New Issue of International Journal of Epidemiology

suppl_1.coverThe latest issue of the International Journal of Epidemiology is dedicated to the history of psychiatric epidemilogy.

Anne M Lovell and Ezra Susser What might be a history of psychiatric epidemiology? Towards a social history and conceptual account

This supplement heralds the start of an interdisciplinary and international effort to trace the origins of psychiatric epidemiology. As a first step, these papers focus primarily on developments during the period 1945 to 1980, in the USA, UK and France, as well as internationally through the World Health Organization (WHO). A post-war modern epidemiology centred on risk factors emerged during this time.

Anne M. Lovell, The World Health Organization and the contested beginnings of psychiatric epidemiology as an international discipline: one rope, many strands

This paper focuses on the relatively late emergence of psychiatric epidemiology as an international discipline, through local-global exchanges during the first 15 years of the World Health Organization (WHO). Building an epidemiological canon within WHO’s Mental Health Programme faced numerous obstacles. First, an idealist notion of mental health inherent in WHO’s own definition of health contributed to tensions around the object of psychiatric epidemiology. Second, the transfer of methods from medical epidemiology to research on mental disorders required mobilizing conceptual justifications, including a ‘contagion argument’. Third, epidemiological research at WHO was stymied by other public health needs, resource scarcity and cultural barriers. This history partly recapitulates the development of psychiatric epidemiology in North America and Europe, but is also shaped by concerns in the developing world, translated through first-world ‘experts’. Resolving the tensions arising from these obstacles allowed WHO to establish its international schizophrenia research, which in turn provided proof of concept for psychiatric epidemiology in the place of scepticism within and without psychiatry.

Nancy D Campbell, The spirit of St Louis: the contributions of Lee N. Robins to North American psychiatric epidemiology

This article takes up the history of North American psychiatric epidemiology with reference to production of knowledge concerning sociopathic or antisocial personality disorder and drug dependence, abuse, and/or addiction. These overlapping arenas provide a microcosm within which to explore the larger shift of postwar psychiatric epidemiology from community studies based on psychological scales to studies based on specific diagnostic criteria. This paper places the figure of sociologist Lee Nelken Robins within the context of the Department of Psychiatry in the School of Medicine at Washington University in St Louis, Missouri. The St Louis research group—to which Robins was both marginal and central—developed the basis for specific diagnostic criteria and was joined by Robert Spitzer, Jean Endicott and other architects of DSM-III in reorienting American psychiatry towards medical, biological and epidemiological models. Robins was a key linchpin working at the nexus of the psychiatric epidemiological and sociological drug addiction research networks. This article situates her work within the broader set of societal and governmental transformations leading to the technologically sophisticated turn in American psychiatric epidemiology and research on the aetiology of drug abuse and mental health and illness.

Dana March and Gerald M Oppenheimer, Social disorder and diagnostic order: the US Mental Hygiene Movement, the Midtown Manhattan study and the development of psychiatric epidemiology in the 20th century

Recent scholarship regarding psychiatric epidemiology has focused on shifting notions of mental disorders. In psychiatric epidemiology in the last decades of the 20th century and the first decade of the 21st century, mental disorders have been perceived and treated largely as discrete categories denoting an individual’s mental functioning as either pathological or normal. In the USA, this grew partly out of evolving modern epidemiological work responding to the State’s commitment to measure the national social and economic burdens of psychiatric disorders and subsequently to determine the need for mental health services and to survey these needs over time. Notably absent in these decades have been environmentally oriented approaches to cultivating normal, healthy mental states, approaches initially present after World War II. We focus here on a set of community studies conducted in the 1950s, particularly the Midtown Manhattan study, which grew out of a holistic conception of mental health that depended on social context and had a strong historical affiliation with: the Mental Hygiene Movement and the philosophy of its founder, Adolf Meyer; the epidemiological formation of field studies and population surveys beginning early in the 20th century, often with a health policy agenda; the recognition of increasing chronic disease in the USA; and the radical change in orientation within psychiatry around World War II. We place the Midtown Manhattan study in historical context—a complex narrative of social institutions, professional formation and scientific norms in psychiatry and epidemiology, and social welfare theory that begins during the Progressive era (1890-1920) in the USA.

