Editorial comments mind (7) that leads many of our colleagues to consider that our field of knowledge is more related to philosophy and social sciences than medicine. It is our impression that this scenario is changing rapidly. Psychiatry is a leading field in many countries, and its prestige is closely related to the scientific achievements in the area. The translational neurosciences as the basis for 21st century psychiatry may help to address many of the challenges raised by our colleagues in their work (6). We cannot call ourselves specialists in neuroscience and, at the same time, call to ourselves the duty of explaining complex human behavior in strictly theoretical terms—as philosophers might. We do not have to convince our colleagues that psychiatry is ‘good’ and that they must think highly of us. What we can do is to focus on our work within medicine and refrain from using psychiatry as a means to provide large explanatory models for human behavior. If we concentrate in our target to help people who suffer from mental disorders using available scientific evidence, our diagnostic and therapeutic achievements shall determine how our colleagues and the community think about us and our work.
F. Kapczinski1,2 and I. C. Passos1,2 Psychiatry, Federal University, UFRGS, Porto Alegre, Brazil and 2 University of Texas at Houston, Houston, TX, USA E-mail: [email protected]
1
References 1. Gore FM, Bloem PJN, Patton GC et al. Global burden of disease in young people aged 10–24 years: a systematic analysis. Lancet 2011;377:2093–2102. 2. Berk M, Kapczinski F, Andreazza AC et al. Pathways underlying neuroprogression in bipolar disorder: focus on inflammation, oxidative stress and neurotrophic factors. Neurosci Biobehav Rev 2011;35:804–817. 3. Osby U, Brandt L, Correia N, Ekbom A, Sparen P. Excess mortality in bipolar and unipolar disorder in Sweden. Arch Gen Psychiatry 2001;58:844–850. 4. Popper K. Three worlds, the tanner lecture on human values, Delivered at The University of Michigan, 1978. 5. Clark A. Supersizing the mind: embodiment, action, and cognitive extension. Oxford UK: Oxford University Press; 2008. 6. Stuart H, Sartorius N, Liinamaa T. Images of psychiatry and psychiatrists. Acta Psychiatr Scand 2015;131:21–28. 7. Shapiro L. The mind incarnate. Cambridge, MA: MIT press, 2005.
Future perspectives on psychiatry DOI: 10.1111/acps.12360 In this issue of Acta Psychiatrica Scandinavica, Stuart et al. (1) investigate and report a bad reputation of psychiatry. The paper reports a high rate of stigma and negative attitudes toward psychiatrists, psychiatric patients, and psychiatry as a medical specialty. However, these discouraging findings are based on statements and attitudes from the medical faculty and not the future generation, that is, the medical students. The students’ perceptions of the specialty matter as recruitment has long been impeded by the negative reputation (2). We believe the former misgivings of psychiatry are changing among the youngest in the medical field: the medical students. The number of initiatives within the field of psychiatry is increasing. While some of these initiatives are instigated by trained psychiatrists and local authorities, some of them are organized by medical students for medical students; for example, in Denmark, the Psychiatric Association of Medi8
cal Students sees growing numbers of members and attendants to their activities. The latest debate session about psychopharmacology hosted by the association attracted more than 600 attendants. Another Danish initiative, The Locomotive, is a group of medical students who teach the oldest children in primary school not to stigmatize persons with mental illnesses. The authors of this comment are all members of The Psychiatric Research Academy (3, 4), which mainly consists of medical students doing psychiatric research as extracurricular activities. Since its birth in June 2012, the academy has gained many members, now counting 18 dedicated students, a doctor, and a professor. Despite what could be feared, the many different initiatives have a synergistic effect; that is, the above-mentioned initiatives do not steal members from each other, instead, more medical students seem to find an interesting niche in the wide array of psychiatric research and practice. Similar innovative ideas emerge internationally, for example, a summer school combining teaching
Editorial comments and clinical work in Finland (5) and a countrywide program with enrichment activities in the UK initiated by The Royal College of Psychiatrists (6) just to mention a few. Through engagement in psychiatric extracurricular activities as well as international congresses such as American Psychiatric Association Annual Meeting 2014, European Congress of Psychiatry 2013 and 2014, the members of The Psychiatric Research Academy have met psychiatrists both ‘early’ and ‘late careers’ who have inspired, tutored, and contributed positively to our image of psychiatry. People have showed an interest in The Psychiatric Research Academy and in us as future colleagues with new perspectives. Most recently, at the 2014 meeting of the Section of Epidemiology and Social Psychiatry of the European Psychiatric Association, two of us presented a symposium on integrating medical students in psychiatric research. Attendants took a great interest in the future generation and cooperation across experience levels. The above-mentioned introduce medical students to psychiatry in several ways: invite medical students to participate in research as in The Psychiatric Research Academy (3, 4), arrange talks and debate sessions with psychiatrists sharing experiences with students as in the Psychiatric Association of Medical Students, or arrange clinical summer schools with tutors as in Finland (5). Introducing medical students to dedicated psychiatrists might contribute to changing the perception of psychiatrists as the bad role models reported by Stuart et al. (1). Indeed, role modeling is important as encouragement from experienced psychiatrists and clinical experience with patients along with extracurricular activities are some of the factors associated with medical students choosing psychiatry as their specialty (6). Besides bad role modeling, psychiatry as a specialty has a reputation of being unscientific (1). Historically, psychiatry has been a descriptive specialty based on subjective evaluations. However, new approaches to psychiatric research such as Research Domain Criteria (RDoC) (7) may attract medical students and young graduates to psychiatry. At least, RDoC could be considered a shift of paradigms.
