Archive for July, 2013

New article by Edward Shorter: “An Alternative, History-Based, Nosology for Psychiatry”

H-Madness is delighted to present a new piece by Prof. Dr. Edward Shorter, PhD FRSC, the Jason A Hannah Professor of the History of Medicine and Professor of Psychiatry, Faculty of Medicine, University of Toronto. Prof. Dr. Shorter has published widely on the history of psychiatry. His books include the classic A History of Psychiatry: From the Era of the Asylum to the Age of Prozac (Wiley, 1997) and, most recently, How Everyone Became Depressed: The Rise and Fall of the Nervous Breakdown (Oxford,  2013). Here he explores the issue of psychiatric nosology, especially in view of the recent publication of the DSM-V.

An Alternative, History-Based, Nosology for Psychiatry

For their comments on earlier versions, the author would like to thank Tom Bolwig, Bernard Carroll, Max Fink, Gordon Parker, Robert Rubin, Michael Alan Taylor, and Lee Wachtel.

Current efforts to produce a classification of disease have not turned out well.  The fifth edition of the Diagnostic and Statistical Manual of the American Psychiatric Association (DSM-5) was released to general dismay in May 2013.  The current DSM, though vastly influenced by history, pays little attention to it, either in the form of attributing significance to patients’ own histories or in acknowledging the historical diagnostic traditions of psychiatry.

Yet it is possible to take history as our guide in drawing up classifications of diseases.  Here is an analogy: In Traditional Chinese Medicine a sifting process lasting thousands of years has taken place to winnow out effective medications from the ineffective ones lost in the mists of time.  Similarly in psychiatry, a winnowing process of mere tens and hundreds of years has distilled a good deal of the collective wisdom of the profession.  It is, in other words, possible to think about historical diagnoses as having the potential of cutting nature closer to the joints than do current diagnostic systems, drawn up on the basis of whim, fad, and consensus.[1]

There are, in disease classifications, lumpers and splitters. The DSM has taken splitting over the side of the cliff.  Philippe Pinel (1801) was the first lumper. The present effort at classification also is a lumping nosology that tries to discern diseases on the basis of biology and historical integrity. It is not meant to be absolutely inclusive of all psychiatric disorders but to convey some notion of how the main ones should be classified in a way that corresponds better than the present system to natural disease entities. In the absence of definitive biological verifications of many disorders, we have as our guide to “nature” the diagnostic traditions of a century and a half of scientific psychiatry, incubated in Germany and France, and brought today to great blossom in the transatlantic community.

Subsequent versions will need to come to grips with the addictions and the adult dementias.  Personality disorders have not been included.

An Alternative, History-Based, Nosology


I. Acute brief psychosis

II. Neuropsychiatric presentations (eg frontal and temporal dysrhythmia syndromes, Parkinsons, etc.)

III. Chronic psychosis: flat affect with avolition:

(a)—chronic psychosis:  hebephrenia

(b)—chronic psychosis: early progression to personality disintegration

IV. Chronic psychosis: Kraepelin’s disease.  (melancholic syndrome with or without mania; biological markers: DST, cortisol, sleep markers)  This includes such entities as vascular depression.   On a lifetime basis, one should rather think of “para-melancholia,” in which patients are at continuous risk of psychotic complications.

V. Chronic psychosis:  paranoia, meaning well-systematized delusional disorder, without  hallucinations, without disintegration of the personality.

VI. Catatonia.  It may also complicate any of these diseases (biological marker: immediate response to lorazepam)

VII. Non-melancholic, non-psychotic depressive and nervous illnesses

(a) mixed depression-anxiety  (Non-melancholic, non-atypical depression, often accompanied by anxious symptoms)

(b) atypical depression  (Note that this is distinct from the depression of what used to be called “bipolar disorder” and corresponds to the depressive disease described by William Sargant and Donald Klein.)

(c) OCD

(d) phobias

(e) paroxystic anxiety (“panic attacks”) (biological marker: various


VIII. Delirium

IX.  Breakdowns in the mind-body relationship


As adult, except for:

—Intellectual disability/learning disabilities

—Autism/catatonia with or without psychosis

—Hyperactivity syndromes (biological marker: abnormal EEG)

—The childhood anxiety disorders, including separation anxiety


II.  Neuropsychiatric presentations are not in DSM but should be.  There is widespread agreement among clinicians that epilepsy, for example, has its own psychiatric pathology.[2]   One senior American psychopathologist, Michael Alan Taylor, argues that psychiatry has erred seriously in omitting neuropsychiatric indications from the nosology[3], and this should be corrected.  We make an early start here with epilepsy and Parkinsons..

