This blog follows the history of psychiatry

The March 2016 issue of History of Psychiatry is now online. It contains a number of articles and a classic text, all outlined below, as well as an Obituary for Professor John Forrester.

“Psychogeriatrics in England in the 1950s: greater knowledge with little impact on provision of services” (Claire Hilton)

In the 1950s, the population aged over 65 years continued to increase, and older people occupied mental hospital beds disproportionately. A few psychiatrists and geriatricians demonstrated what could be done to improve the wellbeing of mentally unwell older people, who were usually labelled as having irreversible ‘senile dementia’. Martin Roth demonstrated that ‘senile dementia’ comprised five different disorders, some of which were reversible. These findings challenged established teaching and were doubted by colleagues. Despite diagnostic improvements and therapeutic successes, clinical practice changed little. Official reports highlighted the needs, but government commitment to increase and improve services did not materialize.

“The nature of delusion: psychologically explicable? psychologically inexplicable? philosophically explicable? Part 2” (J Cutting and M Musalek)

The first part of this article dealt with the extant formulations of delusion, psychiatric and psychological, suggestions which, respectively, regard delusion as psychologically inexplicable or explicable. All this was subjected to critique. This second part puts forward informed philosophical thesis whereby delusion can be explained within the philosophical movement known as phenomenology and, in particular, Max Scheler’s version of this.

Psychiatric governance, völkisch corporatism, and the German Research Institute of Psychiatry in Munich (1912–26). Part 1 (Eric J Engstrom, Wolfgang Burgmair, and Matthias M Weber)

This is the first of two articles exploring in depth some of the early organizational strategies that were marshalled in efforts to found and develop the German Research Institute of Psychiatry (Deutsche Forschungsanstalt für Psychiatrie) in 1917. After briefly discussing plans for a German research institute before World War I, the article examines the political strategies and networks that Emil Kraepelin used to recruit support for the institute. It argues that his efforts at psychiatric governance can best be understood as a form of völkisch corporatism which sought to mobilize and coordinate a group of players in the service of higher biopolitical and hygienic ends. The article examines the wartime arguments used to justify the institute, the list of protagonists actively engaged in recruiting financial and political support, the various social, scientific and political networks that they exploited, and the local contingencies that had to be negotiated in order to found the research institute.

Psychiatric care at a national mental institution during the Spanish Civil War (1936–39): Santa Isabel de Leganés (Paloma Vázquez de la Torre and Olga Villasante)

The scanty research available regarding the health of the mentally ill during the Spanish Civil War is largely due to the loss of most documents, and to the difficulty in accessing the existing archives for decades. Up to the present time, historiography has described overcrowded facilities for the mentally disturbed and the fact that old buildings such as convents and spas were turned into establishments for treating patients with mental problems during the Civil War. However, research reviewing the institutional life and conditions of psychiatric patients during this war is still rather scarce.

The aim of our article is to discuss the characteristics of the patients at Santa Isabel National Mental Asylum between 1936 and 1939, as well as the functioning of this institution located in Leganés, a city to the south of Madrid (Spain). The method for this study includes a review of the medical records, statistical registers and other documents kept in the institution’s Historical Archive. In addition, using documents from other Spanish archives, as well as information obtained from contemporary and secondary sources, we attempt to describe similarities to and differences from other mental institutions.

Pavel Ivanovich Karpov (1873–1932?) – the Russian Prinzhorn: art of the insane in Russia (Vladimir Lerner, Grigory Podolsky, and Eliezer Witztum)

The complicated relationship between the discipline of mental health and the arts has barely been studied systematically. Mental hospitals, shelters and prisons – institutions that accommodate the mentally ill – sometimes promote but often discourage and disrupt the patients’ artistic creativity and the images created. In psychiatric circles, the recognition of patient art was a long, slow and frustrating process. Among the Western psychiatrists who studied the creative activity of the mentally ill, researchers usually mention such names as C. Lombroso, M. Shearing, V. Morgentaller, H. Prinzhorn and others, but rarely refer to their Russian colleagues and contemporaries. Pavel Ivanovich Karpov (1873–1932?), a Russian psychiatrist, was one of the most extensive researchers in the field of the art of the insane, but unfortunately his name is little known among modern psychiatrists. For his clinical and scientific contributions, he deserves to be remembered in the history of psychiatry.

Bipolar disorder and its outcomes: two cohorts, 1875–1924 and 1994–2007, compared (Onome V Atigari, Margaret Harris, Joanna Le Noury, and David Healy)

We compared admission rates and outcomes for bipolar disorder patients using the medical records of patients with a first hospital admission in 1875–1924 retrospectively diagnosed based on International Classification of Diseases (ICD)-10 criteria, and patients with a first admission in 1994–2007. The incidences of first admissions in the historical and contemporary periods are comparable: 1.2 and 1.3 per hundred thousand per year, respectively. Manic episodes constituted a greater proportion of admissions historically, while depressive episodes made up more in the contemporary sample. There is no evidence for a reduction in the mean inter-admission intervals with duration of illness. This study suggests that modern treatments may have decreased lengths of stay in hospital, but at a cost of contributing to more admissions. It also points to a shift in the threshold for admissions.

CLASSIC TEXT: ‘Report of the Committee on Mediumistic Phenomena’, by William James (1886): With an introduction by Carlos Alvarado

Mediumship was a topic of great interest to some nineteenth-century students of mental phenomena. Together with the phenomena of hypnosis and other manifestations, mediumship was seen by many as a dissociative phenomenon. The purpose of this Classic Text is to present an excerpt of an article about the topic that William James (1842–1910) published in 1886 in the Proceedings of the American Society for Psychical Research about American medium Leonora E. Piper (1857–1950). The article, an indication of late nineteenth-century interactions between dissociation studies and psychical research, was the first report of research with Mrs Piper, a widely investigated medium of great importance for the development of mediumship studies. In addition to studying the case as a dissociative experience, James explored the possibility that Piper’s mentation contained verifiable information suggestive of ‘supernormal’ knowledge. Consequently, James provides an example of a topic neglected in historical studies, the ideas of those who combined conventional dissociation studies with psychical research.

The issue also contains a number of book reviews and the John Forrester obituary.

To access it, click here.