Nicolas Henckes, Mistrust of numbers: the difficult development of psychiatric epidemiology in France, 1940–80

This article uses archival as well as published materials to trace the development of psychiatric epidemiology in France from 1945 to 1980. Although a research programme in this field was launched in the early 1960s at the National Institute of Medical Research (INH, later renamed INSERM), psychiatric epidemiology remained an embryonic field in France during the next two decades. French researchers in this field were hampered by limited resources, but their work was primarily characterized by a deep engagement with the epistemological challenges of psychiatric epidemiology. The history of French psychiatric epidemiology in the 1960s and 1970s can be seen as an attempt to create a specifically French way of doing psychiatric epidemiology research. In the first part of this article, the author relates this unique history to internal professional dynamics during the development of psychiatric research and, more broadly, to the biomedical institutional context in which epidemiological work was being done. The next part of this article examines the conditions under which the INH research team framed epidemiological research in psychiatry in the 1960s. The last part focuses on INH’s flagship psychiatric epidemiology programme, developed in cooperation with pioneers of French community psychiatry in Paris’s 13th arrondissement in the 1960s.

Steeves Demazeux, Psychiatric epidemiology, or the story of a divided discipline

This article traces the historical decisions, concepts and key professional collaborations that laid the foundations for the formation of American psychiatric epidemiology during the 20th century, up to the discipline’s institutional consolidation, circa 1980, when the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) was published. Thomas Kuhn’s ‘disciplinary matrix’ is mobilized as a framework that allows the institutional and intellectual construction of a discipline to be analysed as separate but intertwined components, without assuming that the two evolve in tandem. The identification of the strengths as well as the frailties and internal divisions of the discipline as it developed reveals a paradoxical situation: a time lag between psychiatric epidemiology’s institutionalization and public recognition, on the one hand; and the weak coherence of its intellectual components, on the other hand. We briefly trace the origins of split among the discipline’s aetiological models of mental disorders and suggest that the lack of coherence among them has prevented psychiatric epidemiology from achieving the status of a normal scientific discipline, in the Kuhnian sense. Without a more explicit attention to the intellectual rationale of the discipline, psychiatric epidemiology will continue to maintain a strong institutional dimension and weak intellectual matrix.

Art, Anatomy and the Body: Vesalius 500 (NYAM, October 2014)

NYAM's Center for History and Public Health

2nd Annual Festival of Medical History and the Arts

Art, Anatomy, and the Body:
VESALIUS 500

Saturday, October 1​8 • 11:00​ AM – 6:30​ PM

Register now to join us as we celebrate the 500th birthday of anatomist and humanist Andreas Vesalius with a day-long event on October 1​8 from 11​:00 AM to 6:30 PM. Few figures have had as much influence on the arts, learning, and medicine as Vesalius. His groundbreaking De humani corporis fabrica (The Fabric of the Human Body) of 1543 profoundly changed medical training, anatomical knowledge, and artistic representations of the body.

A vibrant roster of performers and presenters will explore the intersection of anatomy and the arts, including the following:

  • Daniel Garrison on translating Vesalius for modern audiences
  • Heidi Latsky’s GIMP Dance Project
  • The comics artists of Graphic Medicine
  • Sander Gilman on posture controlling the unruly body
  • Alice Dreger on inventing the medical photograph
  • Bill Hayes on researching hidden histories of medicine
  • Steven Assael on anatomy in contemporary art
  • Chase Joynt’s Resisterectomy, a meditation on surgery and gender
  • Brandy Schillace on ambivalent depictions of female anatomy in the 18th century
  • Ann Fox exploring extraordinary bodies in contemporary art
  • Lisa Rosner on famous body snatchers Burke and Hare
  • The art of anatomical atlases with Michael Sappol
  • Medical 3D printing demos by ProofX
  • Anatomical painting directly on skin with Kriota Willberg
  • And many more!

“Art, Anatomy, and the Body: Vesalius 500″ is guest curated by artist and anatomist Riva Lehrer.