III.  This form of chronic psychosis splits the former “schizophrenia” into chronic psychotic disorders that partially remit, and those that do not.

(NB: positive symptoms may well be present, but they are not essential for the diagnosis of  chronic psychosis.)

“Schizophrenia” has been given here an overdue burial and replaced with several different forms of chronic psychosis that demolish the former firewall between psychosis and affect.  While abolishing the firewall, this nosology does restore the dividing line between “psychosis” and “neurosis,” although the latter term is shunned in favor of “nervous,” or the more modern-sounding but clunkier “non-melancholic, non-atypical depression. “

On the separation of hebephrenia from other forms of chronic psychosis:  hebephrenia does not carry a disastrous prognosis, even though there is no restitutio ad integrum.[4]   Hebephrenia is further distinguished by its onset in adolescence.[5]   In DSM-3 the hebephrenic subtype became the “disorganized type”; it was filled with catatonic symptoms, and was relentlessly progressive, none of which is true of Hecker’s original “hebephrenia.”   The DSM description also perpetuated the myth of the patients being “silly.”  Even though the subtypes have vanished from DSM-5, a disaggregation of “schizophrenia” is long overdue, and this represents a first step.

The term “personality disintegration” is used in the sense of W. Mayer-Gross et al (1954) in preference to the term “dementia.”[6]

IV.  On Kraepelin’s disease, meaning  “melancholic syndrome with or without mania,” this nosology basically restores the unity of Kraepelin’s “manic depressive illness” that he first formulated in the 6th edition of his textbook in 1899, bringing together all the various depressions, of whatever polarity, together with the manias, whether they occurred in the same illness episode or not.  This nosology follows the current of not considering mania and hypomania as separate illnesses[7]; nor are they part of “bipolar disorder,” as the DSM series presents it, because this version of affairs ignores bipolar disorder.

This nosology tackles head-on the issue of the “Kraepelinian dichotomy,” the firewall that Emil Kraepelin constructed between dementia praecox and manic-depressive illness in 1899.[8]  A fundamental issue in the classification of melancholia is whether it belongs under the psychoses or the non-psychoses.  The recent nosological tendency has been to consider psychotic melancholia (psychotic depression) as a rather anomalous subform of  melancholic disease, which, in general, does not involve delusions or hallucinations.[9]  In my view, this issue needs to be re-thought.  The lower boundary of “psychosis” needs to be pushed downward, beneath formal and systematized delusions, to include fixed ideas and highly eccentric notions. It is true that most melancholic patients do not have systematized delusions or hallucinations.  Still, in the words of Tom Bolwig, “They suffer from unjustified feelings of guilt, they don’t accept being ill, and they are unresponsive to all attempts at psychotherapy.  Isn’t that a deficiency in their reality testing, and thus a forme fruste of psychosis?” [10]

On a lifetime basis, psychosis may well be more common in melancholia than has been thought to date (a common assessment is 30 percent – yet the authors Michael Alan Taylor and Max Fink stipulate that an additional number of patients with forme fruste fixed ideas and delusive suspicions should be added on.[11]).  The percent of melancholics who on a lifetime basis may at some point or another be, or have been, psychotic is among the most difficult statistics to nail in the literature, because, as soon as a depressive patient becomes psychotic, the diagnosis is changed to “schizophrenia,” or “schizoaffective disorder.”  It is true that DSM accepts the category “psychotic depression,” but it is quite underused.    (There is also an ascertainment problem.  As one observer pointed out in 1970:  “It is well known that the more we like a patient, the less likely we are to place him on the psychotic end of the psychiatric spectrum.”[12] )

Many European authors considered melancholia basically a psychotic disorder.  As Wilhelm Griesinger noted in the influential second edition of his textbook in 1861, “The core of [the psychic depressive conditions] consists of the pathological prevalence of a distressing, depressive, negative affect.  . . . Corresponding to the mood there then appear false ideas and judgments that have no external basis, true delusions, distressing and painful in content.” [13]   Such authoritative statements continue into the present-day literature as well:  At a conference in 1991 Joseph Zubin  reflected, “Many outstanding diagnosticians first decide whether the patient before them has a psychosis, and then, after that decision is made, go on to determine whether it is schizophrenia or manic-depressive. . . .  Is it possible that what is the basic feature of the illness is psychosis, and that it takes the direction of either manic-depressive psychosis or schizophrenia depending on other factors . . . ?”[14]

In an effort to straddle this as yet unclarified issue of lifetime prevalence of psychosis in melancholic illness, the term “para” has been added to the lifetime version.

