History of Psychiatry最新文献

This study revisits Eugène Minkowski's concept of schizophrenic melancholia, emphasizing its relevance to contemporary psychiatry. Through a phenomenological lens, Minkowski highlighted how depressive symptoms in schizophrenia are not merely secondary but intrinsic to the disorder, deeply intertwined with disruptions in time, space, and self-experience. By examining clinical cases, theoretical analyses, and existing literature, this research explores Minkowski's idea of the "loss of vital contact with reality" as a framework for understanding the existential dimensions of schizophrenia. His insights bridge psychopathology and philosophy, offering valuable perspectives for integrating subjective patient experiences into modern psychiatric approaches. Minkowski's legacy underscores the need for holistic, patient-centered care that addresses both clinical symptoms and the underlying existential disruptions.

In the 1970s, activist attorneys took on what they saw as a major issue in American society - the authority of psychiatrists to lock up hundreds of thousands of people against their will in state psychiatric hospitals in violation of their civil liberties. After a series of legal challenges to psychiatric power, states constructed mental health codes to limit involuntary psychiatric hospital admissions to a much smaller population of individuals at imminent risk to harm themselves or others. Decades later, issues of psychiatric authority with regard to social dilemmas arose again, but this time with the expectation that psychiatric expertise could help solve the contemporary problem of gun violence. This paper examines the history of the intersection between psychiatry and social problems, especially dangerousness, and the fears and expectations that have accompanied impressions of psychiatric expertise and authority.

This article explores the role of Brazilian art therapy in the 20th century in facilitating linguistic encounters through non-linguistic media for psychotic patients, influenced by the vanguardist movements of the time and framed by Jaspers' theory of language. Osório Cesar's interpretations of patients' artwork, Nise da Silveira's focus on artistic expression, and Lula Wanderley's use of Relational Objects exemplify the potential of non-linguistic media to bridge the communication gap in therapy. These approaches highlight the importance of symbolic content and bodily experiences in conveying meaning. Art therapy, shaped by its relationship with vanguardist movements, harnesses non-linguistic media to create linguistic encounters, allowing psychotic patients to communicate their distress and reshape their reality. This holistic approach enhances mental and emotional well-being by integrating artistic and bodily experiences into therapeutic practices, fostering meaningful transformation.

Since the 2000s, the prevalence of autism spectrum disorder (ASD) has increased, and the diagnosis of ASD has become heterogeneous. Recently, some researchers have begun to regard ASD as a form of neurodiversity rather than a medical disorder. In this article, we re-examine the establishment process of early infantile autism, as reported by Leo Kanner, and place the current debate in a historical context. An essential issue for Kanner was differentiating early infantile autism from childhood schizophrenia, but what made this difficult was the changing concept of schizophrenia over time. We consider how this affected Kanner's arguments and how it relates to the current autism debate.

Alterations of language are a classical hallmark of schizophrenia that many psychologists studied as an expression of psychotic thought disorder. Studies addressing the linguistic specificities of schizophrenic language are less frequent, and those focusing on the semantic sphere are very rare. This paper examines Sergio Piro's studies on schizophrenic language. His theory of semantic dissociation offers a solution to old disputes (e.g. excessive concretism vs abstractness of schizophrenic language). Piro suggests a fluctuating semantic halo that can be enlarged and/or restricted, depending on the linguistic situation. The process of semantic dissociation includes four possible disorders, representing a gradual disorganization of speech: the fluctuation of the semantic halo, the semantic distortion, the semantic dispersion, and the semantic dissolution. Finally, by approaching the topic through semantic analysis, he restored anthropological meaning to linguistic features previously conceived as mere symptoms of a degenerative process.

This article examines the historical narratives of one of the key psychologists who helped to develop and carry out the Enhanced Interrogation programme. The Enhanced Interrogation programme ran from the early to the mid-2000s. It used aggression to facilitate the acquisition of information from suspected terrorists. The programme was unique in its use of mental health professionals to design, implement and monitor its activities. The psychologist's historical accounts were thematically analysed. The article argues that death anxiety and death guilt may drive some health professionals to support Enhanced Interrogation type activities. It also argues that health professionals may be unable to control deviance and violations in situations where Enhanced Interrogation activities are occurring.

Jon Stock's The Sleep Room focuses on mid-century psychiatrist William Sargant, his 'deep sleep therapy', and other physical treatments such as ECT and insulin coma therapy. It exemplifies 'narrative determinism'-the tendency of familiar storytelling tropes to shape historical interpretation. Stock's emotionally charged, selectively sourced account contrasts with the complex clinical realities and ethical standards of the time. Such one-sided narratives distort public understanding, undermine trust in mental health services, and oversimplify psychiatric practice. A more balanced account, attentive to context and therapeutic intent, is needed to understand figures like Sargant and the evolution of psychiatric care. 'Narrative determinism', in keeping with the ideas of Hayden White, offers a way of characterising some forces shaping unhelpful historical accounts.

As a deeply hybrid discipline, psychiatry demands research that tackles the concepts constituting it and its objects. This is an essential prerequisite to empirical studies, the validity of which are directly dependent on a clear understanding of the underlying concepts. Empathy and sympathy are concepts used variably and inconsistently in clinical practice and research, with ensuing uncertainties around their role and meaning. Using a historical epistemology approach, this paper compares these concepts by examining the structures, intersections, stabilities and factors that shape them. It shows that neither concept is invariant, and, despite overlap, the concepts are essentially different, underpinned by different assumptions, holding different functions and capturing different phenomena. In turn, such differences require apposite approaches to their empirical study.

This classic text by the German psychiatrist Karl Wilmanns stands out as exceptional in the literature describing the psychopathology of mentally ill homeless people. Wilmanns' psychopathological descriptions are excellent, as are his observations of the disheartening failure to recognize dementia praecox in courts, prisons and workhouses, and the significant consequences of this failure for the patients. As he vividly shows, most patients manifested a wide range of severe psychiatric symptoms and signs that should have caught the attention of the courts, prison doctors, and even persons with no psychiatric knowledge. Wilmanns considers the main reason for this failure to be inadequate knowledge of psychopathology. Although dementia praecox (schizophrenia) is no longer a new concept, as it was at Wilmanns' time, we still see people with severe psychiatric symptoms roaming the streets and failing to benefit from timely recognition and treatment of their mental disorder.

Mortality is closely linked to age, sex, and social and historical context. Standardised Mortality Rates (SMR) address these contextual factors by comparing mortality in a population under study with that in people of the same age and sex, the same period in history and from a similar cultural context. We use records from the Hatton Asylum and contemporaneous census data in order to calculate SMR in the asylum population, showing rates that were about 2.5 times greater than the population at the time. This is much lower than crude mortality rates, which we calculated as being more than seven times greater than in the population. The SMR method may enable a more meaningful understanding of mortality in asylums or other institutions.