History of Psychiatry最新文献

Psychopathology has been criticized for decades for its reliance on a brain-centred and over-reductionist approach which views mental disorders as disease-like natural kinds. While criticisms of brain-centred psychopathologies abound, these criticisms sometimes ignore important advances in the neurosciences which view the brain as embodied, embedded, extended and enactive, and as fundamentally plastic. A new onto-epistemology for mental disorders is proposed, focusing on a biocultural model, in which human brains are understood as embodied and embedded in ecosocial niches, and with which individuals enact particular transactions characterized by circular causality. In this approach, neurobiological bases are inseparable from interpersonal and socio-cultural factors. This approach leads to methodological changes in how mental disorders are studied and dealt with.

Originally put forward to defend history from the encroachment of physics, the distinction between understanding and explanation was built into the foundations of Karl Jaspers' 'phenomenological' psychiatry, and it is revised, used and defended by many still working in that tradition. On the face of it, this is rather curious. I examine what this notion of 'understanding' amounts to, why it entered and remains influential in psychiatry, and what insights for contemporary psychiatry are buried in the notion. I argue that it is unhelpfully associated with the view that the mental is epistemologically and methodologically autonomous, but that it nevertheless highlights an important lacuna in many views of psychiatry and the scientific study of humans more generally.

The Society for Psychical Research (SPR) of London was founded in 1882 with the purpose of investigating psychical phenomena, especially the theme of survival, with scientific rigour. Despite the recognized importance of the SPR for dynamic psychiatry in the nineteenth and twentieth centuries, there are few studies of its epistemological contributions to the theme of survival and its implications to science. In order to fill this gap, we have consulted the main journals of the SPR in its golden period, and highlight the epistemologies of Sidgwick, Myers, James, Podmore, Schiller, Lodge and Richet. We conclude that the authors, whether for or against survival, argued in defence of an expanded science, and looked forward to understanding the complexity of human experience.

The hybrid constitution of psychiatry carries important implications for understanding the discipline and the legitimacy of its research approaches. One implication concerns the central role of concepts in forming the knowledge base of psychiatry. Because of this, it is vital to explore the structures and interrelationships of concepts through their historical constitution. Using this approach to compare concepts of empathy as articulated by R Vischer, T Lipps and E Stein shows that, despite overlap, the concepts vary in structure, in meaning and in the aspect of reality they capture. This suggests that the concept of empathy carries an unstable ontology and epistemology. In turn, this carries implications for the concept itself, for psychiatry and for research approaches in this field.

Serious and realistic research into the inheritance of the psychoses started in earnest at the beginning of the twentieth century. This was encouraged by both the acceptance of the Kraepelinian classification and the rediscovery of the Mendelian model of inheritance. The application of Mendelian rules to the very complex genetics of the psychoses led to agonizing debate. The Classic Text is a translation of the introduction of the doctoral thesis of Jens Chr. Smith, a little-known Danish psychiatrist who was able to summarize, with the enthusiasm typical to his youth and with surprising accuracy, the early stages of the debate mentioned above.

Amid extensive press coverage, George Stephen Penny (1885-1964) was tried for murder in 1923. He was found 'guilty but insane' due to 'confusional insanity' associated with malaria which he suffered during World War I. Penny was admitted to Broadmoor Criminal Lunatic Asylum at a time of great public concern about inadequate and cruel care in mental institutions, but he was treated with humanity and respect. Penny's story also reveals much about challenges of psychiatric diagnosis and the relationships between crime, insanity, the public, lawyers and the medical profession. Following discharge from Broadmoor, Penny built himself a life in the community. His pseudonymous memoir, with masterly concealment of his identity and crime, tells his story up to 1925.

Mortality in asylum populations increased during World War I. This paper seeks to analyse the mortality data from Scotland, where governmental statistics allow comparison between different lunacy institutions, poorhouses and prisons, as well as people certified under lunacy legislation but living in the community. Detailed study is made of two Lothian asylums, the Royal Edinburgh Asylum and the Midlothian and Peebles District Asylum, and the 1918 influenza pandemic is considered in the asylum context. Similarities and differences between the situation in Scotland and that in England and Wales are discussed, and parallels are drawn with the Covid-19 pandemic in Scotland.

Ancient Greek and Latin medical authors considered a flight into solitude a compelling sign of mental disturbance, frequently described as misanthropia, a word fraught with meaning beyond the medical discourse. The fictionalised character Timon of Athens, the quintessential misanthrope, can shed light on ancient cultural concepts of self-imposed isolation from human contact. To cope with the sense of unease this deviant behaviour induced, misanthropia was explained as 'madness', ridiculed in various genres of humour, morally condemned in philosophy, and ultimately demonized in Christian cosmology. These various attempts at containment echo in the medical works of the age, making it impossible to comprehend the concept of misanthropia in ancient medicine without taking full account of the cultural context.

Expansive autopsychosis, grouped with cycloid psychoses - an illness entity of double origin: (1) Morel's notion degeneracy, reformulated by Magnan and Legrain (reflected in Wimmer's concept: psychogenic psychosis); (2) Wernicke's, Kleist's, Bostroem's (and later Leonhard's) notion of these purportedly independent conditions. Locked in the Danish language, Strömgren and Ostenfeld provided important contributions to this field, exemplified by Ostenfeld's casuistry, translated in this Classic Text.