On the classification of melancholia, the disorder classically has been said to occur in two versions: (1) anxious, agitated (Angstmelancholie), and (2) stuporous (melancholic stupor).  There is no evidence that these represent separate diseases but are, rather, separate presentations.  There is a body of literature suggesting that psychotic anxiety exists as a separate diagnosis.[15][16]

In the spirit of Kraepelin, mania has been abolished as a separate disease and so there is no “bipolar disorder.”   It makes little sense to classify depressions on the basis of polarity, as the depression of bipolar disorder seems to be melancholic in nature, and identical to the melancholic version of unipolar depression (“major depression”).[17]  DSM-5 now accepts that bipolar and unipolar depression are identical, and calls both “major depression.”

“Major depression,” as well, has not found a place in this nosology on the grounds that it is highly heterogeneous, mixing together melancholic and non-melancholic illness.[18]

On the basis of etiology, there are many “depressions,” such as vascular depression, alcoholic depression, the depression of Parkinson’s, and so forth.  Yet it is unclear that any of these depressions have a distinctive psychopathology not included under either melancholia or non-psychotic nervous disease.  As science elaborates the existence of other distinctive depressions, these should be added to the nosology.   Bernard Carroll has raised a thoughtful objection to letting psychopathology drive the nosology:  “Aren’t you getting it backwards?  Our nosology requires distinctive disorders with distinctive etiologies.  The form of psychopathology is just one plank in the platform, not the main thing.”[19]  One can only respond that this view is indeed correct.  And if we were certain of the distinctive etiologies, we would, of course, let them drive the nosology.  But since we are not quite there yet, driving the nosology with psychopathology is a pis aller.

VII.  The classification of what used to be called “nervous disease” has bedeviled psychiatry for a century and a half, ranging through “nerves,” to “psychoneurosis,” to the current avalanche of micro-diagnoses.  The present nosology tries to lessen reliance on the term “depression,” which has been badly stretched out of shape by overuse.  It has also seemed judicious to revive the classic term “nervous disease,” as has ben recently suggested.[20]  The present version of the nosology seeks a compromise with the use of both terms, depression and nerves.

VII (a) Mixed depression-anxiety has been called “cothymia” by Peter Tyrer.[21]  It was the commonest form of depressive illness (with the exception of the psychoanalytic term “depressive neurosis”) in the decades before the appearance of DSM-3 in 1980, which sundered depression and anxiety.

VII (c-e)  There is no special line in the nosology for adult anxiety, or any of the DSM “anxiety disorders,”  several of which have now been shifted to the nervous category.

On removing OCD from the “anxiety disorders” as classified in DSM-4:  the present nosology argues that OCD be made a “nervous” disease, which simply means a non-psychotic, non-melancholic disorder the proper classification of which will have to await further research.  Patients with OCD do not display the classic somatic symptoms of anxiety, such as racing pulse, dizziness, sweating and tremor, nor the fear and dread of a panic attack.   Rather, the obsessive patient is uneasy and apprehensive about his or her symptoms, while fully recognizing that they are unjustified and unrealistic.

On the omission of PTSD from the nosology:  Traumatic neurosis was first described in the late 19th century, and belongs among the classic “nervous complaints.”  Patients who have experienced severe trauma, in wartime or otherwise, may indeed become symptomatic, but that their symptoms (“the full diagnostic criteria” in DSM terms) first occur after some unspecified duration — which is the essence of “post” — is not at all clear.  The whole diagnosis resulted from a systematic campaign of the Vietnam veterans in the late 1970s, and as a political construct PTSD has little place in a scientific classification of disease.

IX.  Breakdowns in the mind-body relationship:  There needs to be a category for what used to be called “hysteria,” “conversion disorder,” and so forth, symptoms that present in a medical way but are caused by the action of the mind.

Similarly, the personality disorders have been omitted from the nosology as they are considered a holdover from psychoanalysis and may well be abolished in ICD-11.

