ("diagnosis, study, and treatment"). FiachraByrne (talk) 01:02, 1 December 2012 (UTC)

Sources please, or are we implying that we never worked from sources to begin? In that case, definitive definitions and descriptions should be used. Diagnosis is simply a part of treatment and is highlighted nicely in the second paragraph. --Ronz (talk) 02:16, 1 December 2012 (UTC)

I'm puzzled. Why do we use the word "diagnosis" at all? Do psychiatrists treat delirium, or do they just diagnose and generally involve internists and other to address the underlying medical problem? It is patently obvious that psychiatrists (and other specialists in Neurology, Urology, Otolaryngology, and Cardiology - need more?) diagnose conditions, and that they don't always treat them. I can't really believe that this is contentious. -- Scray (talk) 02:36, 1 December 2012 (UTC)

They "increasingly" only diagnose and not treat if therapy, not drugs, is called for, per the MEDRS source I put in. Well sourced material I put in the article keeps being removed. Ronz has been trolling me for some reason, and reverting all of my edits everywhere. This includes reverting my edits at the aternative medicine, whereby Ronz sided with the bigest "pro" alternative medicine finatic at that article, a finatic who argues only without citing policies and guidelines. Ronz in his edit summary, and others at other talk pages, say that I exhibit a "antipsyciatry POV", e.g., by putting "diagnose" in this article. Without AGF, Ronz states that I have am pushing this "antipsychiatry POV" by putting in "diagnose", which as discussed above, is not only without basis, but is utterly, preposterously, false. ParkSehJik (talk) 02:53, 1 December 2012 (UTC)

That would be original research, changing the pov without proper sourcing, and focusing on the editors and personalities involved rather than on the relevant policies and guidelines (including WP:OR, WP:NPOV, and WP:DR).

I'm still looking for some definitive sources, but so far I'm seeing no such emphasis on diagnosis, and it appears we're overlooking "prevention" though we don't address it much in the article. --Ronz (talk) 02:58, 1 December 2012 (UTC)

Ronz, are you familiar with the DSM-IV? Are you aware that the "D" stands for "Diagnostic"? -- Scray (talk) 03:25, 1 December 2012 (UTC)

So? --Ronz (talk) 04:14, 1 December 2012 (UTC)

So, it's a definitive WP:MEDRS that emphasizes, in its title, that diagnosis is a major activity of psychiatry. -- Scray (talk) 04:43, 1 December 2012 (UTC)

That would be original research. See below for how to handle the situation properly. --Ronz (talk) 18:00, 2 December 2012 (UTC)

Some sources

• "A psychiatrist is a medical doctor who specializes in the diagnosis, treatment and prevention of mental health, including substance use disorders. " [10] American_Psychiatric_Association
• "The medical specialty concerned with the diagnosis and treatment of mental disorders." [11] Stedman's_Medical_Dictionary
• [12] TheFreeDictionary provides us with multiple sources/definitions:
  • " the branch of medicine dealing with the study, treatment, and prevention of mental disorders" Dorland's
  • "The branch of medicine that deals with the diagnosis, treatment, and prevention of mental and emotional disorders." American Heritage's Medical Dictionary
  • "the branch of medical science that deals with the causes, treatment, and prevention of mental, emotional, and behavioral disorders." Mosby's Dental Dictionary
  • "The medical specialty concerned with physical and chemical interactions in the brain and how they affect mental and emotional processes; the study, treatment, and prevention of mental illness" McGraw-Hill Concise Dictionary of Modern Medicine

Judging by these, "diagnose" should probably be given equal prominence, and we should probably add "prevention." This also suggests that the article needs expansion on issues of prevention. --Ronz (talk) 04:44, 1 December 2012 (UTC)

Actually, treatment also needs expansion or reconfiguring. Another source: "Psychiatry is the branch of medicine concerned with the diagnosis, treatment and study of psychological disorders". I'm trying to figure what psychiatry/psychiatrists actually do currently that might be considered preventative since the height of the mental hygiene movement in the earlier part of the twentieth century. I guess there's been renewed interest in incipient psychosis but that's been very controversial. I'm sure I'm overlooking some programmes aimed at the general or "at risk" population. What would you have in mind Ronz? FiachraByrne (talk) 14:25, 1 December 2012 (UTC)

The emphasis on "prevention" suggests we're overlooking it. All I'm suggesting is that we look.

The APA mention of substance use disorders indicates we should expand that as well, though not in the lede. --Ronz (talk) 16:56, 1 December 2012 (UTC)

I don't dispute that we should look it's just that not a lot is springing to mind for me so I'd be interested if any medical practitioners could shed some light on the issue. My guess is it's mostly rhetorical at least at present with perhaps some pilot programmes using antipsychotics for "prodromal psychosis" and maybe a bit of CBT for the same or other at risk populations.

I'd suggest leaving the lede be for a bit until whatever forthcoming changes to the body of the text are made and agreed upon.FiachraByrne (talk) 17:13, 1 December 2012 (UTC)

• http://www.apa.org/health-reform/prevention-wellness.html
• http://www.who.int/mental_health/evidence/en/prevention_of_mental_disorders_sr.pdf
• http://www.nimh.nih.gov/health/topics/prevention-of-mental-disorders/prevention-of-mental-disorders.shtml

Looks like there's also quite a bit on stress reduction/management and sleep hygiene. --Ronz (talk) 17:36, 1 December 2012 (UTC)

The first link is to a psychological association. The third link brings up suicide prevention which is very relevant as this is likely a programme with some money behind it - should have thought of that one. The WHO report is incredible - just about every adverse social condition is regarded as pathogenic. It has a nice potted history though linking it back to mental hygiene movement. Much of this stuff is pretty much at the level of earlier advice manuals. What proportion of the mental health budget in the US or elsewhere actually goes on preventive measures I wonder (I think I read about 5 per cent recently). Nonetheless, you're right it should be covered but to what extent I'm not sure. Would you be willing to create and develop a stub article on the topic? FiachraByrne (talk) 23:39, 1 December 2012 (UTC)

Difference between psychiatry and psychology

Many people do not know the difference between psychiatry and psychology, or with clinical psychology.[13] The superficial answer that psychiatrists have MD's and psychologists do not is informative, but not very informative. The once common "psychiatrists can prescribe drugs and psychologist cannot" is not true any longer, as in New Mexico and Louisiana. There should be a section with this information for the general reader at the top of the article, and a bit should be added to what is in the lede first paragraph on MDs. ParkSehJik (talk) 01:17, 1 December 2012 (UTC)

It's inappropriate for the lede. --Ronz (talk) 02:13, 1 December 2012 (UTC)

Why? You are trolling me to delete oppose each edit I make everywhere, including at alternative medicine with your siding with the single most hyper-POV-pro-altmed-ADVERT-WP-policy-ignoring-editor on that page, just to revert my edit, with your saying a primary source can be used to support an edit that says that very primary source is "notable". I.e., using a webpage self-declaring notability to estabish notability. Are you now going to argue for placement in this article that CAM alt med can be integrated with psychiatry to increase ifficacy of the medications, withour MEDRS, just because I would oppose it? Why is this inappropriate for the lede? I gave MEDRS that it is a "very common" misundertanding that needs clarification in the general public. ParkSehJik (talk) 03:11, 1 December 2012 (UTC)

Once again, please focus on content.

