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PubMed1985

Yuta (shaman) and community mental health on Okinawa.

This study reports on the relations between the yuta (shaman) and the community mental health activities on Okinawa, Japan. Focus is on the process of initiation of the yuta and its meanings from the mental health viewpoints, the functions of the yuta in the particular cultural background of the island, and the importance of admitting the existence of the yuta in its relations to the psychiatric treatment in a mental hospital. The discussion is based on the authors' research findings which were obtained mostly through their therapeutic activities and their field studies. The authors' assumption is that each culture has in it a certain social background that is unique in that culture by which a stress or insanity is increased or brought about, but in the same culture there are ways to decrease the stress and to cure the insanity.

Cultural Characteristics↗

PubMed1998

An analysis of a recent criminal trial involving sexual misconduct with a child, alcohol abuse and a successful sleepwalking defence: arguments supporting two proposed new forensic categories.

The final judgment from a recent criminal trial in the British Columbia (Canada) Supreme Court is summarized and discussed. The trial involved sexual misconduct with a child, excessive alcohol use, and a successful 'sleepwalking (SW) defence' (non-insane automatism). Our comments on this trial provide an opportunity to present our arguments buttressing two newly proposed forensic categories: (i) parasomnia with continuing danger as a non-insane automatism, which originally was proposed for cases involving recurrent, sleep-related violence, but which can also be applied to SW cases involving sleep-related sexual misconduct and alcohol abuse (and other high-risk self-abusive behaviours); (ii) (intermittent) state-dependent continuing danger, an intermediate category within the 'continuing danger' concept, with the core feature being that a person acquitted of a criminal charge on the basis of the 'SW defence' (or some other parasomnia defence), in which the SW episode was provoked by a high-risk behaviour (e.g. alcohol intoxication) should bear full legal culpability for any future episode that was provoked by a recurrence of the high-risk behaviour--provided that the individual had wilfully engaged in that behaviour.

Adult↗

PubMed2002

The British reaction to dementia praecox 1893-1913. Part 1.

Emil Kraepelin introduced the concept of dementia praecox in 1893. The eventual acceptance of the concept brought a degree of clarity and order previously unknown to psychiatric nosology. The pre-Kraepelin era had been dominated by concepts such as mania, melancholia and adolescent insanity. After Kraepelin these ideas were abandoned in favour of the two great concepts of dementia praecox and manic depressive insanity, both of which remain active within modern psychiatry in the form of schizophrenia and bipolar disorder. This two-part study focuses on the early British reaction to Kraepelin's concept, from 1893, when he first introduced it, to 1913 when it gained general recognition. It examines the struggle experienced by the proponents of dementia praecox before the concept's acceptance by most British psychiatrists in 1913. It argues that both clinical/professional and linguistic factors influenced the British response to dementia praecox. Part 1 of this study describes the backdrop to the development of Kraepelin's ideas and examines the response to the concept in the British psychiatric textbooks and journals of the period. Part 2 will explore reaction to the concept in the professional meetings of the period, and will also examine and evaluate the key issues arising from the debate.

Germany↗

PubMed2003

Two registers of madness in Enlightenment Britain. Part 2.

In Part 1 of this essay, I argued that in Augustan and Georgian England it was widely understood that madness could have two more-or-less distinct meanings. "Moral" madness was the subject's own fault, and he/she remained accountable for actions commissioned under its effects. The "morally" mad individual's thoughts and actions were understood to be self-directed; at base, in moral madness, delusional ideas arose in the mind, and by definition remained within the moral province of the individual. By contrast, in "real" madness, the sufferer was the passive recipient of body-based sickness. Correspondingly, he/she was understood to be innocent, but paid for this exculpation of moral accountability by surrendering full personhood. In Part 2, I shall examine various ways in which eighteenth-century Britons approached and assessed insanity's two meanings. I shall then remark on the late eighteenth-century attempt to develop a psychological (i.e., moral) rendering of insanity's characteristics and its treatment.

History, 18th Century↗

PubMed2006

Avoiding violence by technologies? Rectal feeding in German psychiatry, c. 1860-85.

During the nineteenth century, the use of the stomach tube became the preferred method to treat the insane refusing to eat. But it was not unusual for this practice to result in violence and serious injuries. Especially around 1860, when the discussion of non-restraint in German psychiatry reached its climax, other methods of dealing with sitophobia became the focus of interest. In particular, two psychiatrists who ran a private asylum in Endenich near Bonn, Franz Richarz and Bernhard Oebeke, recommended rectal feeding as a means of avoiding violence and injury. This paper deals with this method and also outlines the different 'technologies' used to treat 'abstinent' insane patients.

