What's the "bread and butter" of psychiatry?

[jack.jaret]

I've always heard from attendings that to truly be happy with a specialty, you have to be okay with the bread and butter (in other words, a trauma surgeons "bread and butter" is a lap chole, not a GSW). I am heavily leaning towards psych but haven't come across its "bread and butter." What do you guys see just constantly and constantly?

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[Ψ-117]

My experience (in child psychiatry) is ADHD, ODD, anxiety, and depression. In adult psych I would say anxiety and depression are also up there.

 

[MacDonaldTriad]

For adults, anxiety disorders > mood disorders >> psychotic disorders and all of them can have substance use disorders and personality disorders.

 

[benlinus]

It all depends on where you are located. No doubt you will get patients that cover the DSM-V from front to back but location and type of practice setting will determine what's more prevalent aka bread and butter. For instance, suburban cash only majority white population anxiety, depression, personality; urban city located public hospital substance use disorders, psychosis, ptsd; student health clinic ADHD, depression, anxiety; inpatient adult unit schizophrenia, bipolar, depression; inpatient geriatric unit dementia of all types, depression; these are just a few examples from my experience, not to speak for everyone

 

[nexus73]

Impatient/consults: Depression, anxiety, bipolar, schizophrenia, addiction, dementia, delirium, PERSONALITY DISORDERS. Also poverty and lack of social services.

 

[Shikima]

Consult: Eval and treat.

 

[COXblocker]

Outpatient: anxiety, depression
Inpatient: borderline, no frontal lobe/drugs
Partial: borderline!
Consult: delirium
Child: add, odd, depression

Those make up roughly 80% of each

 

[HarryMTieboutMD]

Also- the novelty of seeing psychosis and treating it in the inpatient setting wears off eventually (but sometimes you get to use clozapine and ECT or adjuncts rediagnose someone as bipolar and fix them with lithium!). And seeing stable schizophrenics in the outpatient setting can be incredibly boring because most of the time you just continue the meds and try and behaviorally activate them. If they have access to resources and good psychosocial functioning you do a little more...

 

[DD214_DOC]

Child: ADHD, ASD, various mostly behavioral problems related to poor parenting skills, normal child but with anxious parents who have unrealistic expectations
Adolescents: ADHD, conduct disorder, anxiety, depression, family conflict, parent-child problems, normal teen but with anxious parents who have unrealistic expectations

A good chunk of my day consists of me basically telling parents to CTFD and just spend time with their kid

 

[nitemagi]

Psych is quite heterogeneous. The B&B depends more on your setting (academic hospital inpatient, consult, private practice community, addiction center).

 

[hoodwinkd]

I've somehow ended up going a lot of Geri....prob because my program spends a good amount of time at the VA

 

[thoffen]

Psych is quite heterogeneous. The B&B depends more on your setting (academic hospital inpatient, consult, private practice community, addiction center).

Agreed. And I think that's a big advantage. Someone with general psych residency can radically change their practice setting and patient cohort easily.