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CMAG

Notes

26

  • Biomedical is concerned with causes, specific criteria for diagnosis, and a predictable course of development.

  • The paradigm of disease (biomedical) needs to be integrated with the paradigm of the person (psychosocial).

  • Traditionally biomedical and psychotherapeutic skills have been compartmentalized, but each is inadequate alone and needs the other.

Many advances have been made in assisting people with behavioral, cognitive, emotional, and substance-related disturbances. Less than 75 years ago, patients with mental illness were incarcerated to protect society form their troubling behaviors. Hope of effective treatment was a pipe dream for those impaired by obsessions, compulsions, hallucinations, misuse of alcohol, or recurrent thoughts of suicide—all barriers to happiness and productivity.

As scientists learn more about depression, they are developing a more comprehensive approach to treatment. Below are some thoughts about how new thinking is changing treatment strategies.55

  • Evidence is mounting that the disconnect between treating the mind and body results in poor clinical outcomes and excessive health care costs.

  • Advances in the field of mental health allow a better understanding of not just the anatomy of the brain, but of the relationship of brain function to behavior.

  • Regardless of whether a patient is being treated for physical illness, mental illness and/or substance use disorders or both, what is most important is the relationship between the patient and the healthcare provider.

  • This relationship is key and is predictive of improvement and the quality of treatment.

  • All of medicine, including psychiatry, is involved in assessing patients for readiness to change and use motivational interviewing to help patients adhere to beneficial treatments while encouraging them to help themselves through an episode of illness.

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