Enteral Nutrition↗

PubMed1996

The dichotomies: psychosis/neurosis and functional/organic: a historical perspective.

Psychosis and neurosis have formed one of the crucial dichotomies in psychiatric classification. This has not always been the case, and indeed the distinction is again being blurred (Cooper 1989). This article will show how the dichotomy arose and how it was strengthened during the first fifty years after the introduction of the term psychosis. The relationship between psychosis and neurosis has not been examined historically, except briefly by Berrios (1987). Lopez Piñero (1983) has dealt with the origins of the concept of neurosis, but his study does not address later issues. The term psychosis was coined in 1845 (Feuchtersleben 1845) to denote 'mental disorder which affected the personality as a whole' and was a subcategory of the then much wider category of the neuroses. The latter were described by Cullen (1784) in the late eighteenth century to denote all the diseases of the nerves and muscles. In 1800, therefore, the neuroses were seen as diseases with a physical cause. The insanities, by contrast, were viewed as diseases of the mind and not generally of physical origin. By about 1900 this situation had been reversed. Most psychiatrists believed that the insanities were of organic aetiology, while the neuroses were of psychological origin, although at that time some psychiatrists and neurologists still believed that the neuroses were caused by organic changes, albeit ones which were not detectable by currently available means, and ones which were therefore referred to as 'functional disorders'. The historical contrast between the so-called functional and the organic disorders will be addressed in this article, as will its relationship to historical and contemporary issues regarding the psychosis-neurosis dichotomy.

History, 18th Century↗

PubMed2005

Pinel in the Maghreb: liberation, confinement, and psychiatric reform in French North Africa.

For early twentieth century French psychiatrists, the colonies of Algeria, Tunisia, and Morocco appeared as crucial sites for innovation. Citing Pinel's liberation of the insane during the French Revolution as a precedent, colonial psychiatrists preached of their capacity to advance France's "civilizing mission" by delivering the insane from their suffering. Yet colonial renovation programs also drew them to scrutinize the failings of their own common practices. Psychiatrists saw their field in a state of crisis, marked by overcrowded asylums and outdated therapeutic concepts. Attempts to modernize colonial terrains thus also aimed at re creating a discipline that had fallen into decline.

Algeria↗

PubMed1999

Flight into sanity. Jones's allegation of Ferenczi's mental deterioration reconsidered.

In 'The Life and Work of Sigmund Freud', Volume III, Ernest Jones explained Ferenczi's final contributions as the product of a mental deterioration based on a progressive psychosis. Erich Fromm collected various testimonies by witnesses of Ferenczi's last years, all contrasting with Jones's assertions, and challenged Jones's manner of writing history. However, since Fromm was himself a dissident, and his witnesses were pupils, relatives or friends of Ferenczi's, they were discarded as 'partisans'. The present study aims at reconsidering the question of Ferenczi's insanity on the basis of many unpublished documents. The consulted documents do not support Jones's allegation of Ferenczi's insanity. At the same time, they show that Jones's allegation was not a one-man fabrication, but reflected a shared belief, eliciting many questions about the nature of this belief, the lack of scrutiny that characterised its spreading, and its possible function within the psychoanalytic community. It is suggested that Ferenczi's personality and teaching, especially his emphasis on the need to accept the patient's criticism, contrasted with the dominant conception of psychoanalysis, based on the analyst's infallibility.

Austria↗

PubMed2003

Reconsidering the classification of schizophrenia and manic depressive illness--a critical analysis and new conceptual model.

The idea of 'disease entity' in psychiatry and the nosologic map of insanity with the distinction between dementia praecox (schizophrenia since Bleuler 1911) and manic depressive insanity, originally developed by Emil Kraepelin (1986), is an important landmark in the history of psychiatry (Jablensky 1995). This classification, however, has been vigorously debated throughout the years, and new evidence emerging from epidemiological, clinical, genetic and biological research demonstrates that the two nosological categories have distinct features as well as share many similarities in their risk factors, genetic predisposition, brain pathology, neurophysiology, clinical phenomenology and response to treatment, thus raising questions about the validity of the categorical classification of psychoses. In this paper we examine some of the similarities and differences between schizophrenia and bipolar illness emerging from recent biological and clinical research and attempt to clarify major inherent logical contradictions in the application of the 'disease' model of psychiatric diagnosis to the categorical classification of schizophrenia and bipolar illness. Then we examine how similar predicaments have been resolved in other natural classification systems, namely the biological classification of species and the periodic table of the elements. Finally we propose a hypothetical conceptual approach to the classification of psychoses that has been greatly informed by the organizing principle underlying the periodic table of the elements, and is distinct from the 'disease' model of psychiatric classification.

