Chapter 1 Thinking about psychiatry
Abstracts and keywords to be supplied.
- First thoughts 2
- What is disease? 4
- The role of the psychiatrist 6
- Diagnosis in psychiatry 8
- Why don’t psychiatrists look at the brain? 10
- Can psychotherapy change the brain? 12
- Treating patients against their will 14
- Perceptions of psychiatry 16
- Stigma 18
- Anti-psychiatry 20
- A brief history of psychiatry 22
- The future 26
1 Linden DEJ (2003) Cerebral mechanisms of learning revealed by functional neuroimaging in humans. In R Kühn et al. (eds) Adaptivity and learning–an interdisciplinary debate, pp. 49–57. Heidelberg, Springer.
2 Linden DEJ (2006) How psychotherapy changes the brain–the contribution of functional imaging. Molecular Psychiatry, 11, 528–38.[CrossRef][Web of Science][Medline]
1 In 1933 Manfred Sakel introduced insulin coma therapy for the treatment of schizophrenia. This involved the induction of a hypoglycaemic coma using insulin, the rationale being that a period of decreased neuronal activity would allow for nerve cell regeneration. In the absence of alternative treatments, this was enthusiastically adopted by practitioners worldwide. However, with the advent of antipsychotics in the 1950s and the emergence of randomized controlled trials (RCTs), it became clear that the treatment had no effect above placebo and it was subsequently abandoned.