X.  The classification of childhood disorders poses a special conundrum, because “pure” anxiety without depression is commoner in children than in adults.   Children with “pure” depression more often present as angry.  In the adult section these issues are classified under “mixed depression-anxiety.”

It is now considered possible that hyperactivity has a biological EEG test. [22] This revives Charles Bradley’s original 1938 view of the EEG in hyperactivity.[23]

[1] Shorter E.  “The History of DSM,”  in Making the DSM-5: Concepts and Controversies, ed. Joel Paris and James Phillips.  New York: Springer, 201), 3–19, doi 10.1007/978-1-4614-6504-1_1

[2] Reynolds ED.  Trimble MR.  Epilepsy, psychiatry, and neurology.  Epilepsia, 50 (Suppl 3), 50-55, 2009.

[3] Taylor MA.  Hippocrates cried: the decline of American psychiatry.  New York: Oxford University Press, 2013.

[4] See Ilberg G.  Das Jugendirresein (Hebephrenie und Katatonie).  {Volkmann] Sammlung Klinischerr Vorträge, NF, nr. 67, 1287-1308, 1898. “ganz gut in der Lage, gewohnte Geschäfte zu besorgen.”  (1288)

[5] Taylor MA.  Shorter E. Vaidya NA.  Fink M. The failure of the schizophrenia concept and the argument for its replacement by hebephrenia: applying the medical model for disease recognition.  Acta Psychiatr Scand. 122, 173-183,  2010  doi: 10.1111/j.1600-0447.2010.01589.x.

[6] Mayer-Gross W.  Slater E.  Roth M.  Clinical Psychiatry.  London: Cassell, 1954, 262-264.

[7] Mayer-Gross W.  Slater E.  Roth M.  Clinical Psychiatry.  London: Cassell, 1954, 187f.

[8] Craddock N.  Owen MJ.  The beginning of the end for the Kraepelinian dichotomy.  British Journal of Psychiatry.  186: 364-366, 2005.

[9] Parker G.  Hadzi-Pavlovic D.  Melancholia: a disorder of movement and mood.  New York: Cambridge University Press, 1996.

[10] Bolwig personal communication, 22 July 2013.

[11] Taylor MA.  Fink M.   Melancholia: the diagnosis, pathophysiology, and treatment of depressive illness.  New York: Cambridge University Press, 2006, 16., 55.

[12] Jackson B.  The revised Diagnostic and Statistical Manual of the American Psychiatric Association.  American Journal of Psychiatry.  127: 65-73, 67, 1970.

[13] Griesinger W. Die Pathologie und Therapie der psychischen Krankheiten für Aerzte und Studirende, 2nd ed.  Berlin: Krabbe, 1861,  213.

[14] Zubin J. discussion comment, in Carroll BJ.  Psychopathology and neurobiology of manic-depressive disorders.  In Carroll BJ.  Barrett JE eds.  Psychopathology and the brain.  New York: Raven Press, 1991, 265-285, 283.

[15] Shorter E.  How everyone became depressed: the rise and fall of the nervous breakdown.  New York: Oxford University Press, 2013, 72-75.

[16] Stransky E.  Zur Lehre von der Amentia.  Journal für Psychologie und Neurologie. 6: 37-83, 155-191, 1906, see 163. “hochgradiger Angstparoxysmus.”

[17] Taylor MA.  Vaidya NA.  Descriptive psychopathology: the signs and symptoms of behavioral disorders.  New York: Cambridge University Press, 2009, 383.

[18] Parker G.  Beyond major depression.  Psychological Medicine.  35: 467-474. 2005.

[19] Bernard Carroll personal communication to Edward Shorter, 20 July 2013.

[20] Shorter E.  How everyone became depressed: the rise and fall of the nervous breakdown.  New York: Oxford University Press, 2013.

[21] Tyrer P.  The case for cothymia: mixed anxiety and depression as a single diagnosis.  British Journal of Psychiatry.  179, 191-193, 2001.

[22] Arns M. et al.  EEG phenotypes predict treatment outcome to stimulants in children with ADHD.  J Integrative Neurosci, 7, 421-438, 2008.

[23] Jasper HH.  Solomon P.  Bradley C.  Electroencephalograhic analyses of behavior problem children.  American Journal of Psychiatry, 95, 641-658, 1938.

For a more detailed bibliography of his work, click here.

