History of Psychiatry最新文献

In this paper I compare the methodology of two of the most famous epidemiological studies: The Midtown Manhattan Study (1952-60) and the Epidemiologic Catchment Area Study (1980-5). At first sight, there are few features that distinguish them; both were studies of large samples of the general population; they both used highly sophisticated methods of data analysis and standardized instruments; and they involved interviewers who were not professional clinicians. However, if we carefully compare the protocols that define how 'clinical' information is collected, we realize that some important changes in methodology were not only due to practical necessities, but also involved an important transformation in the role of the interviewer and the skills traditionally associated with the clinician.

This paper examines the psychiatric work villages in Israel, which have so far had little historiographic attention. In the 1950s and 1960s, four work villages were established for people with psychiatric disabilities. They were intended to create a long-term rehabilitative alternative to the common hospitalization practice. These villages were organized around employment in various branches of farming and also offered recreational and cultural activities to alleviate the patients' loneliness and to create a community life. The villages echoed central values of the new country: labour, manufacturing, cooperativity, and cultural and community life. I will discuss the similarities between the psychiatric work villages and earlier, mostly Western, psychiatric therapeutic models, such as moral treatment and the therapeutic community model.

The roots of the recent controversy about how mental health professionals should respond to gender non-conforming children are traced. To make historical sense, this paper distinguishes between epistemological (discursive) and ontological (non-discursive) aspects and describes their features, since 1970. This helps to clarify some of the confusions at the centre of the still heated debate about sexuality and gender identity today. In the concluding discussion, the philosophical resource of critical realism is used to interpret the historical narrative provided. It cautions against the anachronistic tendency to amalgamate the short-lived, and now defunct, experiment of aversion therapy for homosexuality with more recent defences of exploratory psychotherapy. The latter have challenged a different form of experimentation: the bio-medicalisation of gender non-conforming children.

A traditional view in psychiatry is that personality disorders or traits are intimately related to primary mental disorders. Psychic functions with common roots might be constitutive of personality and psychosis or other disorders. Hoche held that paranoia, mania and melancholia lie in the normal psyche, and Kraepelin conceded such a view, explicitly implying personality. According to Carl Schneider, endogenous symptom complexes or associations and normal functional associations are fuzzy. Many other psychopathologists emphasize personality characteristics in connection with endogenous or functional psychoses, such as the sensitive and melancholic types. When adopting a continuum view of mental disorders, they behave in a unitary or systemic configuration, corresponding to endogenous-functional dispositions interacting with the milieu and composing personality.

The institutional organization of psychiatry in Poland when it became independent faced the problem of the integration of three ex-partition territories having different laws, health-care systems and psychiatric cultures. Due to the high incidence of mental health problems, among which psychosis was the most frequent, psychiatric care facilities had to be organized as quickly and efficiently as possible and had to address the issue of psychosis both conceptually and practically. This study investigates the concept of psychosis and methods of its treatment in inter-war Polish psychiatric care facilities in relation to the sociocultural context of the institutional organization of psychiatry in Poland and the influence of major European concepts and treatment practices regarding psychoses.

Danilo Cargnello was one of the greatest authors of Italian phenomenological psychopathology. He wrote the first articles on the subject in 1947-8, a period in which phenomenological ideas began to spread in Italy. His main contribution was to introduce and disseminate Binswanger's ideas in Italy and to emphasise the anthropological character of Daseinsanalyse. His book analysing results of experimental psychosis constitutes one of the most important and meticulous psychopathological reports of substance-induced psychosis. It is essential to keep alive the knowledge of phenomenological authors such as Cargnello, who are of great clinical and psychopathological relevance, and also to integrate the teachings they have left us into professional training.

In his article 'On the question of unitary psychosis' (1926), Harry Marcuse (1876-1931) undertook a thought experiment in which he challenged clinical psychiatrists to entertain the possibility that the concept of unitary psychosis could be a useful diagnostic and nosological tool. Drawing on the psychology of Friedrich Jodl (1849-1914) and contemporary notions of energeticism, Marcuse proposed a non-empirical, 'analytic' method of overcoming growing dissatisfaction with Kraepelinian categories in the 1910s and 1920s.