It doesn't belong because the article is about psychiatry. Any misunderstanding about what psychiatry vs other professions/fields/etc. should not be in the lede unless it was due the same weight as what is already in the lede. That is not the case here. --Ronz (talk) 03:17, 1 December 2012 (UTC)

Once again, Ronz, you fail to understand Wikipedia basic policies and guidelines. Please read WP:UNDUE and WP:NPOV. I cited MEDRS that this misunderstanging the difference between psychiatry and psychology is "very common, and few in the general public could say the diference". You removed my MEDRS source, and content-free went off into pseudoWiklawywering, just to pick a fight. Your argument that transcranial magnetic stimulation should be in the lede is completely without understanding WP:UNUDE, as you have never once justified your position re WEIGHT with any source, ever. Yet you delete my content and its MEDRS sources that directly point to WEIGHT. Please famililarize yourself with these policies and guidelines, and try reading content in the field to gain at least a vague understanding before making declarations re WEIGHT without justifying your edits with sources. ParkSehJik (talk) 03:37, 1 December 2012 (UTC)

I'm sorry. Please explain how this compares to a general description and definition of psychiatry in terms of due weight? --Ronz (talk) 03:58, 1 December 2012 (UTC)

OK, transcranial magnetic stimulation is not part of the core description of psychiatry. Per the MEDRS "most" people confuse what what psychiatrists do, diagnose then either refer to therapy or give drugs and refer to thera, with what pypsychologists do, give therapy. So that belongs in the lede, and TMS does not. I suggest that you read the article after I remove the constuction tag, and your "common confusion" might be gone as to your understanding of what psychiatry is. Please focus on content, and if you do not understand the content in the sources, refrain from editing at that article. ParkSehJik (talk) 04:34, 1 December 2012 (UTC)

I'm sorry, but my concern was with adding information on the difference between psychiatry and psychology as the topic heading indicates.

So again, how does this compare to a general description and definition of psychiatry in terms of due weight? --Ronz (talk) 04:42, 1 December 2012 (UTC)

Personally, I'm not sure about this inclusion. However, I don't think there's much point in considering whether it strictly falls within policy or not. The addition of this to the lede falls outside of either considerations of weight or whether its due or whether its summarising the body of the article and rather addresses the need to orientate the reader who may not be familiar with the distinction between clinical psychology and psychiatry. I think if it's to be included it should stick to the basics (Psychiatrists are doctors, power of prescription, etc). The position of psychiatrists in mental health service hierarchies is likely to differ between jurisdictions so I'm not sure that should be included but perhaps their central role in diagnosis could be? Is there a pressing need for the distinction to be made and if so can the distinction be made succinctly? FiachraByrne (talk) 23:48, 1 December 2012 (UTC)

Massive deletion of well sourced history content

Why did USER:The Four Deuces delete, in one sweep[14], all of the well sourced history content I added one step at a time with edit summary quoting from my stepwise addition and that it was sourced. TFD's edit summary was "RV unexplained edits". ParkSehJik (talk) 02:30, 1 December 2012 (UTC)

I don't know. Maybe they thought it was off-topic. Biosthmors (talk) 02:34, 1 December 2012 (UTC)

"In the early 1800’s, psychiatry made a significant advance in diagnosis of mental illness by broadening the category of mental disease to include mood disorders, in addition to disease level delusion or irrationality. Jean-Étienne Dominique Esquirol, a student of Pinel, made the first elaboration of what was to become our modern depression, lypemania, one of his affective monomanias (excessive attention to a single thing). ParkSehJik (talk) 03:02, 1 December 2012 (UTC)

I had the paragraph that started, "In 1621..." in mind.[15] Biosthmors (talk) 03:08, 1 December 2012 (UTC)

Then why not just delete that offending paragraph? (Aside, That 1621 publication describes a book "...Melancholy ... its Causes, Cures... Medicinealy..." etc, and was used in English speaking countries to treat the insane, e.g., by drilling holes in their head to let out the bad humors treatments. How is it offtopic?) ParkSehJik (talk) 03:28, 1 December 2012 (UTC)

Your addition included a passage about the ancient Greeks sourced to an 1881 satirical book. Since the author does not mention psychiatry, it is synthesis to conclude that he was writing about ancient psychiatry. Also the fact that the book is satirical means that its accounts may be incorrect. Also it adds undue emphasis to precursors of psychiatry. TFD (talk) 05:23, 1 December 2012 (UTC)

Slightly off-topic: I'm working my way through Melvyn Bragg's In Our Time series and today, before reading this thread, I listened to his discussion of Burton's Anatomy of Melancholy (the 1621 publication mentioned above). A nice summary. --Anthonyhcole (talk) 05:54, 1 December 2012 (UTC)

@Anthonycole, I actually own an original edition of that book (an numerous seiminal psychiatry, psychlogy, and proto-pschyiatry boks), and the amazing cover has been oiled by 400 years of hands, likely most proto-psychiatrists and psychiatrists, since it was used as a medical text (not having satire, but definitely having humor). There was an edit conflict so I wrote the below reply to TFD before seeing your comment. Please check what I wrote for accuracy, since my edit was an attempt at Burton-eque humor, in I tried to get in humor while retaining scholastic facts and accuracy, by uaig a 1621 source rather than a more modern source because it is RS as to the scholasticism, which makes it RS as to proto-psychiatric practice re medicines etc. to cure melancholia. Now I am posting the below and going to the website you just pointed to, and note that the quote from it, "a fascinating insight into seventeenth-century medical theory", addresses in part somc of TFD's concerns. ParkSehJik (talk) 06:17, 1 December 2012 (UTC)

