Other psychiatrists and mental health professionals in the field of psychiatry may also specialize in psychopharmacology, neuropsychiatry, eating disorders, and early psychosis intervention.

Treatment Overview
In general, psychiatric treatments have changed over the past several decades (see History section, below). In the past, psychiatric patients were often hospitalized for six months or more, with some cases involving hospitalization for many years. Today, most psychiatric patients are managed as outpatients. If hospitalization is required, the average hospital stay is around two to three weeks, with only a small number of cases involving long-term hospitalization.

Individuals with mental health conditions are commonly referred to as patients but may also be called clients. They may come under the care of a psychiatric physician or other psychiatric practitioners by various paths, the two most common being self-referral or referral by a primary-care physician. Alternatively, a patient may be referred by hospital medical staff, by court order, involuntary commitment, or, in the UK and Australia, by sectioning under a mental health law.

Initial Assessment
Whatever the circumstance of their patient's referral, a psychiatrist first assesses their patient's mental and physical condition. This usually involves interviewing the patient and often obtaining information collated from other sources such as other health and social care professionals, relatives, associates, law enforcement and emergency medical personnel and psychiatric rating scales. Physical examination is usually performed to establish or exclude other illnesses, such as thyroid dysfunction or brain tumors, or identify any signs of self-harm; this examination may be done by someone else other than the psychiatrist, especially if blood tests and medical imaging are performed.

Like all medications, psychiatric medications can have toxic effects in patients and hence often involve ongoing therapeutic drug monitoring, for instance full blood counts or, for patients taking lithium salts, serum levels of lithium. Electroconvulsive therapy (ECT) is sometimes administered for serious and disabling conditions, especially those unresponsive to medication.

Outpatient Care Psychiatric patients may be either inpatients or outpatients. Psychiatric outpatients periodically visit their clinician for consultation in his or her office, usually for an appointment lasting thirty to sixty minutes. These consultations normally involve the psychiatric practitioner interviewing the patient to update their assessment of the patient's condition, and to provide psychotherapy or review medication. The frequency with which a psychiatric practitioner sees patients varies widely, from days to months, depending on the type, severity and stability of each patient's condition, and depending on what the clinician and client decide would be best.

Inpatient Care Psychiatric inpatients are patients admitted to a hospital or clinic to receive psychiatric care, sometimes involuntarily, in which case they could be involuntarily committed to a standard, otherwise non-psychiatric prison. In North America, the criteria for involuntary admission vary with jurisdiction. It may be as broad as having a mental health condition and being capable of mental or physical deterioration or as narrow as a patient being considered to be an immediate danger to themselves or others. In the UK, involuntary admission is limited to this narrow criterion. Inpatient psychiatric wards may be secure (for those thought to have a particular risk of violence or self-harm) or unlocked/open. Some wards are mixed-sex whilst same-sex wards are increasingly favored as safer.

Once in the care of a hospital, patients are assessed, monitored, and often given medication and receive care from a multidisciplinary team, which may include physicians, psychiatric nurses, clinical psychologists, occupational therapists, psychotherapists, psychiatric social workers, and other mental health professionals. If patients are assessed as at particular risk of harming themselves or others, they may be put on constant or intermittent one-to-one supervision, and may be physically restrained or medicated. Inpatients may be allowed leave periods, either accompanied or on their own.

Theory and Focus
Mainstream psychiatry is considered a branch of medicine that is, or should aim to be, evidence-based in theory and practice. Psychiatric diagnosis is based on the concept of a distinct boundary between the mentally healthy and the mentally ill, and between different kinds of mental health conditions that can be medically differentiated, understood and treated. This is commonly done through standardized categories dubbed 'neo-Kraepelian' (Klerman, 1978), based on patterns of so-called 'Feighner criteria' (lists of symptoms with rules on the combinations required for different diagnoses).

Psychiatry is often described as being based within, or dominated by, a biomedical paradigm, although there are different theoretical approaches:

• Biopsychiatry (or Neuropsychiatry) - focused on genetics, neurochemistry and medication.
• Social psychiatry or Community Psychiatry - focused on the interpersonal or public health context, including psychiatric rehabilitation.
• Cross-cultural psychiatry - focused on the relevance of culture, including ethnicity and globalization.
• Psychoanalytic psychiatry (or Dynamic Psychiatry) - concerned with applying concepts and methods from psychoanalysis.

It is currently in its fourth revised edition (IV-TR, published 2000) and is also used world-wide, perhaps more so than the ICD-10. The ICD-10 and the DSM are considered roughly on a par with one another, and an explicit concern in the development of the DSM-IV was compatibility with the diagnostic categories and codes of the ICD. The lack of a case example version of the ICD-10 is considered a problem by some[citation needed]. The Chinese Society of Psychiatry has also produced a diagnostic manual, the Chinese Classification of Mental Disorders (CCMD).

The stated intention of diagnostic manuals is typically to develop replicable and clinically useful categories and criteria, to facilitate consensus and agreed standards, whilst being atheoretical as regards etiology. However, the categories are nevertheless based on particular psychiatric theories and data, they are are broad and often specified by numerous possible combinations of symptoms, and many of the categories overlap in symptomology or typically occur together. While originally intended only as a guide for experienced clinicians trained in its use, the nomenclature is now widely used by clinicians, administrators and insurance companies in many countries.

The DSM has five axes:

• Axis I: Psychiatric disorders.
• Axis II: Personality disorders/mental retardation.
• Axis III: General medical conditions.
• Axis IV: Social functioning and impact of symptoms.
• Axis V: Global Assessment of Functioning (described using a scale from 1 to 100).