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.
Continue reading New Issue: History of Psychiatry
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.
To help build on Kelly’s findings, a selection of readings on “religion and madness” are provided below the fold. Continue reading Female Forensic Committal in Ireland, 1910–1948
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.
Here is the official DSM-V website.