TFD, rather than deleting all of the content I added, you should have at most just deleted that part you questioned, and started a talk page with explanation. How could anyone possibly know what part of your deletion you qestioned? And how does "RV unexplained edits" refer to "satirical". I assume you mean 1621, not 1881. ) The term psychiatry had not yet been coined so cannot occur in the text. But as the title indicates, it is about diagnosis and cure of melancholy with medicine, or however he spelled it. Burton's book is not a satire, but accurately states things in a humorous way. For example, it obliquely refers to the etymology of "anatomy", derived from Greek to "cut", whereby the body is cut up to learn what it is made of. Now go back and read his title, and you will see the humor, hidden in the accuracy of description of the content. It is a "medical text", and intended as such. But at that time, medicine was a scholastic commpendium of the past "tratments", and at that time including humor as acceptable and desireable, so long as accuracy was maintained. The "science" is appalling, but the scholasicism superb, and he became famous for it. It is RS as a secondary source. (Especially so as one can actually check it against the primary source Greek Hippocrates account. It specifically describes psychiatric practices that continued hundreds of years (it is a medical text), including drilling holes in the head to let out all the bad Humors. I can add a "according to Burton" if that would help, but he should be acceptable as RS as to the reading of Greek classics on the topic. If you meant "1881", you just read a lot for nothing. ParkSehJik (talk) 06:17, 1 December 2012 (UTC)

Hi Park. I meant to do this ages ago but like most of my wiki plans it came to nothing but a History of psychiatry article should be created at this point which this parent article could then summarise. Burton's is a great text but it's not a secondary source - if it's to be added you'll need a secondary to interpret it for you. It's a very complex text and Burton's use of terms of like melancholia (the English disease, etc) do not correspond to present day concepts of depression. That 1967 book by Elkes and Thorpe is out of date and better references should be found (of which they are many). There was something about witchcraft/demonic possession in your edits. For a treatment of that I'd advocate the use of Michael McDonald's Mystical Bedlam (unfortunately I don't have a copy to hand but I could probably get one in couple of weeks) - it's specific to England; I think RA Houston has a decent book for Scotland in the 17th century. FiachraByrne (talk) 16:14, 1 December 2012 (UTC)

I'm going to have another stab at writing a History of psychiatry article but this time, rather than working from the content already on this article I'm going to reorganise it from scratch. I'll be putting up a draft in my own userspace but anyone is welcome to contribute constructively: User:FiachraByrne/History of psychiatry. At the moment I'm just doing subject headings, linking to existing articles and adding references. It's structured a little too much around social/cultural history at the moment and needs more clinical history. Anyhow, if anyone's interested in lending a hand it would be much appreciated. FiachraByrne (talk) 23:55, 1 December 2012 (UTC)

Was this edit intentional?

Was this edit intentional, or a slip of some "save page" button? It had no edit summary, deleted content and sources, undid the reording Ronz just did, and ignored consensus just reached as to the word "diagnosis". I reverted it. If it was intentional, please explain it, and the absense of talk page discussion and edit summary basis. ParkSehJik (talk) 06:30, 1 December 2012 (UTC)

Lede updated

I changed the lede to the version prior to the recent discussions (12 Nov), but included the changes where there was fairly clear consensus - the common use of medication paired with psychotherapy and the definition including "diagnosis" and "prevention." I hope didn't overlook something and that this isn't controversial. --Ronz (talk) 21:42, 3 December 2012 (UTC)

The China Psychiatry Crisis

I will be proposing edits using these sources - The China Psychiatry Crisis: Following Up on the Plight of the Falun Gong, Alan A. Stone, M.D., Psychiatric Times, and Freud, psychiatry, and mental health in China, New Yorker, Evan Osnos. Many editors and other users may find it surprising, as pointed out in the first linked source, that criticism of psychiatry abused for political ends is more prevalent in the US than in China. This is especially true regarding conservatorship hearings using forensic psychiatry to pick out the least scientific elements of psychiatry, and use them to push a partisan position by attorneys and others such as with political or other nonmedical ends. Nonmedical ends include financial gain, such as in conservatorship hearings to seize assets and the freedom of wealthy elderly people. The article I just cited points to anectdotal evidence that the dollar, not politics, is the new bottom line in China, but is located at a different place than where the dollar is bottom line in some psuychiatric abuses in the US. I will give editors a chance to read this article before proposing edits from it. ParkSehJik (talk) 14:43, 10 December 2012 (UTC)

Alternative medicine (Ayurveda) used in psychiatry in India

I will be proposing edits using this article as a source - History of psychiatry in India, SR Parkar, VS Dawani, JS Apte, Department of Psychiatry, Seth G.S. Medical College and K.E.M. Hospital, Mumbai, Journal of Postgraduate Medicine. Since it involves use of Ayurveda, an anti-scientific alternative medicine, within psychiatry, any such edit can be expected to be controversial here, so I am posting the source before proposing edits later. ParkSehJik (talk) 14:55, 10 December 2012 (UTC)

POV in antipsychiatry section

"highly subjective diagnostic process, leaving too much room for opinions and interpretations."

If you're going to say it's "highly subjective" it seems like there should be a source. Also saying there's "too much" room for opinion and interpretations is simply a point of view. — Preceding unsigned comment added by 207.42.135.25 (talk) 01:30, 20 March 2013 (UTC)

Yes, a source is needed, so I put a citation needed-tag. Yes, it is a point of view, but it is also presented as "The anti-psychiatry movement describes ..." making it clear that this is the point of view of the anti-psychiatry movement. Lova Falk talk 19:03, 1 April 2013 (UTC)

Have updated the Anti-psychiatry section based on main article, per WP:SS. The language has been softened and references have been added. Johnfos (talk) 22:27, 9 April 2013 (UTC)

I removed "militantly" before anti-psychiatric in the controversy section as the term is both POV and unfair to many (actually, most) consumer/survivor groups. E. Francesca Allan (talk) 15:23, 5 July 2013 (UTC)

I see that "militantly" has been put back in. To whoever's responsible, I have been arrested, incarcerated, isolated, mechanically and chemically restrained, electroshocked. I believe I have the right to call myself a psychiatric survivor without being accused of being "militant." If you want to argue about this, please be respectful and have the discussion here first. E. Francesca Allan (talk) 21:35, 5 July 2013 (UTC)

