[Integration or polarization of psychiatry]

Integration vs. polarization is an issue which presents in various aspects of psychiatry. Its position within medicine is still insecure, partly because of a one-sided preoccupation at times with psychodynamic or social factors. The same divisive tendencies are evident within psychiatry itself. Biological science can make an essential contribution to psychiatry, as recent research on depression demonstrates. But only by combining pharmacotherapy with psychosocial interventions can optimal treatment results be achieved. Within psychotherapy there is an ever stronger trend towards integration of schools and methods. Research in outcome could not demonstrate any clear superiority of one single method over the other approximately 200 methods now known. Consequences for research and practice are discussed. The relationship of psychiatry with society is rather tense, being largely based on prejudice. This should be understood less as a global criticism than as an attempt of individuals and society at large to cope with the potential threat of mental illness. Psychiatry must take its responsibility towards society seriously, especially with regard to economic and ethical issues, and afford priority in care to those in the urgent need.