The June 2016 issue of History of Psychiatry is now online. Articles in this issue explore psychiatric semiology, the German Research Institute of Psychiatry in Munich, madness in novelist Muriel Spark’s work, LSD as treatment in Denmark, the DSM and learning disabilities, Joseph Mason’s madhouse, and the work of Max Scheler. Full titles, authors, and abstracts follow below.
“The emergence of psychiatric semiology during the Age of Revolution: evolving concepts of ‘normal’ and ‘pathological’,” by Diego Enrique Londoño and Professor Tom Dening. The abstract reads,
This article addresses some important questions in psychiatric semiology. The concept of a sign is crucial in psychiatry. How do signs emerge, and what gives them validity and legitimacy? What are the boundaries of ‘normal’ and ‘pathological’ behaviour and mental experiences? To address these issues, we analyse the characteristics and rules that govern semiological signs and clinical elements. We examine ‘normality’ from the perspective of Georges Canguilehm and compare the differences of ‘normal’ in physiology and psychiatry. We then examine the history and the philosophical, linguistic and medical-psychiatric origins of semiology during the eighteenth and nineteenth centuries (the Age of Revolution). The field of rhetoric and oratory has emphasized the importance of passions, emotions and language as applied to signs of madness. Another perspective on semiology, provided by Michel Foucault, lays stress on the concept of ‘instinct’ and the axis of voluntary-involuntary behaviour. Finally, we analyse how statistics and eugenics have played an important role in our current conceptualization of the norm and therefore the scientific discourse behind the established clinical signs.
The December 2015 issue of History of Psychiatry is now online. Articles in this issue explore multiaxial assessment in the DSM-III, electroconvulsive therapy, and veridical hallucinations in France, among other topics. Full titles, authors, and abstracts follow below.
“Félix Voisin and the genesis of abnormals,” by Claude-Olivier Doron. The abstract reads,
This article traces the genealogy of the category of ‘abnormals’ in psychiatry. It focuses on the French alienist Felix Voisin (1794–1872) who played a decisive role in the creation of alienist knowledge and institutions for problem children, criminals, idiots and lunatics. After a presentation of the category of ‘abnormals’ as understood at the end of the nineteenth century, I identify in the works of Voisin a key moment in the concept’s evolution. I show how, based on concepts borrowed from phrenology and applied first to idiocy, Voisin allows alienism to establish links between the medico-legal (including penitentiary) and medical-educational fields (including difficult childhood). I stress the extent to which this enterprise is related to Voisin’s humanism, which claimed to remodel pedagogy and the right to punish on the anthropological particularities of individuals, in order to improve them.
The September 2013 issue of History of Psychiatry is now online. Included in this issue are articles on the Weberian influence on Karl Jaspers’ (left) work, psychiatric analyses of Bavarian royalty, Swedish child psychiatry, and more. Full titles, authors, and abstracts follow below.
“The theoretical root of Karl Jaspers’ General Psychopathology. Part 2: The influence of Max Weber,” by Tsutomu Kumazaki. The abstract reads,
The present study explores and compares Jaspers’ methodology of psychopathology with Weber’s methodology of sociology. In his works, Weber incorporated the arguments of many other researchers into his own methodology. Jaspers respected Weber as a mentor and presented arguments that were very similar to Weber’s. Both Weber and Jaspers began from empathic understanding, but at the same time aimed for a rational and ideal-typical conceptualization. In addition, their methodologies were similar with respect to their detailed terminology. Such similarities cannot be seen with any other scholars. This suggests that Weber may have played an integral role as a mediator between his contemporary scholars and Jaspers. Thus, Weber may have had the most significant influence on Jaspers.
“The Bavarian royal drama of 1886 and the misuse of psychiatry: New results,” by Heinz Häfner and Felix Sommer. The abstract reads,
The March 2013 issue of the History of Psychiatry is now online. Included in this issue are a number of articles ranging from morbidity and mortality caused from melancholia, to a revisiting of the mental hygiene movement, and even to William James’ psychical research. Full titles, authors, and abstracts follow below.