This word is now gone. Lova Falk talk 08:34, 4 August 2013 (UTC)

Series of proposed edits broken down into parts

User:Anthonycole wrote on my talk page - "We've had a long-term problem here with people harrying the psychiatry pages out of personal grievance or religious (Scientology) zeal. No one here appreciates new editors making many significant controversial changes to many articles in a short time, because it takes time to check..." I was unaware of this context. Apparently in this context, Ronz reverted all my editsto the lede[16], and TheFourDeuces revderted edits I made to the history section[17]. It would be impossible for anyone not immersed in the field to be able to read enough of the sources I used to verify my edits at the pace at which I made them. I will therefore break them into individual sentences, to discuss as subsections here.ParkSehJik (talk) 04:27, 10 December 2012 (UTC)

Esquirol's broadening of category of mental disease to include mood disorders

This edit - "In the early 1800’s, psychiatry made a significant advance in diagnosis of mental illness by broadening the category of mental disease to include mood disorders, in addition to disease level delusion or irrationality. Jean-Étienne Dominique Esquirol, a student of Pinel, made the first elaboration of what was to become our modern depression, lypemania, one of his affective monomanias (excessive attention to a single thing)."

This is not really in dispute as one of the most significant advances in the history of psychiatry (and the continued broadening without limit is today widely viewed as just as historically significant, but as a possible backwards step, a fact that should be added in a later history section, with reliable sources, such as the former Chair of DSM IV and the current issue of Discover Magazine's Top 100 Science stories).

Text above by Park. I'd have some minor points to make about this edit but I would have let it stand and would be interested in hearing the justification for its reversion. I wouldn't use the term "advance" even if its in the secondary source as its inherently value-laden and whiggish. Mention of monomania should include a discussion of: partial versus total insanity (very significant for criminal insanity/insanity defence); movement away from humoral theory to focus on the nervous system; importance of faculty psychology; and the somaticisation of monomania through phrenology. Also, while its included in the reference note I think the point that this marks an early move in the division of insanity into affective, cognitive and connative (disoders of the will) disorders merits inclusion in the article text. However, those points relate to how the coverage of monomania could be improved and do not constitute arguments for the removal of this edit.

Second paragraph: avoid references to anything being "backward" or "advanced" - these are subjective terms that imply a value judgement.FiachraByrne (talk) 11:13, 10 December 2012 (UTC)

Democritus and Hippocrates on Madness and Meloncholy

This edit - "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 was attempting to discover the cause of madness and melancholy. Hippocrates praised his work. Democratus had with him a book on madness and melancholy.

The source is a noted Greek scholar, Robet Burton, a secondary source who quotes directly from the Greek sources, which are primary sources, then restates what is quoted with minimal change. I provided the internet link to Google books to easily verify this. (Note that "melancholy" is not necessarily the same as modern "depression", nor is "madness". But this is the same with all Greek concepts, such as Democritus' "atom".) ParkSehJik (talk) 04:27, 10 December 2012 (UTC)

Burton is not an appropriate source for this. Treat Burton as a primary source. Look to more recent scholarship on antique notions of madness.FiachraByrne (talk) 09:13, 10 December 2012 (UTC)

I should add that Elkes and Thorpe's texts (1961 & 1967) are also inappropriate secondary sources (dated; whiggish).FiachraByrne (talk) 09:46, 10 December 2012 (UTC)

1621 Anatomy of Melancholy and science of the mind

This edit - "In 1621, Oxford University mathematician, astrologer, and scholar Robert Burton published the English language The Anatomy of Melancholy, What it is: With all the Kinds, Causes, Symptomes, Prognostickes, and Several Cures of it. In Three Maine Partitions with their several Sections, Members, and Subsections. Philosophically, Medicinally, Historically, Opened and Cut Up. Burton wrote "I write of melancholy, by being busy to avoid melancholy. There is no greater cause of melancholy than idleness, no better cure than business." Unlike English philosopher of science Francis Bacon, Burton assumes that knowledge of the mind, not natural science, is humankind's greatest need."

In 1621, the fields of psychology and psychiatry were not yet named, defined, or delineated. Since Burton's book specifically discusses "symtpms" and "medicines" and "cures" of "madness", and was used as a medical text for a very long time, there should be no doubt as to its historic significance. ParkSehJik (talk) 04:27, 10 December 2012 (UTC)

It is a significant and delightfully strange historical text.FiachraByrne (talk) 11:18, 10 December 2012 (UTC)

Lede

Reverted version -

Psychiatry is the medical specialty devoted to the study, diagnosis, treatment, and prevention, of mental disorders. These include affective (mood and emotion related), behavioral, cognitive (related to thinking and reasoning), and perceptual disorders (such as delusions). The combined treatment of psychoactive medication and psychotherapy has become the most common mode of psychiatric treatment in current practice, but current practice also includes widely ranging variety of other modalities. Psychiatrists in private practice increasingly spend their time with management of medications, and not psychotherapy, and may refer patients to therapists such as clinical psychologists.

Unlike a psychologist, a psychiatrist first gets a medical degree then goes on to do specialized training. Other mental health practitioners who believe their patient might benefit from medication may send their patient to psychiatrists for an evaluation and possibly a prescription. Treatment may be delivered on an inpatient or outpatient basis, depending on the severity of functional impairment or on other aspects of the disorder in question. Research and treatment within psychiatry as a whole are conducted on an interdisciplinary basis, sourcing an array of sub-specialties and theoretical approaches.

Psychiatric assessment typically starts with a mental status examination and the compilation of a case history. Psychological tests and physical examinations may be conducted, including on occasion the use of neuroimaging or other neurophysiological techniques. Mental disorders are diagnosed in accordance with criteria listed in diagnostic manuals such as the widely used Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association, and the International Classification of Diseases (ICD), edited and used by the World Health Organization. The fifth edition of the DSM (DSM-5) is scheduled to be published in 2013, and its development is expected to be of significant interest to many medical fields.

The term "psychiatry" was first coined by the German physician Johann Christian Reil in 1808, and literally means the 'medical treatment of the soul' (psych-: soul; from Ancient Greek psykhē: soul; -iatry: medical treatment; from Gk. iātrikos: medical, iāsthai: to heal). Controversies exist involving some areas of psychiatry and the diagnostic manuals they use to classify mental disease, including regarding use of questionable scientific methodologies, lack of objectivity in calling a mental state a "disorder" solely because it is outside an arbitrarily set "norm", and political and financial interests distorting studies and practice.

