Abstract

Psychiatry has always relegated itself to being the Cinderella speciality of medicine. Nowadays it appears that general adult psychiatry is competing for the Cinderella subspeciality of the speciality. The profession may or may not be in crisis but it probably is depressed. Would we accept, unchallenged, such low self-regard and hopelessness from patients? Not if we are trying to be in the least bit therapeutic.

Highlights

  • Psychiatry has always relegated itself to being the Cinderella speciality of medicine

  • Nowadays it appears that general adult psychiatry is competing for the Cinderella subspeciality of the speciality

  • If adult psychiatry is the ‘Cinderella’ speciality, have we become paralysed into waiting to be rescued by a fairy godmother?

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Summary

Adult psychiatry is a psychiatric subspeciality

I often perceive that adult psychiatrists resent being expected to deal with psychiatric emergencies. The nature of adult psychiatric epidemiology means that, de facto, we have to develop expertise in emergency and intensive care psychiatry. Knowing when to refer patients to other subspecialities is a skill we have developed. Like our colleagues specialising in general practice, we look after the vast majority of patients coming through our doors without referring on. One would not refer to a forensic psychiatrist or an alcohol specialist for help with agoraphobia. Too, have to develop special understanding of the life-stage changes related to adulthood. This provides exciting opportunities to develop expertise in perinatal and reproductive psychiatry, adult relationships and the occupational aspects of mental health. Adult psychiatrists deal with these issues every day but seldom stop to realise they might have become rather good at it!

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