Bipolar Disorder↗

PubMed1998

The ethics of farming-out: ideology, the state, and the asylum in nineteenth-century Quebec.

This article traces the development of the farming-out system of asylum provision which emerged in Quebec for the treatment and care of those who were considered to be insane. The kind of asylum provision that developed in Quebec was met with strong criticism by alienists elsewhere in Ontario, Britain and the United States who considered farming-out to be highly unethical. These criticisms were not lost on the state which tried to exercise increased control over the daily affairs of the asylum. But for much of the nineteenth century the state largely failed in these efforts. The community response to the rise of the farming-out system further complicated the role of the state in the management and control of insanity. I argue that the farming-out system is best considered as the product of complex relations between the state officials, alienists, and community members. This understanding of asylum development in Quebec has important implications for the study of the nineteenth-century state formation.

Canada↗

PubMed1981

Eleanor Clarke Slagle Lectureship--1981. Occupational therapy revisited: a paraphrastic journey.

Occupational Therapy's roots are in the subsoil of the moral movement developed in Europe during the Age of Enlightenment. Philippe Pinel, a French philosopher-physician, and William Tuke, an English merchant-philanthropist, developed the principles and applied them to the insane in institutions. Moral treatment came to the United States as part of the Quaker's religious and intellectual luggage. It expanded rapidly in private, as well as in public, institutions for the insane. During the last quarter of the 19th century moral treatment disappeared. It re-emerged in the early decades of the 20th century as Occupational Therapy. A diverse group of women and men developed principles and definitions and founded an organization to support the practice of the re-titled moral treatment and management. Susan Tracy, a nurse; George Barton, an architect; William Rush Dunton, Jr., a physician; Eleanor Clarke Slagle, a partially trained social worker also trained in invalid occupations; and Adolf Meyer, another physician, figure prominently in the development of this century's Occupational Therapy. A second generation of occupational therapists elaborated upon, codified, and applied the founders' principles. Their efforts through one individual: Beatrice D. Wade, OTR, FAOTA. Lessons from 200 years of development of moral treatment and occupational therapy are cited.

Adult↗

PubMed1975

[Lope de Vegas comedy "Los locos de Valencia" a view of a 16th century psychiatric institution].

With the comedy "Los locos de Valencia" (The Insane of Valencia) Lope de Vega left us valuable evidence of the nursing of the insane in the 16th century. After a summarizing presentation of the intricate plot of the play the manifold details about admission, general treatment of the mentally ill as well as the habits in the oldest psychiatric institution of the world are communicated and analysed by means of citations form comedy. Furthermore, an attempt is being made to demonstrate the nosolgic understanding of the Humanist and non-physician Lope de Vega for the psychiatric conditions and way of living from the same source.

History, 16th Century↗

PubMed2000

[The establishment of the "dollhouse" at Oslo hospital].

The "Dollhouse" at Oslo Hospital was established in 1778 in a municipal institution built in 1538 to serve poor people that had become struck by illness. A medical doctor cared for the insane inmates' somatic ailments and a priest for the needs of the soul. However, from the beginning of the nineteenth century the medical view came to dominate. The first Norwegian law concerning "The Treatment and Care of the Insane" was approved in 1848, co-authored by the first medical superintendent at Oslo Hospital, Herman Wedel Major, the first institutional psychiatrist in Norway. The Oslo Hospital is still in operation, now for both sexes as part of the community-run psychiatric services in Oslo.

Community Mental Health Services↗

PubMed1997

[Not Available].