Version I found when I came here -

Psychiatry is the medical specialty devoted to the study and treatment of mental disorders. These mental disorders include various affective, behavioural, cognitive and perceptual abnormalities. The term was first coined by the German physician Johann Christian Reil in 1808, and literally means the 'medical treatment of the soul' (psych-: soul; from Ancient Greek psykhē: soul; -iatry: medical treatment; from Gk. iātrikos: medical, iāsthai: to heal). A medical doctor specializing in psychiatry is a psychiatrist.

Psychiatric assessment typically starts with a mental status examination and the compilation of a case history. Psychological tests and physical examinations may be conducted, including on occasion the use of neuroimaging or other neurophysiological techniques. Mental disorders are diagnosed in accordance with criteria listed in diagnostic manuals such as the widely used Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association, and the International Classification of Diseases (ICD), edited and used by the World Health Organization. The fifth edition of the DSM (DSM-5) is scheduled to be published in 2013, and its development is expected to be of significant interest to many medical fields.

Psychiatric treatment applies a variety of modalities, including psychoactive medication, psychotherapy and a wide range of other techniques such as transcranial magnetic stimulation. Treatment may be delivered on an inpatient or outpatient basis, depending on the severity of functional impairment or on other aspects of the disorder in question. Research and treatment within psychiatry as a whole are conducted on an interdisciplinary basis, sourcing an array of sub-specialties and theoretical approaches.

• The parenthetical descriptions of the principal categories of disorder is required by WP:USE PLAIN ENGLISH, or MOS "define technical terms".
• The reverted version correctly adds "diagnosis" and "prevention".
• The reverted version corrects an error - a mental disease need not be an "abnormality".
• The reverted version correctly moves historic information about etymology, which some might question as being important at all for the lede, to the end of the lede.
• The reverted version moves defining information from later parts of the lede to the first paragraph, so it can stand alone per MOS (lede) first paragraph.
• Historical curiosities, such as etymolgies, belong at the bottom, Uncommon, overly specific, and scientifically dubious practices such as "transcranial magnetic stimulation" do not belong in the lede, and may not belong in tha article at all.
• The second paragraph opening, stating the difference between clinical psychology and psychiatry should be upfront, since it is sourced that most people cannot say the difference. This needs to be improved further still, since having a medical degree barely scrathces the surface of what is truly the difference.
• The statement of controversies at the last sentence in the lede is straight out of the article body, and is grossly understated given the significance these controversies have. They are causing a 20 year old book to be the only thing going in current use, which separates psychiatry from all of the rest of medicine, which has kept pace with the exponentially growing advances in medical science.

ParkSehJik (talk) 04:55, 10 December 2012 (UTC)

You've succeeded in having many of these edits successfully incorporated into the current version of the lead.

I think your point about the placement of the etymology of the word psychiatry is valid - especially as it has little relevance to the meaning of the term psychiatry today. It should, in my view, be removed from the lead and placed in the historical section although I'm sure there's some argument for its inclusion in the lead to be cobbled together from the manual of style.

Difference between clinical psychology and psychiatry. Probably more relevant for the article Psychiatrist.FiachraByrne (talk) 11:40, 10 December 2012 (UTC)

Controversies statement in lede and content already in article body

From MOS (lede) - "The lead should be able to stand alone as a concise overview. It should define the topic, establish context, explain why the topic is notable, and summarize the most important points—including any prominent controversies"

Proposed addition to lede -

"Controversies exist involving some areas of psychiatry and the diagnostic manuals they use to classify mental disease, including regarding use of questionable scientific methodologies, lack of objectivity in calling a mental state a "disorder" solely because it is outside an arbitrarily set "norm", and political and financial interests distorting studies and practice."

This statement summarizes content already in substantial portions of the article body.

"Prominent" is estblished by these sources - Discover Magazine's "Top 100 Science Stories of 2012". The original story regarding widespread acknoledgement of the unscientific (or worse) basis of the field from the top people inside the field was published on 7-13-2012 - The "Bible of Psychiatry" Faces Damning Criticism—From the Inside. Note the words "Damning Criticism—From the Inside" as having nothing to do with "antipsychiatry", and "prominent" is established by it being a top 100 science story of the year. (If there is any further doubt as to "prominent" and thereby not UNDUE, there was also extensive coverage in the science section of just about every major newpaper in America, and there is a history of such criticism in the academic journals ever since Freud's work, which was clearly compelling, yet was done without using any scientific methodology whatsover.)

From that story -

"...the most recent attack comes from within the DSM-5’s ranks. Roel Verheul and John Livesley, a psychologist and psychiatrist who were members of the DSM-5 work group for for personality disorders, found that the group ignored their warnings about its methods and recommendations. In protest, they resigned, explaining why in an email to Psychology Today. Their disapproval stems from two primary problems with the proposed classification system: its confusing complexity, and its refusal to incorporate scientific evidence.

The story quotes the DSM V doctors who resigned in protest -

The proposal displays a truly stunning disregard for evidence'. Important aspects of the proposal lack any reasonable evidential support of reliability and validity. For example, there is little evidence to justify which disorders to retain and which to eliminate. Even more concerning is the fact that a major component of proposal is inconsistent with extensive evidence…This creates the untenable situation of the Work Group advancing a taxonomic model that it has acknowledged in a published article to be inconsistent with the evidence."

Further sourcing that this controversy meets MOS (lede) "prominent", and so is not UNDUE, is is the "scathing editorial by Dr. Frances published a few days ago in the Psychiatric Times" (language of the main autism organization, hardly an antipsychiatry group) - Opening Pandora’s Box, Allen Frances, Psychiatric Times.

Being a "Top 100 Science Story of 2012", criticism from "the inside" by resignations over "refusal to incorporate scientific evidence" and "lack any reasonable evidential support of reliability and validity", and criticism by the Chair of DSM IV establishes "prominent" as to the controversy, so the material is not UNDUE and belongs in the lede per WP:MOS (lede).