“The morbidity and mortality linked to melancholia: two cohorts compared, 1875–1924 and 1995–2005,” by Margaret Harris, Fiona Farquhar, David Healy, Joanna C Le Noury, Stefanie C Linden, J Andrew Hughes, and Anthony P Roberts. The abstract reads:
For over a century, melancholia has been linked to increased rates of morbidity and mortality. Data from two epidemiologically complete cohorts of patients presenting to mental health services in North Wales (1874–1924 and 1995–2005) have been used to look at links between diagnoses of melancholia in the first period and severe hospitalized depressive disorders today and other illnesses, and to calculate mortality rates. This is a study of the hospitalized illness rather than the natural illness, and the relationship between illness and hospitalization remains poorly understood. These data confirm that melancholia is associated with a substantial increase in the standardized mortality rate both formerly and today, stemming from a higher rate of deaths from tuberculosis in the historical sample and from suicide in the contemporary sample. The data do not link melancholia to cancer or cardiac disease. The comparison between outcomes for melancholia historically and severe mood disorder today argue favourably for the effectiveness of asylum care.
National Public Radio (NPR) in the US has posted an episode of its program “On the Media” centered on the debate over the contents of the forthcoming 5th edition of the Diagnostic and Statistical Manual (DSM-V) of the American Psychiatric Association. The episode is entitled “The Art of Diagnosis.” The issues discussed focus mainly on the social acceptance or stigmatization of people complaining of particular clusters of symptom and not, perhaps surprisingly, on access to insurance payments or pharmaceutical company windfalls.
Among the politically-charged syndromes under review are “Gender Identity Disorder,” an extreme form of PMS called “Premenstrual Dysphoric Disorder” (for which a specific pharmaceutical, Sarafem, has already been marketed), and “Social Anxiety Disorder” (better known as shyness). Questions about this sort of “diagnostic bracket creep” are discussed on the program. Continue reading DSM-V Debate on NPR→
In a recent issue of Social History of Medicine, 21(2), Brendan D. Kelly reports the findings of his examination of the case records for all women admitted to Dublin’s Central Criminal Lunatic Asylum between 1910 and 1948.
The majority of women were Roman Catholic (85.4 per cent) and had a mean age of 36.4 years. The majority were convicted of a crime (85.7 per cent), of whom 75.0 per cent were convicted of killing, most commonly child-killing. The majority of women detained ‘at the Lord Lieutenant’s Pleasure’ (indefinitely) were convicted of murder (51.7 per cent), assault (20.7 per cent) or infanticide (13.8 per cent); mean duration of detention was 5.6 years. The most common diagnoses were ‘mania’ or ‘delusional insanity’ (38.1 per cent) and ‘melancholia’ (23.8 per cent); 7.1 per cent were considered ‘sane’. Following their detention, 28.1 per cent of women were transferred to district asylums and the remainder were released under various different circumstances. In common with similar studies from other countries, these data demonstrate that the fate of these women was largely determined by a combination of societal, legal and medical circumstances, as evidenced by the socio-economic profile of women admitted and changes in admission patterns following the introduction of the Mental Treatment Act 1945. The role of other factors (such as religion) in determining their fate merits further study.
Back on November 17 we wrote a short item on the current battle over how much transparency there would be in the process by which the forthcoming 5th edition of the Diagnostic & Statistical Manual of the American Psychiatric Association (DSM-V) is assembled. What is at stake is the level of influence that pharmaceutical companies will have on the people who decide which the psychiatric conditions (and their pharmacological treatments) will be insurable. In short, billions and billions of dollars are at stake. Today the New York Times published an article on the same topic. Continue reading More on the DSM-V Process→
Mind Hacks has a good piece on the current negotiations over how much transparency there will be to the development of the forthcoming (May, 2012) 5th edition of the Diagnostic and Statistical Manual (DSM-V) of the American Psychiatric Association. At stake is whether anyone apart from the DSM writing committee itself will know how much pressure is being brought to bear on the authors by pharmaceutical companies, which have a vested interest in diagnosable conditions being included in the Manual for which they claim to have specific treatments (i.e., billions of dollars are at stake). One of the major criticisms of the last edition of the DSM was that several of the authors had deep entanglements with major pharmaceutical companies, leading to questions about possible conflicts of interest.
In this keynote address, Professor Thomas Szasz appeals to the history of psychiatry in making his argument against the labeling of children as having, for example, ADD/ADHD. (In the speech, he calls this “stigmatization not diagnosis.”) But does the history to which he refers simply show progress in the medicalization of moral treatment? Or is it, as he claims, evidence of something more sinister?
This video has been edited, but not by us. (The full text of this speech, or one very much like it, can be found here.)
Professor Szasz is famous for, among other things, his anti-psychiatry bias. That, however, is not what’s on display for our purposes here.
AHP has covered similar issues in the past, most notably here (on changing the DSM), here (on how psychiatry is financed), and here (on the removal of homosexuality from the DSM). A bibliography of readings related to Professor Szasz’ comments, for interested students, is appended below the fold. Continue reading Thomas Szasz on diagnostic malpractice→