Furthermore, the increasing focus on the link between physical and mental health (8) might help alter the perception that psychiatry does not draw on all aspects from medical school. The days when a stethoscope was not necessary in psychiatry are long gone, and it is our belief that the medical students are aware of that. Psychiatry is an upcoming specialty, which interests and attracts medical students. This generation carries a huge potential for psychiatry. It is up to the psychiatrists currently in charge to involve, engage, and share their knowledge and experience with the students who will then, hopefully, enlist to become future colleagues. C. B. Kristiansen1, J. N. Kjær1, C. R. Medici1, L. M. Kai1,2 and N. Okkels1,3 1 Department of Organic Psychiatric Disorders and Emergency Ward (Dept. M), Aarhus University Hospital, Risskov, 2Translational Neuropsychiatry Unit, Aarhus University Hospital, Risskov and 3 Psychiatric Hospital Augustenborg, Hospital of Southern Jutland, Denmark E-mail: [email protected]
References 1. Stuart HSN, Liinamaa T. Images of psychiatry and psychiatrists. Acta Psychiatr Scand 2015;131:21–28. 2. Bauer J, Okkels N, Munk-Jørgnsen P. State of psychiatry in Denmark. Int Rev Psychiatry 2012;24:295–300. 3. www.psychiatricresearchacademy.com (accessed 30 September 2014). 4. Okkels N, Ahlers FS, Harboe LF et al. Klinisk Psykiatrisk Forskerskole (Clinical psychiatric research school). Ugeskrift for Læger (Dan Med Bull) 2013;19:1364–1365. 5. Karukivi M, Saxen U, Haapasalo-Pesu KM. Improving recrutiment into psychiatry: a summer school for medical students combining clinical work and education. Acad Psychiatry 2014;38:647–651. 6. Farooq K, Lydall GJ, Bhugra D. What attracts medical students towards psychiatry? A review of factors before and during medical school. Int Rev Psychiatry 2013;25:371–377. 7. Ostergaard SD, Fave M, Rothschild AJ, Deligiannidis KM. The implications of the National Institute of Mental Health Research Domain Criteria for researchers and clinicians. Acta Psychiatr Scand 2014;130:409–414. 8. THE LANCET. The integration of mental and physical health care. Lancet 2014;384:1072.
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F. Kapczinski1,2 and I. C. Passos1,2 Psychiatry, Federal University, UFRGS, Porto Alegre, Brazil and 2 University of Texas at Houston, Houston, TX, USA E-mail: [email protected]
1
References 1. Gore FM, Bloem PJN, Patton GC et al. Global burden of disease in young people aged 10–24 years: a systematic analysis. Lancet 2011;377:2093–2102. 2. Berk M, Kapczinski F, Andreazza AC et al. Pathways underlying neuroprogression in bipolar disorder: focus on inflammation, oxidative stress and neurotrophic factors. Neurosci Biobehav Rev 2011;35:804–817. 3. Osby U, Brandt L, Correia N, Ekbom A, Sparen P. Excess mortality in bipolar and unipolar disorder in Sweden. Arch Gen Psychiatry 2001;58:844–850. 4. Popper K. Three worlds, the tanner lecture on human values, Delivered at The University of Michigan, 1978. 5. Clark A. Supersizing the mind: embodiment, action, and cognitive extension. Oxford UK: Oxford University Press; 2008. 6. Stuart H, Sartorius N, Liinamaa T. Images of psychiatry and psychiatrists. Acta Psychiatr Scand 2015;131:21–28. 7. Shapiro L. The mind incarnate. Cambridge, MA: MIT press, 2005.
