Griesinger's psychiatric approach

The standpoint from which Griesinger considered mental illness and the closely connected relationship between body and mind is described. The conclusion is drawn that Griesinger, realising that body and mind form an entity with the brain as an organ and psychological processes as its function, regarded mental illness as an organopathological process. This played a great role in raising psychiatry to the status of the purely somatic fields of medicine.     

The status of legally committed psychiatric patients in the psychiatric hospital

101 mental patients hospitalized according to a court decision stayed on average for 9.7 years. General behaviour, social independence and chances for discharge were not related to illness but to the duration of accommodation. The chances for discharge decrease as the stay in hospital increases. The initial medical reasons for hospitalization are the less important factor in the period of in-patient treatment. The foundations for successful medical and social rehabilitation can only be laid in the early stage of accommodation.     

Surgery for psychiatric disorders

The modern therapeutic approach to most psychiatric diseases involves a combination of well-supervised psychotherapy, pharmacotherapy, and electroconvulsive therapy. Patients who fail to adequately respond to these modern treatment methods and remain severely disabled may be considered for surgical intervention. Cingulotomy, capsulotomy, subcaudate tractotomy, and limbic leucotomy are the most common psychosurgical procedures performed today, with response rates in the 35% to 65% range. Modern stereotactic techniques have reduced complication rates, but controversy remains regarding the optimal surgical procedure. The major psychiatric diagnostic categories that might respond to surgery include treatment-refractory major affective disorders, obsessive-compulsive disorder, and chronic anxiety states. Surgery should be considered as one part of an entire treatment plan and must be followed by an appropriate psychiatric rehabilitation program. It should only be carried out by an expert multidisciplinary team consisting of a neurologist a neurosurgeon, and a psychiatrist with experience in these disorders. Surgical intervention remains a reasonable therapeutic option for select patients with a disabling psychiatric disease and may be underutilized.     

No more psychiatric labels: Why formal psychiatric diagnostic systems should be abolished

This article argues that psychiatric diagnoses are not valid or useful. The use of psychiatric diagnosis increases stigma, does not aid treatment decisions, is associated with worsening long-term prognosis for mental health problems, and imposes Western beliefs about mental distress on other cultures. This article reviews the evidence base focusing in particular on empirical findings in relation to the topics of: aetiology, validity, reliability, treatment and outcome, prognosis, colonialism, and cultural and public policy impact. This evidence points toward diagnostic based frameworks for understanding and intervening in mental health difficulties being unable to either improve our scientific knowledge or improve outcomes in clinical practice and suggests that we need to move away from reliance on diagnostic based approaches for organising research and service delivery. Alternative evidence-based models for organising effective mental health care are available. Therefore formal psychiatric diagnostic systems such as the mental health section of the International Classification of Diseases Tenth Edition (ICD-10) and Diagnostic Statistical Manual Fifth Edition (DSM 5) should be abolished.     

Spiritual discernment in psychiatric patients

The author uses resources from the Christian tradition of discernment of spirits to provide clinicians with guidelines for distinguishing the authentic and pathological aspects of religion in psychiatric patients.