For more information and guest posts from participants throughout the summer follow our blog Books, Health, and History and join the conversation at #NYAMHistFest.

Date

Saturday, October 1​8, 2014

Time

11:0​0 AM – 6:3​0 PM

Location

The New York Academy of Medicine
121​6 Fifth Avenue at 10​3rd Street, New York, NY 1002​9

Sponsored by

The Brandt Jackson Foundation and
Friends of the Rare Book Room

Cost

General Admission – $35
NYAM Fellows, Members, and Friends of the Rare Book Room – $20
Students and Hospital House Staff (ID required) – FREE
Wheelchair Seating and Companion Seat – $35

Registration

www.nyam.org/events

 

The New York Academy of Medicine • 1216 Fifth Avenue, NY 10029 • (212) 822-7200www.nyam.org

New issue – History of Psychiatry

The September 2014 issue of History of Psychiatry is now out, and includes the following articles:

Benjamin Lévy
Cheryl McGeachan
Chris Walker
Herman Westerink
Ellen Nakamura

Psychopathological fringes. Historical and social science perspectives on category work in psychiatry

color spectrumDate: 13./14.2.2015
Venue: Berlin, Institute for the History of Medicine, Dahlem
Organization: Nicolas Henckes, Volker Hess, Emmanuel Delille, Marie Reinholdt, Stefan Reinsch, Lara Rzesnitzek,
Contact: stefanie.voth@charite.de

Over the last few years, the revision process of both the DSM and the chapter V on mental disorders of the ICD has stimulated within psychiatry a series of attempts at challenging established diagnostic categories. These challenges reflect both dissatisfaction with categories as they are defined in existing diagnostic classifications, and a will to adjust them to the demands of clinical and research activities. They are expressed in ways that sometimes strongly resembles the discourse of critical social science. For instance, the conveners of the conference “Deconstructing psychosis” – organized by the American Psychiatric Association along with the WHO and the US National Institutes of Health in 2005 – developed a stringent critique of the proliferation of diagnostic categories in the field of psychosis: “Although these categories are meant to refer to broadly defined psychopathological syndromes rather than biologically defined diseases that exist in nature, inevitably they undergo a process of reification and come to be perceived by many as natural disease entities, the diagnosis of which has absolute meaning in terms of causes, treatment, and outcome as well as required sampling frame for scientific research.” (( van Os, J. and C. Tamminga (2007). “Deconstructing psychosis.” Schizophrenia Bulletin 33(4) p. 861. ))
Controversies over diagnostic categorization in fact have a long history in psychiatry. Rejection of diagnosis has long been prominent among certain segments of psychiatry, from Adolf Meyer’s synthesis in interwar US psychiatry through parts of phenomenological psychiatry in Germany to antipsychiatry and Lacanian psychoanalysis in 1970s France. However, the deconstruction of diagnosis has also been a core feature of what might be termed category work in psychiatry, at least since the fall of the unitary psychosis concept in the last quarter of the 19th century. By the notion of category work we understand the multifaceted practices developed by clinicians, epidemiologists, biologists, administrators and patients to negotiate and objectify the boundaries of diagnostic categories. While such practices have mostly been devoted to securing the internal coherence of major categories, the requirements of both research and clinical work have prompted the development of liminal categories meant to target conditions situated between illness and health, or between broader established diagnostic classes. Examples of such categories include prodromal schizophrenia, latent depression as well as “borderline” disorder and a range of personality disorders. Closely related to these constructs are notions of comorbidity and dimensional concepts of diagnostic spectra or continua. In many of these cases, the challenge for psychiatrists has been to devise entities that include in their very definition the possibility of their transitory status. These diagnostic constructs thus convey a paradox: while they question categorical thinking, they are usually framed within the language of categories.
The aim of this workshop is to offer a historical and social science perspective on the history and current status of category work at the fringes of psychopathology. Unlike constructionist perspectives on psychiatric diagnosis that have aimed to demonstrate the less than solid nature of core categories such as depression, schizophrenia and neurosis, we are interested in the already internally contested and marginal categories devised to target conditions situated at the borders of psychopathology. Thus, rather than elaborating on the longstanding debates between “lumpers” and “splitters”, we would like to examine the ways in which psychiatry has developed knowledge and practices to target these conditions.
This workshop has its origins in the German-French research program “Psychiatric Fringes. A historical and sociological investigation of early psychosis in post-war French and German societies” funded by the ANR and the DFG for the period 2012-2014, and it will be an opportunity to discuss results from this research project. We welcome papers on other aspects of the history, the sociology and the anthropology of psychiatry at the fringes of psychopathology that complement our research and might lead to a wider understanding of this work. Papers may explore for instance one or more of the following issues:

