Journal: History of psychiatry
The term nostalgia was first proposed in 1688 by Johannes Hofer as equivalent to the German term Heimweh. It referred to a state of moral pain associated with the forced separation from family and social environment. Consecutive clinical descriptions from the seventeenth century up to the present day have been subjected to the aetiopathogenic and clinical paradigms of each period. Golden-age descriptions of nostalgia that are of particular interest were derived from the observation of conscript soldiers in Napoleonic campaigns by authors such as Gerbois and Larrey. In 1909 Jaspers devoted his doctoral thesis to this topic (Nostalgia und Verbrechen). From a cultural history point of view, it could be considered today as an example of ‘transient illness’. The nosological relay has taken place through clinical pictures such as the pathology associated with exile, forced displacements and psychosis of captivity.
In the 1960s Franco Basaglia, the Director of a Psychiatric Hospital in a small city on the edge of Italy (Gorizia), began to transform that institution from the inside. He introduced patient meetings and set up a kind of Therapeutic Community. In 1968 he asked two photographers - Carla Cerati and Gianni Berengo Gardin - to take photos inside Gorizia and other asylums. These images were then used in a photobook called Morire di Classe (To Die Because of your Class) (1969). This article re-examines in detail the content of this celebrated book and its history, and its impact on the struggle to reform and abolish large-scale psychiatric institutions. It also places the book in its social and political context and as a key text of the anti-psychiatry movement of the 1960s.
We compared admission rates and outcomes for bipolar disorder patients using the medical records of patients with a first hospital admission in 1875-1924 retrospectively diagnosed based on International Classification of Diseases (ICD)-10 criteria, and patients with a first admission in 1994-2007. The incidences of first admissions in the historical and contemporary periods are comparable: 1.2 and 1.3 per hundred thousand per year, respectively. Manic episodes constituted a greater proportion of admissions historically, while depressive episodes made up more in the contemporary sample. There is no evidence for a reduction in the mean inter-admission intervals with duration of illness. This study suggests that modern treatments may have decreased lengths of stay in hospital, but at a cost of contributing to more admissions. It also points to a shift in the threshold for admissions.
This paper traces the significance of the diagnosis of ‘moral insanity’ (and the related diagnoses of ‘monomania’ and ‘ manie sans délire’) to the development of psychiatry as a profession in the nineteenth century. The pioneers of psychiatric thought were motivated to explore such diagnoses because they promised public recognition in the high status surroundings of the criminal court. Some success was achieved in presenting a form of expertise that centred on the ability of the experts to detect quite subtle, ‘psychological’ forms of dangerous madness within the minds of offenders in France and more extensively in England. Significant backlash in the press against these new ideas pushed the profession away from such psychological exploration and back towards its medical roots that located criminal insanity simply within the organic constitution of its sufferers.
This paper provides an overview and critical reassessment of the cases of clinical lycanthropy reported in the medical literature from 1850 onwards. Out of 56 original case descriptions of metamorphosis into an animal, only 13 fulfilled the criteria of clinical lycanthropy proper. The remaining cases constituted variants of the overarching class of clinical zoanthropy. Forty-seven cases involved primary delusions, and nine secondary delusions on the basis of somatic and/or visual hallucinations which may well have affected the patients' sense of physical existence, also known as coenaesthesis. Cases of secondary delusions in particular warrant proper somatic and auxiliary investigations to rule out any underlying organic pathology, notably in somatosensory areas and those representing the body scheme.
The sphygmograph, an instrument to measure and visually chart the pulse, was used by a number of asylum researchers in the late nineteenth century in an attempt to better understand mental disease. In charting the use of such a medical technology in the asylum, this article explores the utility of a practice-oriented approach in the history of psychiatry - as a window onto the alienist profession and as a means of investigating how new medical technologies were assimilated into everyday practice.
This paper uses the unique collection of Scottish outsider art, labelled Art Extraordinary, as a window into the often neglected small spaces of asylum care in the early twentieth century. By drawing upon materials from the Art Extraordinary collection and its associated archives, this paper demonstrates the importance of incorporating small and everyday spaces of care - such as gardens, paths, studios and boats - into the broader historical narratives of psychiatric care in Scotland. Examples of experiential memorialization and counterpoints to asylum surveillance culture will be illuminated. The significance of using ‘outsider’ art collections as a valuable source in tracing geographical histories will be highlighted.
Writing the recent history of a subject is notoriously difficult because of the lack of perspective and impartiality. One way to gain insight and understanding into the recent past of a discipline of knowledge is to consult directly the living practitioners who actually experienced first-hand the major changing circumstances in the discipline during the period under study. This article seeks to explore the most significant changes occurring in Western, and especially American, psychiatry from the end of World War II up to the present by interrogating a representative selection of psychiatrists and psychologists about the subject. Over a three-year period, the author surveyed approximately 200 mental health experts on their perceptions of change in the world of psychiatric theory and practice during this enormously eventful 70-year period. After presenting the survey results, the article then attempts to analyse the answers that the author did (and did not) obtain from his poll-taking subjects.
During decolonization, Henri Collomb was appointed to the first Chair of Psychiatry at the University of Dakar. Using a neuropsychiatric approach, he quickly made significant advances in the field, despite the colonial era’s poor legacy of assistance facilities for mentally ill people. Through alliances with professors and researchers from the university Departments of Psychology and Sociology, an original interdisciplinary dialogue was set up to build up a research team which would develop rich and varied activities in the fields of transcultural psychiatry, medical anthropology and psychoanalytic anthropology. The methodological and theoretical contributions of such an approach are well illustrated in the book Œdipe africain by M-C and E Ortigues and in the journal founded in 1965, Psychopathologie africaine.
Mental illness in a hospital in a medium-sized town in Sweden was studied. Consecutive case records from 1896 to 1905, and also from 2011, were selected. In the historical sample, neurasthenia was the most common diagnosis, followed by affective disorders and alcohol abuse. ICD-10 diagnoses corresponded well with the historical diagnoses. Melancholia resembled modern criteria for depression. Mania, insania simplex and paranoia indicated more severe illness. Abuse was more common among men and hysteria among women. Those with a medical certificate for mental hospital care were very ill and showed no gender difference. There were no diagnoses for abuse, but 17% had a high level of alcohol consumption. The pattern of signs and symptoms displayed by patients does not appear to change with time.