The wording I suggested is directly from the article body and "prominence" and not being UNDUE is established by reliable sources. Note: I refactored the talk page, and added sources establishing "prominence" after FiachraByrne's suggestion that a response to potential clams of UNDUE needs to be made, and responding to Ronz's request for sourcing in support of claims that UNDUE does not apply. Some of the material above was added after Fiachra Byrne's comment below, re potential claims of UNDUE needing response. ParkSehJik (talk) 15:53, 10 December 2012 (UTC)

The statement on controversies is going to engender the most resistance. I'll have to reread article prior to commenting on this. FiachraByrne (talk) 11:40, 10 December 2012 (UTC)

Park's suggested addition to the lead on psychiatric controversies:

Controversies exist involving some areas of psychiatry and the diagnostic manuals they use to classify mental disease, including regarding use of questionable scientific methodologies, lack of objectivity in calling a mental state a "disorder" solely because it is outside an arbitrarily set "norm", and political and financial interests distorting studies and practice.

Relevant sections of the article body which may provide support for this statement:

Psychiatry#Diagnostic manuals -

"The DSM has attracted praise for standardizing psychiatric diagnostic categories and criteria. It has also attracted controversy and criticism. Some critics argue that 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 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."

Psychiatry#General considerations -

"The close relationship between those prescribing psychiatric medication and pharmaceutical companies is a source of concern for some, particularly anti-psychiatry advocates. Also, such advocates are prone to questioning the influence which pharmaceutical companies are exerting on mental health policies."

Psychiatry#Political abuse of psychiatry -

"In some instances psychiatrists have been involved in the suppression of individual rights by states wherein the definitions of mental disease had been expanded to include political disobedience. Nowadays, in many countries, political prisoners are sometimes confined to mental institutions and abused therein. Psychiatry possesses a built-in capacity for abuse which is greater than in other areas of medicine. The diagnosis of mental disease can serve as proxy for the designation of social dissidents, allowing the state to hold persons against their will and to insist upon therapies that work in favour of ideological conformity and in the broader interests of society. In a monolithic state, psychiatry can be used to bypass standard legal procedures for establishing guilt or innocence and allow political incarceration without the ordinary odium attaching to such political trials. In Nazi Germany in the 1940s, the 'duty to care' was violated on an enormous scale: A reported 300,000 individuals were sterilized and 100,000 killed in Germany alone, as were many thousands further afield, mainly in eastern Europe. From the 1960s up to 1986, political abuse of psychiatry was reported to be systematic in the Soviet Union, and to surface on occasion in other Eastern European countries such as Romania, Hungary, Czechoslovakia, and Yugoslavia. A "mental health genocide" reminiscent of the Nazi aberrations has been located in the history of South African oppression during the apartheid era. A continued misappropriation of the discipline was subsequently attributed to the People's Republic of China."

Psychiatry#Medicalization of deviance -

"The concept of medicalization is created by sociologists and used for explaining how medical knowledge is applied to a series of behaviors, over which medicine exerts control, although those behaviors are not self-evidently medical or biological. According to Kittrie, a number of phenomena considered "deviant", such as alcoholism, drug addiction and mental illness, were originally considered as moral, then legal, and now medical problems. As a result of these perceptions, peculiar deviants were subjected to moral, then legal, and now medical modes of social control. Similarly, Conrad and Schneider concluded their review of the medicalization of deviance by supposing that three major paradigms may be identified that have reigned over deviance designations in different historical periods: deviance as sin; deviance as crime; and deviance as sickness. According to Franco Basaglia and his followers, whose approach pointed out the role of psychiatric institutions in the control and medicalization of deviant behaviors and social problems, psychiatry is used as the provider of scientific support for social control to the existing establishment, and the ensuing standards of deviance and normality brought about repressive views of discrete social groups. As scholars have long argued, governmental and medical institutions code menaces to authority as mental diseases during political disturbances."

"Controversies exist involving some areas of psychiatry": general statement that is supported in the main article text.

"and the diagnostic manuals they use to classify mental disease": the DSM has been particularly controversial and some of the criticism directed at this manual has been included in the main article text. In fact, your statement on controversies draws most heavily from the final paragraph of the DSM section.

"including regarding use of questionable scientific methodologies": as documented in the DSM section, some critics have called the DSM an "unscientific system".

"lack of objectivity in calling a mental state a 'disorder' solely because it is outside an arbitrarily set 'norm'": statement again supported in DSM section of article.

"and political and financial interests distorting studies and practice": corrupting effect of financial interests is detailed in DSM section. Also oblique reference to political influence there. Support for influence of political interests can also be derived from sections on medicalization and political abuse.

However, you may hit WP:UNDUE for inclusion in the lead for some of these items (probably statement about scientific methodology in particular). I would also probably rephrase the statement to some extent. FiachraByrne (talk) 13:04, 10 December 2012 (UTC)

I boldfaced the "scientific methodology" quotes in response to FiachraByrne's comment re scientific methodology, in the quotes from the sources, and I WP:RTP refactored the talk page. I added sources establishing "prominence" at the top. This was after FiachraByrne's suggestion above that a response to both potential claims of UNDUE and re "scientific methodology" is needed. This is also an effort to respond to Ronz's request (in another section above) for sourcing of claims of "prominent" controversy, as sources would be needed to counter WP:UNDUE claims. ParkSehJik (talk) 16:09, 10 December 2012 (UTC)

There are lots of sources on the validity - or not - of psychiatric diagnostic categories. In fact, there are many reasoned and objective analyses of their benefits and drawbacks that are also fair in their treatment of the limitations of psychiatric knowledge. Where aetiology is largely unknown there are non-trivial problems in constructing a taxonomy that is clinically useful, has diagnostic reliability and is scientifically valid. The DSM is imperfect and sometimes very much so. The Discover Magazine article relates, if I'm not mistaken, to the fall-out from the workgroup on personality disorders in DSM-5 where some participants appear to feel that their definition has been sidelined and that the favoured definitions do not meet rigorous scientific criteria. This is a news story and I don't think is appropriate for inclusion until we see how this episode pans out. The opinions of the disgruntled members of the workgroup are just that - opinions. I think it will be difficult to generalise from this workgroup to the whole classification system. You need decent research papers that explore the validity and reliability of diagnostic categories. FiachraByrne (talk) 16:55, 10 December 2012 (UTC)

I would avoid Discover in general because it is aimed at laymen. The opinions of one or two people is not relevant to the subject unless their views receive considerable support within psychiatry. To use an analogy, every documentary about a conspiracy theory has a retired military officer, often a general, who claims that UFOs are real, there are Communist bases in the US, etc. TFD (talk) 17:09, 10 December 2012 (UTC)

Discover Magazine is used only to establish "prominence", because of Ronz's request to provide a good secondary source RS as to its prominence. It is RS as to that, since the story having been in the science section of almost every major newspaper, with massive response from within the field, was the basis for Discover naming it to be a top 100 science story.