  •   The construction of knowledge at the fringes of psychopathology. What knowledge practices have been involved in the creation of categories targeting liminal conditions? What have been the respective roles of epidemiology, biological science, brain imaging, biometrics, and the clinic in the development and objectification of these categories? What have been the practical and ethical implications of such work?
  • Diagnostic practices. Liminal categories have been developed to address specific clinical uncertainties, but they also have raised new ones. What are these, and how are they practically managed by clinicians and patients? What are the specific diagnostic instruments developed by clinicians, and how are these used? What has been the role of psychopathological scales, psychological tests or biological treatments in diagnostic processes?
  • The specific role of patients´ experience in category work. To what extent have patients, as individuals or as organized groups, contributed to shaping categories at the borders of psychopathology?
  • The trajectories of categories. Like the psychiatrists quoted above, we might be tempted to think that categories always end up in some ways reified. Is this always the case? What has been the use of liminal categories in different historical and social contexts? What has been the influence of these contexts on the very definition of such categories?

Interested prospective participants should send a title and a 350-word paper description to Ms. Stefanie Voth: stefanie.voth@charite.de by September 15th. Travel expenses and accommodation in Berlin will be covered by the conference organizers.

New issue of “Journal of the History of Medicine and Allied Sciences”

3.coverA new issue of Journal of the History of Medicine and Allied Sciences is available online. The July issue 2014 contains the following article that may interest readers of h-madness.

Cadaver Brains and Excesses in Baccho and Venere: Dementia Paralytica in Dutch Psychiatry (1870–1920) by Jessica Slijkhuis and Harry Oosterhuis

This article explores the approach of dementia paralytica by psychiatrists in the Netherlands between 1870 and 1920 against the background of international developments. The psychiatric interpretation of this mental and neurological disorder varied depending on the institutional and social context in which it was examined, treated, and discussed by physicians. Psychiatric diagnoses and understandings of this disease had in part a social–cultural basis and can be best explained against the backdrop of the establishment of psychiatry as a medical specialty and the specific efforts of Dutch psychiatrists to expand their professional domain. After addressing dementia paralytica as a disease and why it drew so much attention in the late nineteenth and early twentieth century, this essay discusses how psychiatrists understood dementia paralytica in asylum practice in terms of diagnosis, care, and treatment. Next we consider their pathological–anatomical study of the physical causes of the disease and the public debate on its prevalence and causes.

A Malady of Migration: A theatrical examination of diaspora, displacement and mental disorders in the 19th century

A Malady of Migration

A theatrical examination of diaspora, displacement and mental disorders in the 19th century

At a time when the issues of migration and mental health are seldom out of the news, CHM has worked with Talking Birds and the Centre for the History of Medicine in Ireland to develop a new theatre production which explores why the mid-19th century saw a prevalence of mental disorders among Irish migrants.

This follows the successful collaboration with Talking Birds on ‘Trade in Lunacy’ in 2013, and will again use original music, song, humour and sharp characterisations to tell a series of intertwining stories.

The new piece is called ‘A Malady of Migration’ and is based on research being carried out by Professor Hilary Marland of Warwick and Dr Catherine Cox of University College Dublin, in a project called Madness, Migration and the Irish in Lancashire, c.1850-1921, funded by the Wellcome Trust. They are supported by postgraduate students and others, who will conduct supplementary research and take supporting roles in the drama.