Future perspectives on psychiatry DOI: 10.1111/acps.12360 In this issue of Acta Psychiatrica Scandinavica, Stuart et al. (1) investigate and report a bad reputation of psychiatry. The paper reports a high rate of stigma and negative attitudes toward psychiatrists, psychiatric patients, and psychiatry as a medical specialty. However, these discouraging findings are based on statements and attitudes from the medical faculty and not the future generation, that is, the medical students. The students’ perceptions of the specialty matter as recruitment has long been impeded by the negative reputation (2). We believe the former misgivings of psychiatry are changing among the youngest in the medical field: the medical students. The number of initiatives within the field of psychiatry is increasing. While some of these initiatives are instigated by trained psychiatrists and local authorities, some of them are organized by medical students for medical students; for example, in Denmark, the Psychiatric Association of Medi8
cal Students sees growing numbers of members and attendants to their activities. The latest debate session about psychopharmacology hosted by the association attracted more than 600 attendants. Another Danish initiative, The Locomotive, is a group of medical students who teach the oldest children in primary school not to stigmatize persons with mental illnesses. The authors of this comment are all members of The Psychiatric Research Academy (3, 4), which mainly consists of medical students doing psychiatric research as extracurricular activities. Since its birth in June 2012, the academy has gained many members, now counting 18 dedicated students, a doctor, and a professor. Despite what could be feared, the many different initiatives have a synergistic effect; that is, the above-mentioned initiatives do not steal members from each other, instead, more medical students seem to find an interesting niche in the wide array of psychiatric research and practice. Similar innovative ideas emerge internationally, for example, a summer school combining teaching
Editorial comments and clinical work in Finland (5) and a countrywide program with enrichment activities in the UK initiated by The Royal College of Psychiatrists (6) just to mention a few. Through engagement in psychiatric extracurricular activities as well as international congresses such as American Psychiatric Association Annual Meeting 2014, European Congress of Psychiatry 2013 and 2014, the members of The Psychiatric Research Academy have met psychiatrists both ‘early’ and ‘late careers’ who have inspired, tutored, and contributed positively to our image of psychiatry. People have showed an interest in The Psychiatric Research Academy and in us as future colleagues with new perspectives. Most recently, at the 2014 meeting of the Section of Epidemiology and Social Psychiatry of the European Psychiatric Association, two of us presented a symposium on integrating medical students in psychiatric research. Attendants took a great interest in the future generation and cooperation across experience levels. The above-mentioned introduce medical students to psychiatry in several ways: invite medical students to participate in research as in The Psychiatric Research Academy (3, 4), arrange talks and debate sessions with psychiatrists sharing experiences with students as in the Psychiatric Association of Medical Students, or arrange clinical summer schools with tutors as in Finland (5). Introducing medical students to dedicated psychiatrists might contribute to changing the perception of psychiatrists as the bad role models reported by Stuart et al. (1). Indeed, role modeling is important as encouragement from experienced psychiatrists and clinical experience with patients along with extracurricular activities are some of the factors associated with medical students choosing psychiatry as their specialty (6). Besides bad role modeling, psychiatry as a specialty has a reputation of being unscientific (1). Historically, psychiatry has been a descriptive specialty based on subjective evaluations. However, new approaches to psychiatric research such as Research Domain Criteria (RDoC) (7) may attract medical students and young graduates to psychiatry. At least, RDoC could be considered a shift of paradigms.
Furthermore, the increasing focus on the link between physical and mental health (8) might help alter the perception that psychiatry does not draw on all aspects from medical school. The days when a stethoscope was not necessary in psychiatry are long gone, and it is our belief that the medical students are aware of that. Psychiatry is an upcoming specialty, which interests and attracts medical students. This generation carries a huge potential for psychiatry. It is up to the psychiatrists currently in charge to involve, engage, and share their knowledge and experience with the students who will then, hopefully, enlist to become future colleagues. C. B. Kristiansen1, J. N. Kjær1, C. R. Medici1, L. M. Kai1,2 and N. Okkels1,3 1 Department of Organic Psychiatric Disorders and Emergency Ward (Dept. M), Aarhus University Hospital, Risskov, 2Translational Neuropsychiatry Unit, Aarhus University Hospital, Risskov and 3 Psychiatric Hospital Augustenborg, Hospital of Southern Jutland, Denmark E-mail: [email protected]
References 1. Stuart HSN, Liinamaa T. Images of psychiatry and psychiatrists. Acta Psychiatr Scand 2015;131:21–28. 2. Bauer J, Okkels N, Munk-Jørgnsen P. State of psychiatry in Denmark. Int Rev Psychiatry 2012;24:295–300. 3. www.psychiatricresearchacademy.com (accessed 30 September 2014). 4. Okkels N, Ahlers FS, Harboe LF et al. Klinisk Psykiatrisk Forskerskole (Clinical psychiatric research school). Ugeskrift for Læger (Dan Med Bull) 2013;19:1364–1365. 5. Karukivi M, Saxen U, Haapasalo-Pesu KM. Improving recrutiment into psychiatry: a summer school for medical students combining clinical work and education. Acad Psychiatry 2014;38:647–651. 6. Farooq K, Lydall GJ, Bhugra D. What attracts medical students towards psychiatry? A review of factors before and during medical school. Int Rev Psychiatry 2013;25:371–377. 7. Ostergaard SD, Fave M, Rothschild AJ, Deligiannidis KM. The implications of the National Institute of Mental Health Research Domain Criteria for researchers and clinicians. Acta Psychiatr Scand 2014;130:409–414. 8. THE LANCET. The integration of mental and physical health care. Lancet 2014;384:1072.
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