The Chair of DSM IV is not comperable to an outlier "conspiracy theorist general". Neither are two of the select group on mood disorders who resigned in protest because DSM V was about to publish results counter to evidence in peer reviewed scientific publications. Neither are the massive numbers of psychiatrists and academicians who are making similar comments in response, or on their own. This is in no way comperable to "a conspiracy theory has a retired military officer, often a general". ParkSehJik (talk) 17:44, 10 December 2012 (UTC)

Absent from both the lede and the body - What is the essential conceptual difference between psychiatry and clinical psychlogy or other related professions?

This article entirely lacks information of the basic distinction of MD training or not, as a dividing line between psychiatry and clinical psychology, and fails to distinguish psychiatry from related fields.

I proposed this as being clarifying - Unlike a psychologist, a psychiatrist first gets a medical degree then goes on to do specialized training. Other mental health practitioners who believe their patient might benefit from medication may send their patient to psychiatrists for an evaluation and possibly a prescription.

But while I think my proposal improves the lede, it does not improve it enough as to this issue. The "MD" distinction, while true, glosses over the true essential difference between psychiatry and clinical psychology, and other related fields. The superficial "MD" distinction, at a minimum, belongs in the lede and in the article body as a section, but the more essential answer should be both in the body and in the lead. Does anyone have a proposal, with or without sources? ParkSehJik (talk) 18:40, 10 December 2012 (UTC)

I removed a previous entry from the talk page because it was a duplicate. In some countries outside the US, it is legal to practice Psychiatry without a Medical Degree. Medical Degrees (MD's) are required in the US because of the unique history of Psychiatry in America. At the time of Sigmund Freud there were no laws to prevent lay people from declaring themselves doctors wherever they chose to do it, the US included.

This article may be edited from outside the US, which may account for that constant removal from the lede. The MD distinct needs to be made local to the countries which require it by law. Angrybeavers (talk) 01:55, 21 July 2014 (UTC)

"Medical Psychologists" can also gain prescriptive authority (ability to prescribe treatments) in three US states. In response to "medical psychology" legislation in Louisiana, the American Psychiatric Association sent a statement in protest (dated may, 2014) to the Human Services Committee to explain the conceptual difference between psychiatry and psychology.EDIT: whoops, fixed wrong reference --Flyingducks (talk) 00:42, 17 October 2014 (UTC)

Addition of CRPD Human Rights treaty to this article

Disability advocates have stated the treaty's language bans involuntary psychiatric treatment and commitment. The full text of the treaty is available here On the UN's Website. Please discuss the treaty here and do not duplicate.

Listing of Reliable sources:

- The UN and the OHCHR have released comments to clarify. The United nations has issued this comment in April 2014 on the CRPD treaty to further clarify it's intent. (the following is truncated to save space)

       Articles 14 and 25: Liberty, security and consent
       40.
       Respecting the right to legal capacity of persons with disabilities on an equal basis
       with others includes respecting the right of persons with disabilities to liberty and security
       of the person. The denial of the legal capacity of persons with disabilities and their
       detention in institutions against their will, either without their consent or with the consent of
       a substitute decision-maker, is an ongoing problem. This practice constitutes arbitrary
       deprivation of liberty and violates articles 12 and 14 of the Convention. States parties must
       refrain from such practices and establish a mechanism to review cases whereby persons
       with disabilities have been placed in a residential setting without their specific consent.
       
       41.
       The right to enjoyment of the highest attainable standard of health (art. 25) includes
       the right to health care on the basis of free and informed consent. States parties have an
       obligation to require all health and medical professionals (including psychiatric
       professionals) to obtain the free and informed consent of persons with disabilities prior to
       any treatment

and

       Articles 15, 16 and 17: Respect for personal integrity and freedom from
       torture, violence, exploitation and abuse
       42.
       As has been stated by the Committee in several concluding observations, forced
       treatment by psychiatric and other health and medical professionals is a violation of the right 
       to equal recognition before the law and an infringement of the rights to personal integrity (art. 17); 
       freedom from torture (art. 15); and freedom from violence, exploitationand abuse (art. 16). 
       

- The Office of the United Nations High Commissioner for Human Rights (OHCHR) has also commented less recently with slightly less clarity. I believe I located the document here. The below passages are retrieved from this document. The two big questions appear to be addressed here, but if it's not specific enough please search the OHCHR website for abetter reference.

       2. Powerlessness and the doctrine of “medical necessity
       ~"For example, the mandate has held that the discriminatory character of forced psychiatric
       interventions, when committed against persons with psychosocial disabilities, satisfies both
       intent and purpose required under the article 1 of the Convention against Torture,
       notwithstanding claims of “good intentions” by medical professionals (ibid., paras. 47, 48).
       In other examples, the administration of non-consensual medication or involuntary"
       
    C. Interpretative and guiding principles
     ~"One of the core principles of the Convention on the Rights of Persons with Disabilities is “respect for inherent
       dignity, individual autonomy including the freedom to make one‟s own choices, and independence of persons” (art. 3
       (a)). The Committee on the Rights of Persons with Disabilities has interpreted the core requirement of article 12 to
       be the replacement of substituted decision-making regimes by supported decision-making, which respects the person‟s
       autonomy, will and preferences.1"

And:

       "30.
       The intimate link between forced medical interventions based on discrimination and the deprivation of legal capacity
       has been emphasized both by the Committee on the Rights of Persons with Disabilities and the previous 
       Special Rapporteur on the question of torture.13"

(The UN defines "supported decision-making" as "the presumption is always in favour of the person with a disability who will be affected by the decision.")

- The NCD The National Council on Disability (An independent US government agency) seems to confirm the treaty does prohibit involuntary commitment and treatment.