This paper is concerned with an important and original chapter in the history of experimental psychology in Italy, at the end of the nineteenth century. The first growth of the new science was connected with the possibility of using the methods of experimental psychology to study insanity problems. The limits of anatomical investigations were overcome by neurophysiological researches, but also by studies on reaction time. The measurement of time taken by a given mental operation showed the importance of attention in every mental act. These experiments, carried out on lunatics, showed considerable fluctuations of reaction time, an indication of the diminished power of attention. Great variations were due to different forms of mental disease, which could be better known thanks to this study. The first laboratory of experimental psychology in Italy was established in the Psychiatric Institute of Reggio Emilia, and Gabriele Buccola, a young psychiatrist, was the first to make use of lunatics to study the problems of normal psychology. An exact description of his psychometric researches, which used recent scientific instruments like Hipp's chronoscope, made it possible to verify the validity of the most important psychological laws and to go deep into the study of mental disease. In this way many problems-like the distinction between illusions and hallucinations, the existence of fixed ideas or particular maniacal forms-could be considered from a different point of view. Through the description of the Buccola's work, this paper aims to assess the relationship between experimental psychology and psychiatry: if the study of mental pathology has given rise to the growth of psychological researches, a new explanatory model has made it possible to overcome the conflicts between medico-organic and psychic approach in insanity studies.

Academies and Institutes↗

PubMed1999

[Not Available].

The author describes the beginning and the development of accommodation and care of psychiatric patients in the canton of Graubunden, Switzerland, in the 19th century. There were several precursors of lunatic asyla, repeated counts of the insane people and various projects of psychiatric hospitals who were rejected in case of a financial shortage. Connected with a considerable gift and a lot of donations for the funds of the canton and the charity for poor mentally ill people, the psychiatric hospital Waldhaus was opened in Chur (capital of the canton of Graubunden) in 1892. Additional remarks are made in the 20th century concerning the extension of the hospital capacity and the foundation of the second psychiatric care unit in Realta in 1919, and further to early psychiatric treatments and some case reports. The cantonal statistics of the insane people are analyzed and compared. The most important personalities regarding the matter of lunatics are portrayed shortly. The appendix contains the most interesting historical documents in orginal version.

History, 19th Century↗

PubMedDate not supplied

[The mental patient and the psychiatric institution: the voice of the silenced].

A systematized observation of human behavior towards madness induced personal questions on what mental patients had to say about their own life dynamics. The perspective of these people, regarding the concept of insanity, is the subject of this study. This descriptive and qualitative investigation has two objectives. The first is the description of the speech of mental patients in relation to insanity. The second objective is the analysis of their perception of the psychiatric process. Results obtained through semi-structured interviews showed that the great majority of the patients do not consider themselves mentally ill. They approach madness as stereotypy, aggressiveness, mendicancy and absence of reasoning. Although they admitted being different, they did not consider themselves mentally ill.

Humans↗

PubMed1957

Mental health; a discussion of various program approaches used in California and the basic assumptions involved.

The nation's Number One health problem, mental illness, compels careful reevaluation of past and current methods of attack. It also invites consideration of the ways and means of integrating preventive measures that emphasize the conservation of mental health with prophylactic efforts that stress the avoidance of mental illnesses.A REVIEW OF THE DEVELOPMENT OF BOTH LOCAL AND STATEWIDE MENTAL HEALTH PROGRAMS IN CALIFORNIA REVEALS THAT THREE FUNDAMENTALLY DIFFERENT APPROACHES HAVE BEEN USED: (1) The traditional approach which confines itself to the protection of society from the "insane" by the state, and to the treatment of those who are not legally insane through "private enterprise"; (2) the public health approach which seeks to minimize the causes and/or spread of selected types of psychiatric disorder regarded as mass phenomena; and (3) the sociological approach which stresses the importance of social factors both in the causation and in the rehabilitation of those mental conditions that are considered to be symptomatic of a "sick" society. An approach that combines the theoretical and practical implications of all three viewpoints offers some new solutions to the problems of (1) fitting mental health programs to populations; (2) financing; and (3) balancing preventive and clinical services. Mental illness is not a single disease-entity but a long list of distinctly different conditions. The causes and manifestations are multiple. Biological, psychological and social components in either mental health or mental illness cannot be dissociated in any attempt to understand and deal with so wide a range of illnesses and states of comparative health. Therefore, many professions and multiple public and private agencies are involved in planning, developing and administering a mental health program.

California↗

PubMed2004

[The insigne and suntuoso Royal Hospital of Granada (II). Officers and servants in a general hospital (1526-1535)].

After the merging of the two hospitals founded by the Catholic Kings, the Royal Council of Granada extended the centralisation of medical care by incorporating the municipal House of the Insane in the process. The new Royal Hospital, re-founded as a general hospital, offered alms (bread), gave medical and spiritual care to patients with pox and looked after the insane. This was done using officers from the old Alhambra hospital, who found an opportune salvation in the new buildings. Their administrators directed an institution that was highly committed to the dynamics of patronage and client subordination.

Charities↗