How to Study Psychiatry

Psychiatry is the branch of medicine concerned with the diagnosis, treatment, and prevention of mental disorders. These include, but are not limited to mood, psychotic, and personality disorders, often with large variability in presentation and severity. Try the following study strategies and tips to help you learn how to study psychiatry.

Study Tip #1 - Don't get distracted by the drugs.

Science students are trained to focus on a single drug or a step-wise mechanism for a treatment; however, psychiatric disorders often demand more varied therapeutic methods. Usually, a multiple-pronged approach is necessary to combat psychiatric symptoms and a "cure" often means that the patient is able to only manage his/her symptoms, not eradicate them. So instead of focusing on the drug treatment, spend more time on the non-drug methods; such as, cognitive behavioral versus analytic psychotherapy, inpatient versus outpatient, group vs. individual vs. family counseling, etc. Know the drug, but know that it is usually only small piece of the entire therapy program.

Study Tip #2 - Look for drug side effects.

Usually multiple drugs are capable of treating the same disorder and symptoms; however, some have unique adverse effects that warrant additional precautions. Knowing which drugs out of the bunch are eliminated via renal or hepatic metabolism, reversible vs. irreversible damage, and likely drug interactions that increase or decrease the level of the drug in circulation are common exam questions.

Study Tip #3 - Prioritize the treatment steps.

Students often cite that their psychiatric course questions resemble subjective, no-right, no-wrong "what would you do in this situation" questions. This frustration usually stems from the fact that some clinical vignettes ask that you prioritize different treatment methods as you approach a resolution. The best way to handle these concepts is to know what symptoms constitute forceful treatment (i.e. tranquilizers, hospital admittance, etc.) and hospital admittance, when and if second line drugs are added to the regime, and what steps should be omitted because of individual patient contraindications (i.e. renal failure, prone to seizures, etc.).

Study Tip #4 - Watch out for a GMC.

Any general medical condition, meaning a physical or organic pathological process will void a psychiatric disorder diagnoses. Usually every DSM (Diagnostics and Statistics Manual) entry will include a clause that the patients symptoms must not be attributed to any pre-existing medical condition. For that reason, most mental illnesses are diagnoses of exclusion. However, keep in mind that a patient may have a completely unrelated medical condition and still qualify for a mental disorder diagnosis, as long as the mental illnesses symptoms can not be caused by the GMC.

Study Tip #5 - Put it all together on the Multi-Axial System.

The DSM is very clear on which scenarios belong in a certain category, or axis.

Be aware that a patient may have more than one disorder on multiple axes simultaneously. Also, be sure to differentiate between a learning or developmental disorder (Axis I) versus mental retardation caused by a birth defect, or teratogen (Axis II).

Study Tip #4 - Keep an eye on the timing, "distress or impairment" clause, and any hints at violence.

Most DSM entries state that a condition must be ongoing or that symptoms must appear together within a general time period; and some go on further to include age of onset. These subtleties are effective in distinguishing between some subtypes of mental disorders. The "distress or impairment" clause is a minor, but necessary statement. The person is only labeled as having a disorder if the condition causes a certain degree of difficulty or stress in their normal everyday lives. Without any resulting disturbance in their lives, it may be best to avoid the stigma of a mental illness label. Any hints or thoughts a patient may give about suicide, homicide, or assault should be taken seriously and followed with appropriate action. In this case, the clinician must legally act on suspicion and may be held responsible by authorities.