      Article 14 – Liberty and security of the person:
       "Therefore, while as currently interpreted and enforced, there appears to be a gap between U.S. law and the CRPD,
       there is no reason why with more vigorous interpretation and/or action by Congress, the two could not be on an 
       equal level."

and

       Article 15 – Freedom from Torture or Cruel, Inhuman, or Degrading Treatment or Punishment
       "Starting in the 1980's, there was a line of deinstitutionalization cases that culminated in the landmark Supreme
        Court case of Youngberg v. Romeo,[29] which affirmed the Fourteenth Amendment Due Process clause rights of
        individuals with intellectual disabilities to reasonably safe conditions of confinement, freedom from unreasonable
        bodily restraints, and such minimally adequate habilitation training as reasonably might be required by those
        interests.[30]  The Civil Rights of Institutionalized Persons Act[31] also empowers the Attorney General of
        the United States to investigate confinement conditions at state run institutions, including prisons, nursing homes,
        and institutions for people with psychiatric or developmental disabilities. In the event the Attorney General
        believes those conditions are "egregious or flagrant," subject individuals to "grievous harm," and are part of a
        "pattern or practice" of undermining individuals' full enjoyment of their rights, the Attorney General may initiate
        a civil law suit.[32]
        
        United States law seems therefore to be harmonious with the prohibitions set forth in the CRPD. Ultimately, however,
        the efficacy of these protections depends upon rigorous implementation.  "

and

        Article 17 – Protecting the Integrity of the Person
        Current United States law, both statutory and constitutional, formally prevents forced medical treatment or
        restraint against a patient's will, except in limited circumstances. At the same time, protection of these rights
        heavily depends upon their enforcement, including the perceptions of judges and other adjudicators regarding the
        equality of person with disabilities. With proper enforcement, U.S. law should be on the level with what the CRPD
        envisions. 

Angrybeavers (talk) 22:17, 21 July 2014 (UTC)

- The American Psychiatric Association, and the WPA, have replied to a report prepared for the United Nations Human Rights Council (UNHRC) in April, 2014. The comment was published in the Newspaper of the American Psychiatric Association, psychiatryonline.org. The article was entitled "UN Report Says Common Psychiatric Practices Amount to ‘Torture’".

        APA and WPA disagree with a report prepared for the United Nations that equates involuntary 
        psychiatric treatment with torture.

The APA's news article also makes a mention of a "346 page book published by the American University" (Washington College of Law). The book is located here on the University's (Center for Human Rights & Humanitarian Law) website.

A quote from the UN's Special Rapporteur’s Feb. UN report (in AU's booklet linked above):

        "Both this mandate and the United Nations treaty bodies have established that involuntary 
        treatment and other psychiatric interventions in healthcare facilities are forms of torture 
        and ill treatment. Forced interventions, often wrongfully justified by theories of incapacity 
        and therapeutic necessity  inconsistent with the Convention on the Rights of Persons with 
        Disabilities, are legitimized under  national laws, and may enjoy wide public support as being 
        in the alleged “best interest” of the person concerned. Nevertheless, to the extent that they 
        inflict severe pain and suffering, they violate the  absolute prohibition of torture and cruel, 
        inhuman and degrading treatment…Only in a life threatening emergency in which there is no 
        disagreement regarding absence of legal capacity may a healthcare  provider proceed without 
        informed consent to perform a life saving procedure."

Another quote from the February UN General Assembly:

        "States should impose an absolute ban on all forced and non-consensual medical interventions 
        against persons with disabilities, including the non-consensual administration of psychosurgery, 
        electroshock, and mind-altering drugs, for both long and short term application. The obligation 
        to end forced psychiatric interventions based on grounds of disability is of immediate application."

It should be noted the UN rapporteur stated in a reply letter to the APA that he was "not aware of any states that had yet enacted such a ban", and that he regretted some 'inartful wording' and 'had not meant to call for an absolute ban on all interventions' (just irreversible interventions and druggings?). Afterward, a clarifying letter was written by the Special Rapporteur on his report. As soon as I've read it, I'll review it here. I believe that's the most recent material available to date Flyingducks (talk) 06:21, 24 August 2014 (UTC)

There are mutiple UN treaty bodies it seems, CAT (Convention Against Torture) and CRPD. This section should be named "United Nations prohibition". The rough Draft is below.

TEMPLATE For United Nations prohibition:

United Nations prohibition

On the 26th of June 1987, the UN Convention Against Torture was entered into force. In May 2008, the UN entered into force the first Human Rights Treaty of the 21st century, the CRPD. These conventions intended to address, among many other issues, the prohibition of Involuntary Psychiatric Commitment and Involuntary Psychiatric Treatment on the basis of a disability.

UN Special Rapporteur on torture Juan Mendez of the UNHRC delivered a report to the United Nations General Assembly on Feb 1st 2013 which equated Involuntary Psychiatric services to torture, prohibited under the Convention Against Torture and CRPD treaty bodies.

"Both this mandate (CRPD) and the United Nations treaty bodies have established that involuntary treatment and other psychiatric interventions in healthcare facilities are forms of torture and ill treatment."

"States should impose an absolute ban on all forced and non-consensual medical interventions against persons with disabilities, including the non-consensual administration of psychosurgery, electroshock, and mind-altering drugs, for both long and short term application" - Special Rapporteur on torture Juan Mendez

The World Psychiatric Association and American Psychiatric Association have responded to the UN report, and the UN Special Rapporteur has replied. No UN member State has yet proposed a resolution to the Council on the basis of the report itself, which remains a vessel for discussion.

TEMPLATE For United Nations prohibition.

This article isn't about the treaty; therefore it would be inappropriate to insert large blockquotes from it. We should summarize what reliable sources say about how the treaty applies to psychiatric treatment. It appears that ratifying states largely interpret the treaty differently than the UN does — our article on Involuntary commitment discusses current legal processes for psychiatric commitments in a number of signatory states. More reliable sources would help us explain the situation... if the treaty does ban it, those provisions are apparently ignored. NorthBySouthBaranof (talk) 21:31, 21 July 2014 (UTC)

Agreed blockquotes are ugly and inappropriate, and agreed some states appear to have violated the spirit of the treaty though reservations and declarations. I have fixed the UN's "issued this comment in April 2014" link at the top, it was broken.

The treaty Template has been changed to reflect the current reliable sources: UN-OHCHR, and NCD.gov. Angrybeavers (talk) 02:46, 23 July 2014 (UTC)

Added a statement released by the American Psychiatric Association and WPA concerning a report about the CRPD. Angrybeavers (talk) 05:21, 7 August 2014 (UTC)

added some blocksquotes from the feb 2013 UN General Assembly, mentioned the clarifying letter Flyingducks (talk) 06:21, 24 August 2014 (UTC)

Updated the entry template and included the UN's clarifying letter. That's all I have to contribute, I think, if anyone has anything more to add please do so, otherwise this entry is ready to be added to the main article's controversy section. Flyingducks (talk) 14:51, 10 October 2014 (UTC)