Recent Dissertations in the History of Psychiatry and Psychology

Thanks again to Jonathon Erlen (History of Medicine Librarian, Health Science Library System at the University of Pittsburgh), a list of recent doctoral dissertations in North America – harvested from the July 2011 volumes of Dissertation Abstracts – pertaining to the history of psychiatry and psychology can be found here.

How Depression Went Mainstream: Interview with Dr. Edward Shorter

George Mason University’s History News Network features a recent article entitled “How Depression Went Mainstream”. In the piece, Robin Lindley interviews renowned psychiatrist and historian of psychiatry Dr. Edward Shorter, who talks about his new book How Everyone Became Depressed: The Rise and Fall of the Nervous Breakdown (Oxford University Press):

Every year, more and more Americans are treated for complaints of depression and often do not derive relief from treatment for their symptoms that may include anxiety, fatigue, poor sleep, and physical problems.

According to acclaimed historian of psychiatry, Dr. Edward Shorter, the diagnosis of depression has increased steadily over the past forty years and, during our lifetimes, “one American in five will receive a diagnosis of depression.” That’s more than sixty million people.

To read the entire article, click here.

New issue – History of the Human Sciences

The July 2013 issue of History of the Human Sciences is now online and contains the following articles:

How autism became autism: The radical transformation of a central concept of child development in Britain (Bonnie Evans)

This article argues that the meaning of the word ‘autism’ experienced a radical shift in the early 1960s in Britain which was contemporaneous with a growth in epidemiological and statistical studies in child psychiatry. The first part of the article explores how ‘autism’ was used as a category to describe hallucinations and unconscious fantasy life in infants through the work of significant child psychologists and psychoanalysts such as Jean Piaget, Lauretta Bender, Leo Kanner and Elwyn James Anthony. Theories of autism were then associated both with schizophrenia in adults and with psychoanalytic styles of reasoning. The closure of institutions for ‘mental defectives’ and the growth in speech therapy services in the 1960s and 1970s encouraged new models for understanding autism in infants and children. The second half of the article explores how researchers such as Victor Lotter and Michael Rutter used the category of autism to reconceptualize psychological development in infants and children via epidemiological studies. These historical changes have influenced the form and function of later research into autism and related conditions.

‘I am a philosopher of the particular case’: An interview with the 2009 Holberg prizewinner Ian Hacking (Ole Jacob Madsen, Johannes Servan, and Simen Andersen Øyen)

When Ian Hacking won the Holberg International Memorial Prize 2009 his candidature was said to strengthen the legitimacy of the prize after years of controversy. Ole Jacob Madsen, Johannes Servan and Simen Andersen Øyen have talked to Ian Hacking about current questions in the philosophy and history of science.

Adam Smith’s economic and ethical consideration of animals (Nathaniel Wolloch)

This article examines Adam Smith’s views on animals, centering on the singularity of his economic perspective in the context of the general early ethical debate about animals. Particular emphasis is placed on his discussions of animals as property. The article highlights the tension between Smith’s moral sensitivity to animal suffering on the one hand, and his emphasis on the constitutive role that the utilization of animals played in the progress of civilization on the other. This tension is depicted as a precursor of problematic aspects of the modern environmental crisis.

The question-and-answer logic of historical context (Christopher Fear)

Quentin Skinner has enduringly insisted that a past text cannot be ‘understood’ without the reader knowing something about its historical and linguistic context. But since the 1970s he has been attacked on this central point of all his work by authors maintaining that the text itself is the fundamental guide to the author’s intention, and that a separate study of the context cannot tell the historian anything that the text itself could not. Mark Bevir has spent much of the last 20 years repeating a similar counter-argument. Although ‘study the linguistic context’ might be a useful heuristic maxim, Bevir says, it does not express a necessary or sufficient condition for understanding. But Skinner is right, and one of the figures he has consistently identified as a formative inspiration, R. G. Collingwood, has already (in his work of the 1930s) shown why. What Collingwood calls his ‘logic of question and answer’ explains why the historian cannot answer his characteristic ‘intention’ question about past texts without knowing the context of problems to which authors think they are offering solutions. The study of context is neither ‘prior’ (as Bevir incorrectly supposes) nor ‘separate’ (as Skinner inaccurately says), but it is, as Skinner maintains, nevertheless impossible to grasp an author’s intention without it. This ‘logic of question and answer’ also explains why, in history, dismissing the study of context is in fact a pre-judgement of evidence yet unseen.

