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Learn about Psychiatry Subspecialties

Updated: Mar 5

Author: Ioannes Salamanes

Editor: Anand Somasundaram

Artist: Denise Suarez

Psychiatry is a medical specialty focused on the treatment of mental illnesses. Psychiatrists hold medical degrees and are one of the few mental health practitioners capable of administering medications to treat mental health problems. These doctors also order medical tests and conduct physical assessments, in addition to practicing psychotherapy. Psychiatrists work alongside a team of occupational therapists, clinical counselors, psychologists, primary care doctors, and social workers. Psychiatrists are professionals and have good knowledge of biochemistry, genetics, general medicine, neurology, pharmacology, and psychology. Doctors who wish to specialize in psychiatry undergo a 4-year psychiatry residency after graduation from medical school, but many choose to study a particular psychiatry subspecialty beyond those 4 years.

One psychiatry subspecialty, child and adolescent psychiatry, involves the intersection of pediatrics and psychiatry. Child and adolescent psychiatrists deal with young people who suffer from mental health issues and are under the age of 18. These psychiatrists recognize and support young people with their psychiatric and emotional issues. Childhood mental health issues not only affect the growth of a child but also affect the family. Conditions diagnosed earlier in life have a better likelihood of effective recovery, and the treatment of these mental health issues could alter the entire course of a child’s life. Child and adolescent psychologists work with the child along with their parents or guardians, which requires child and adolescent psychiatrists to be able to understand issues from multiple viewpoints. Much of the practice of child and adolescent psychiatrists will take place in clinics and outpatient settings, but there are some cases involving serious mental health issues that require inpatient settings.

Old age psychiatry, on the other hand, involves the treatment of older people who suffer from a number of mental health issues such as dementia, depression, and schizophrenia and is often referred to as geriatric psychiatry. Old age therapists have only dealt with patients over the age of 65 in the past, but now they function in a "needs-led" manner rather than a rigid age cap. A significant part of old age psychiatry is memory disorders and dementia treatment. Delirium and personality disorders are other common mental health conditions that old age psychiatrists deal with. Old age psychiatrists need to have special expertise to adequately handle these issues because of the disparities in mental health concerns in older people relative to the younger population. In old age, social and mental health issues are closely associated, so old age psychiatrists work in conjunction with GPs, occupational therapists, social workers, and charitable organizations. Old age psychiatrists need to have an understanding of the philosophical and legal issues surrounding ability, end-of-life decisions, civil rights of persons, informed consent, and regulations on mental health, in addition to a strong working knowledge of general medicine. Old age psychiatrists operate in in-patient units and residential nursing facilities in acute general hospitals as well as in mental health. A growing major health problem that old age psychiatrists are battling is mental illness among older people.

Another prevalent subspecialty of psychiatry is addiction psychiatry. Addiction psychiatry focuses on the treatment and diagnosis of drug dependence and any associated mental health problems. Psychiatrists treat individuals of many ages who have alcohol, illicit substance, or prescription drug addictions that are exacerbated by co-existing mental health conditions such as bipolar syndrome, depression, or schizophrenia. Addiction psychiatrists do various things, such as assessing the capacity of a patient to conduct daily tasks, communicating with other members of the medical team of a patient, diagnosing mental disorders and illnesses, evaluating the history of a patient, administering drugs, and ordering and interpreting diagnostic and imaging studies. Most patients are referred to addiction psychiatrists by either an addiction specialist, a general physician, a primary care doctor, or a psychiatrist; however, some patients admitted to addiction treatment centers may also be seen by addiction psychiatrists. Addiction psychiatrists not only treat their patients but also fight for them and are critical in destigmatizing drug use and mental health conditions.

Child and adolescent psychiatry, old age psychiatry, and addiction psychiatry are just three of the various subspecialties of psychiatry. Each subspecialty requires training beyond residency and all of them assist various individuals with mental disorders in various ways. Those jobs enable psychiatrists to work with a particular community or in a specific setting. Psychiatry is a very important area of medicine and all psychiatrists know how important it really is to give patients the assistance they need.



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