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The Problem of the Psychopharmacologist

Received July 4, 2005; revised October 6, 2005; accepted October 10, 2005. Dr. Kontos is Associate Director of Consultation-Liaison Psychiatry, Cambridge Health Alliance, Cambridge, Massachusetts, and Instructor in Psychiatry, Harvard Medical School, Boston, Massachusetts. Dr. Querques is Assistant in Psychiatry, Massachusetts General Hospital, and Instructor in Psychiatry, Harvard Medical School, Boston, Massachusetts. Dr. Freudenreich is Director, Massachusetts General Hospital First Break and Early Psychosis Program, and Assistant Professor of Psychiatry, Harvard Medical School, Boston, Massachusetts. Address correspondence to Dr. Kontos, Cambridge Hospital, 1493 Cambridge Street, Macht Building, Cambridge, MA 02139; nkontos{at}challiance.org (E-mail). Copyright © 2006 Academic Psychiatry.

OBJECTIVE: The psychopharmacologist designation currently pervades and heavily influences the practice, perception, and teaching of clinical psychiatry. The authors hope to make a case and provide the raw material for informed discussion of this role during psychiatric residency training. METHOD: A definition for the psychopharmacologist is sought. Historical trends in psychiatry which contributed most to its evolution are explored. Problems of the psychopharmacologist role are delineated. Extant solutions to psychiatry’s problematic adaptation to an increasingly biological clinical role are critiqued, and a more effective one is pursued. RESULTS: The term psychopharmacologist seems linked to presumed scientific and medical approaches, a goal of symptom relief through medication, and often other providers who are considered patients’ "primary" treaters. The role derives largely from economic and remedicalization trends. Aspects of disengagement are determined to form the core problem of the psychopharmacologist. The authors propose that psychiatry is defined by its practice of the medical model and call attention to three areas where the psychopharmacologist role and the medical model collide. CONCLUSIONS: Engaging psychiatric residents in a new dialogue about their role as physician will challenge the previously unquestioned psychopharmacologist categorization, begin to address its problems, and bring a vital element to trainees’ professional identity development.

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				N. KONTOS, O. FREUDENREICH, and J. QUERQUES Using a Medical Model With Psychotic Patients Am J Psychiatry, September 1, 2006; 163(9): 1646 - 1647. [Full Text] [PDF]

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