Moralizing biology: The appeal and limits of the new compassionate view of nature (Maurizio Meloni)

In recent years, a proliferation of books about empathy, cooperation and pro-social behaviours (Brooks, 2011a) has significantly influenced the discourse of the life-sciences and reversed consolidated views of nature as a place only for competition and aggression. In this article I describe the recent contribution of three disciplines – moral psychology (Jonathan Haidt), primatology (Frans de Waal) and the neuroscience of morality – to the present transformation of biology and evolution into direct sources of moral phenomena, a process here named the ‘moralization of biology’. I conclude by addressing the ambivalent status of this constellation of authors, for whom today ‘morality comes naturally’: I explore both the attractiveness of their message, and the problematic epistemological assumptions of their research programmes in the light of new discoveries in developmental and molecular biology.

This issue also contains reviews of the books The Dawn of Critical Neuroscience and Futurist: Noise, Visual Arts and the Occult.

For more information, click here.

Yale University working group in history of psychiatry 2013-4

Dear Colleagues,

I coordinate a working group in the history of psychiatry at Yale University, and starting academic year 2013-2014, we’d be interested in hosting junior scholars to workshop their work amongst the group members (post docs, junior faculty, grad students, medical students and physicians). We have a modest budget that won’t enable us to fly anyone in, but if someone is in the Northeast area for other reasons, we could pay for a few expenses and host the speaker.
If you’d be interested in sharing your work-in-progress this academic year, please email me at!
Looking forward to hearing from you,

Mical Raz, MD, PhD
Resident, PGY-1, Dept of Internal Medicine
and Section of the History of Medicine
Yale School of Medicine
P.O. Box 208015
New Haven, CT 06520-8015

CFP Geschichte(n) von Gesundheit und Krankheit: Gesellschaft und Psychiatrie in Österreich 1945-1970 – Krems 06/14

small_logoVerein für Sozialgeschichte der Medizin;

Sektion Ethik und Geschichte der Österreichischen Gesellschaft für Psychiatrie und Psychotherapie

19.06.2014-21.06.2014, Krems

Deadline: 31.08.2013


Die Jahrestagung 2014 des österreichischen Vereins für Sozialgeschichte der Medizin (VSGM) ist dem Thema “Gesellschaft und Psychiatrie in Österreich 1945-1970” gewidmet und wird von diesem in Kooperation mit der Sektion Ethik und Geschichte der Österreichischen Gesellschaft für Psychiatrie und Psychotherapie (ÖGPP) veranstaltet: Die ersten Jahrzehnte nach dem Zweiten Weltkrieg rückten in den vergangenen Jahren verstärkt in den Fokus sozial-, kultur- und wissenschaftshistorischer Forschung. Für den Bereich der Medizin insgesamt und der Psychiatrie im Besonderen, liegen zu dieser geschichtlichen Phase – zumal für Österreich – aber noch wenige Forschungsarbeiten vor, trotz ihrer erheblichen Bedeutung in mehrerlei Hinsicht: So fand eine erste – vornehmlich politische und juristische – Auseinandersetzung mit dem Nationalsozialismus statt. Diese tangierte angesichts der von nationalsozialistisch orientierten Psychiatern legitimierten und organisierten “Euthanasie”-Verbrechen das psychiatrische Feld in ganz besonderem Maße. Vertreibung, Flucht bzw. Tod zahlreicher österreichischer Ärzte während NS-Herrschaft und Zweitem Weltkrieg hatten die psychiatrische und psychotherapeutische ‘community’ in Österreich massiv dezimiert. Verurteilungen und Berufsverbote, aber auch Suizide von belasteten Psychiatern dünnten die Personaldecke weiter aus, während sich die Anzahl der Rückkehrer in überschaubaren Grenzen hielt. Im Verlauf der 1950er und 1960er Jahre kam es zur beruflichen Re-Etablierung ehemaliger Nationalsozialisten. Zugleich waren Psychiater mit anderen – bzw. ohne – politischen Positionierungen weiterhin oder erneut ärztlich tätig, auch begann eine jüngere Generationen von ‘Neueinsteigern’ unterschiedlicher Orientierung ihre berufliche Laufbahn. Eine analoge Situation einer – oftmals prekären – Koexistenz von Kontinuitäten und Diskontinuitäten ist auch für den – gerade für den Patientenalltag sehr wichtigen – Bereich der psychiatrischen Pflege zu konstatieren.

