New Issue of PSN

A new issue of PSN (Psychiatrie Sciences Humaines Neurosciences) has just been released online. Included in this issue are two pieces that may be of interest to h-madness readers. Titles, authors and abstracts listed below:

Interview with Alain Ehrenberg: social signification of narcissistics pathology in France and United States of America by Bernard Granger

Anxiety disorders in the history of medicine Second part: from neurasthenia to generalized anxiety disorder by T. Haustgen

The last “great neurosis,” described by general practitioners before the Freudian classification, the neurasthenia (Beard, 1869, 1880; Charcot, 1887) originated between 1870 and 1900 in the USA and in Europe. It was then dismembered and annexed by the psychiatrists, through psychasthenia (Janet, 1903) and mild depressive states. It declined slowly at the beginning of the 20th century, but is still alive in the textbook of P. Guiraud (1956) and in the ICD-10 (1992). Helped by the works of E. Brissaud (1890) and E. Hecker (1892), Freud’s “anxiety neurosis” (1895) remains, however, the most famous clinical entity resulting from the dismemberment of neurasthenia. It includes anxious expectation, anxiety attacks, and somatic equivalents. Diffused in France by Hartenberg, Lalanne (1902), and then Heckel (1917), it was contested by G. Ballet, Pitres and Regis (1902) and F. Raymond (1911) — successor of Charcot at the Salpêtrière Hospital. After 1910, the hereditary “emotive constitution” of E. Dupré tended to gather the manifestations of anxiety neurosis, several hysterical symptoms, some depressive disorders, and post-traumatic disorders resulting from the lst World War (Devaux and Logre, 1917; De Fleury, 1924). But many French authors separated psychical anxiety and somatic anguish — later named panic disorder, (Brissaud, 1902; Claude and Lévy-Va1ensi, 1938; Ey, 1950). After 1945, the emergence of several somatic entities such as stress, vagotonia, and spasmophilia can be seen as new attempts by general practitioners for the annexation of anxiety disorders. After 1960, two opposite clinical orientations can be described: those inspired by psychoanalysis maintain the autonomy of anxiety neurosis; others separate, from psychopharmacological criteria, generalized anxiety and acute anguish. This last, named “panic attack” (D. Klein, 1962), gathers in fact the symptoms of paroxysmal anxiety (Brissaud), anxiety attack (Freud), emotive attack (Dupré), emotive or anxious crisis (Devaux and Logre), and the mental paroxysmal form of anxiety (Heckel). Though the clinical dichotomy between generalized anxiety and panic disorder has been emphasized by DSM-IV and ICD-10, a dimensiona1 approach of mental disorders would include most anxious and “neurotic” symptoms, beyond anxiety neurosis.

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