Enigmas in Psychiatry

Abstract

1 Department of General Psychiatry, Institute of Mental Health, Singapore 2 Duke-NUS Graduate Medical School, Singapore 3 Department of Psychiatry, Singapore General Hospital, Singapore Address for Correspondence: Dr Ng Beng Yeong, Department of Psychiatry, Singapore General Hospital, Outram Road, Singapore 169608. Email: ng.beng.yeong@sgh.com.sg Many practitioners of medicine find psychiatry “woolly” and difficult to grasp or understand. This article focuses on “Enigmas in Psychiatry” and hopes to clarify some of the mysteries surrounding psychiatry and shed some light on the difficult concepts that the novice practitioners may have to come to grips with. In medicine, we are taught and trained to diagnose and treat diseases as far as possible according to known aetiology. However in mental disorders, in cases when aetiology is less certain, we talk of predisposing, precipitating and perpetuating factors. Hence the holistic view of the human person is that he possesses physical, psychological, social and spiritual attributes that are inter-related, interactive and integrated in function. In other words, the individual and his environment, his body and his mind and the different aspects of his mental functions are integral in health and in illness. Disturbance in any one aspect would affect the well being of the rest, causing stress and distress to the individual as a whole. Psychiatric conditions evolve in the presence of biological vulnerability, psychological adversity and social stressors.