Professor Hilary Marland, explains, “This is a chance to showcase our research in a way that is interesting, informative and sensitive, weaving in stories based on patients’ case histories and experiences. The aim is to make the findings of the research available to wider publics and to stimulate thinking and debate about mental illness in the past and present.”

“The performance, based on an insightful and compassionate interpretation of the historical material, reveals both change and continuity in how we view mental illness, its causes and in particular its relationship to displacement, migration, isolation and poverty.”

There will be an expert panel discussion after the Thursday evening performances in each venue and a post performance discussion on Saturday lunchtime, providing opportunities for audience members to discuss the making of the piece with researchers and the theatre company, and to engage in debate on issues raised by the performances. Details of the panellists are on the Expert Panel page – link above and here.

A series of short briefing sheets have been produced to complement the drama and provide background information. These can be accessed from the Background Reading page – link above and here.

Performance dates:

Running time approx. 55 minutes
Coventry:

2 performances a day (lunchtime and evening): Thursday 26th, Friday 27th, Saturday 28th June 2014

Dublin:

2 performances a day (lunchtime and evening): Thursday 3rd, Friday 4th, Saturday 5th July 2014

More about The Centre for the History of Medicine in Ireland, University College Dublin

Talking Birds is an extraordinary, award-winning theatre company, renowned for working in unusual spaces. More about Talking Birds theatre company

Coventry:

2 performances a day (lunchtime and evening): Thursday 26th, Friday 27th, Saturday 28th June 2014

Dublin:

2 performances a day (lunchtime and evening): Thursday 3rd, Friday 4th, Saturday 5th July 2014

More details are available here.

 

Call for doctoral position – Globhealth ERC Project

Screenshot from 2014-06-26 13:54:14CERMES3 announces a three-year doctoral fellowship (2014-2017) financed through the European Research Council project GLOBHEALTH, “From international to global: Knowledge and diseases and the post-war government of health”. The PhD will be defended at the EHESS – Paris.

This doctoral research should centre on a critical history of the development of international research on schizophrenia and other severe mental disorders and the central role of WHO, including but not limited to the 25-year WHO international research programme on schizophrenia. It may address the scientific findings and controversies; the relationship of this research to international public health, epidemiology, psychiatry and other branches of medicine; the changing nature of expertise. The project may also focus on more recent history of the incorporation of schizophrenia into global health through new alliances (e.g. NGOs, universities, pharmaceutical markets), metrics (e.g. Global Burden of Disease), and movements for health and human rights. The nature of the project may be historical, anthropological or sociological. However, it should focus on local-global exchanges, particularly in outside Europe and North America. The doctoral project falls into the domain, “Placing mental health on the world health agenda: the globalization of a refractory problem”, one of four to be examined by the ERC programme GLOBHEALTH.

The PhD project will be located at CERMES3, Villejuif/Paris, but will involve on-site research in Geneva (WHO) and possibly sites in Africa or Asia. Supervision will be offered by Jean-Paul Gaudillière (historian) and Anne M. Lovell (medical anthropologist).

Applicants should hold a Masters’ Degree in anthropology or history, but other disciplines will be considered. Some background or interest in mental health, psychiatry, pharmaceuticals or public health is an asset. Good oral, reading and writing skills in English are required; some knowledge of French is preferable.

Applicants should include the following in their application:

  • contact details, including phone number
  • CV (degrees, educational/training experiences, work history, skills, honours/awards, publications)
  • transcripts from university diplomas
  • letter of motivation
  • draft project of 5 to 10 pages. Include: subject, materials, methods, field-site, intended outcomes,
  • dissemination and a 3-year timeline for the project.
  • Sample of writing that applicant deems relevant to the project.
  • Names and contact details of two references

Information on CERMES3 is available through http://www.cermes3.fr.
Description of the ERC Project is accessible through globhealth.vjf.cnrs.fr.
The complete applications to be sent to gaudilli@vjf.cnrs.fr and anne.lovell@parisdescartes.fr
Please indicate “Globalizing Schizophrenia – GLOBHEALTH” in the subject line.
The deadline for applications is July 15, 2014.

The selection will completed at the end July 2014 and the successful candidate is expected to start employment by the end of October 2014.

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