In dieser höchst spannungsreichen Phase nach Bürgerkrieg, NS-Diktatur und Weltkrieg erfuhr die österreichische Psychiatrie aber auch Neuerungen und bedeutenden Weichenstellungen – als Wissenschaft wie als Institutionengeflecht und medizinisches Handlungssystem -, durch Übernahmen von ausländischen Innovationen, aber auch durch eigenständige Weiterentwicklungen. In den 1950er und 60er Jahren sind auch in Österreich neben Fortschritten in der (neuro-) psychiatrischen Grundlagenforschung, der praktischen Einführung neuer psychopharmakologischer Behandlungsmethoden bedeutsame Ausbauschritte im Bereich psycho- und soziotherapeutischer Angebote zu verzeichnen. Dies gilt sowohl für die Universitätskliniken und die traditionellen psychiatrischen Großanstalten (“Landessonderkrankenhäuser” u.ä.), wie auch für den allmählich an Bedeutung gewinnenden niedergelassenen und extramuralen Bereich. Größere Reforminitiativen blieben im hier zu betrachtenden Zeitraum in Österreich – im Gegensatz zu manchen anderen europäischen Staaten – freilich noch aus.

Die Zeit nach 1945 war somit von erheblichen Umbrüchen gekennzeichnet,denen aber auch beträchtliche Kontinuitäten gegenüberstehen – personelle wie ideologische.

Dieser durchaus komplexen Phase der österreichischen Psychiatriegeschichte wird sich die kommende Tagung unter konsequenter Bezugnahme auf relevante gesellschaftliche, politische, ökonomische und kulturelle Prozesse zuwenden. Alle einschlägig Forschenden aus dem In- und Ausland – aus welchen Disziplinen auch immer, ausdrücklich auch DoktorandInnen – sind hiermit eingeladen, bis 31.08.2013 Vorschläge für Vorträge in Form von abstracts im Umfang von einer Seite an das Organisationsteam einzureichen.


Wir ersuchen um Zusendungen per Email an:

PD Dr. Carlos Watzka, Institut für Soziologie, Karl Franzens Universität Graz, Universitätsstrasse 15/G4, 8010 Graz;



Insgesamt sind 15-20 Vorträge an drei Konferenztagen vorgesehen. Das vorläufige Tagungsprogramm wird im Herbst 2013 ausgesandt. Es ist vorgesehen, dass alle geeigneten Tagungsbeiträge im Anschluss in überarbeiteter Fassung in der (peer-reviewten) Zeitschrift “Virus” des Vereins für Sozialgeschichte der Medizin publiziert werden. Die Tagung wird voraussichtlich in Kooperation mit der gerade in Gründung befindlichen Karl Landsteiner Universität für Gesundheitswissenschaften stattfinden. Tagungssprachen sind Deutsch und Englisch. Die (auch für ReferentInnen fällige) Tagungsgebühr wird 50 Euro betragen und deckt Kosten für Kaffeepausen und Getränke während der Konferenz ab. Reise- und Aufenthaltskosten können nur in Ausnahmefällen (bes. bei ‘NachwuchswissenschafterInnen’) teilweise übernommen werden.


Das Vorbereitungskomitee:

Gerhard Baader, Elisabeth Dietrich-Daum, Carlos Watzka für den Verein für Sozialgeschichte der Medizin

Eberhard Gabriel, Hartmann Hinterhuber, Theodor Meiszel für die Sektion Geschichte und Ethik der Österreichischen Gesellschaft für Psychiatrie und Psychotherapie

Buchankündigung: Qu’est-ce que le DSM ? Genèse et transformations de la bible américaine de la psychiatrie (Steeves Demazeux)

41FIcmmrbwL._Die umstrittene 5. Auflage des amerikanischen Diagnostic and Statistical Manual of Mental Disorders, kurz DSM-5 erschien im Mai diesen Jahres, die Monographie von Steeves Demazeux fast zeitgleich schon im April 2013. Das ist kein Zufall, denn der französische Wissenschafts-philosoph beschäftigt sich in Qu’est-ce que le DSM? mit der Entstehung und Entwicklung des DSM.

Eine vom Psychiater und Psychoanalytiker Christian Colbeaux verfasste Buchbesprechung ist auf seinem Blog zu finden.

Der Autor selbst stellt sein Buch per Video auf youtube vor.

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