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Historical origins of schizophrenia: Two early madmen and their illness

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Abstract

Schizophrenia is a serious mental illness with a remarkably short recorded history. Unlike depression and mania, which are recognizable in ancient texts, schizophrenia-like disorder appeared rather suddenly in the psychiatric literature of the early nineteenth century. This could mean that the illness is a recent disease that was largely unknown in earlier times. But perhaps schizophrenia existed, embedded and disguised within more general concepts of madness and within the arcane languages and cultures of remote times. Both possibilities present major challenges to historical and psychiatric scholarship. These challenges are explored in this paper by presenting two "new" cases of schizophrenia, one from the eighteenth and one from the fourteenth century. The cases suggest that the illness may have existed as early as the medieval period. However, establishing the population prevalence of schizophrenia in earlier times--and therefore resolving the permanence-recency debate--may not be a feasible enterprise.

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... The trend for labelling human experience with psychiatric diagnoses has been a remarkable characteristic of modern culture since the nineteenth century (Akerknecht, 1943). Ancient texts have been investigated from various perspectives in search of descriptions readily assimilated to schizophrenia (Bark, 1988;Ellard, 1987;Evans, McGrath and Milns, 2003;Freud-Loewenstein, 2004;Hare, 2002;Heinrichs, 2003;Jeste, del Carmen, Lohr and Wyatt, 1985;Simon, 1978;Vakili and Gorji, 2006;Youssef and Youssef, 1996). Some authors maintain that ancient texts contain examples of schizophrenialike descriptions (Bark, 1988;Haldipur, 1984;Jeste et al., 1985; Otsuka and and DSM-IV diagnostic criteria are based on lists of specific symptoms (splitting approach), both classifi cations use a lumping approach to introduce the definition of schizophrenia. ...
... Dilip V. Jeste et al. (1985) proposed that several factors may contribute to a false perception of lack of schizophrenic cases in ancient times, for example: recent origin of syndrome-based approaches to illness, lack of interest in chronic incurable conditions in antiquity, considering mental symptoms as the domain of religion rather than medicine, confusing terminology to describe symptoms of mental dysfunction, non-seeking of medical care by mentally ill subjects and their relatives, and a possible change in the clinical manifestation of schizophrenia over the centuries. In fact, studies using a lumping approach have found evidence of schizophrenia-like descriptions in fi rst-century India (Haldipur, 1984), ancient Greece and Rome (Drabkin, 1955;Fabrega, 1990;Jeste et al., 1985), medieval Persia ( Vakili and Gorji, 2006), medieval Europe (Fabrega, 1990;Heinrichs, 2003;Jeste et al., 1985), medieval Islamic society ( Youssef and Youssef, 1996), Shakespeare's tragedies (Andreasen, 1976;Bark, 1985), Cervantes' Don Quijote (Bailón Blancas, 2006;Gracia Guillén, 2005;López Muñoz, Rubio, Álamo and García-García, 2006), seventeenth century England ( Hill and Shepherd, 1976), seventeenth-and eighteenth-century Germany (Heinrichs, 2003;Jeste et al., 1985;Otsuka and Sakai, 2004), seventeenth-and eighteenth-century Mexico (Bartra, 2004), seventeenth-and eighteenth-century New England (Goodheart, 2002;Jimenez, 1986), and progressively worldwide since the nineteenth century (Altschuler, 2001;Berrios, 2002;Crighton, 1996;Jablensky, 1999;Turner, 1992). ...
... Dilip V. Jeste et al. (1985) proposed that several factors may contribute to a false perception of lack of schizophrenic cases in ancient times, for example: recent origin of syndrome-based approaches to illness, lack of interest in chronic incurable conditions in antiquity, considering mental symptoms as the domain of religion rather than medicine, confusing terminology to describe symptoms of mental dysfunction, non-seeking of medical care by mentally ill subjects and their relatives, and a possible change in the clinical manifestation of schizophrenia over the centuries. In fact, studies using a lumping approach have found evidence of schizophrenia-like descriptions in fi rst-century India (Haldipur, 1984), ancient Greece and Rome (Drabkin, 1955;Fabrega, 1990;Jeste et al., 1985), medieval Persia ( Vakili and Gorji, 2006), medieval Europe (Fabrega, 1990;Heinrichs, 2003;Jeste et al., 1985), medieval Islamic society ( Youssef and Youssef, 1996), Shakespeare's tragedies (Andreasen, 1976;Bark, 1985), Cervantes' Don Quijote (Bailón Blancas, 2006;Gracia Guillén, 2005;López Muñoz, Rubio, Álamo and García-García, 2006), seventeenth century England ( Hill and Shepherd, 1976), seventeenth-and eighteenth-century Germany (Heinrichs, 2003;Jeste et al., 1985;Otsuka and Sakai, 2004), seventeenth-and eighteenth-century Mexico (Bartra, 2004), seventeenth-and eighteenth-century New England (Goodheart, 2002;Jimenez, 1986), and progressively worldwide since the nineteenth century (Altschuler, 2001;Berrios, 2002;Crighton, 1996;Jablensky, 1999;Turner, 1992). ...
Article
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Studies concerning the presence of schizophrenia in the distant past are controversial. Some authors maintain that schizophrenia-like illnesses existed in antiquity, while others argue that this is quite doubtful. Imprecise definition of schizophrenia, imposition of the current concept of schizophrenia onto the past, difficulties in interpreting ancient texts describing schizophrenia-like conditions, and cultural variables involved in the clinical definition of schizophrenia underlie these controversies. This article reviews the methodological issues that arise in such retrospective studies of schizophrenia.
... The earliest medical description of schizophrenia symptoms belongs to Haslam and Pinel published in 1809. However, schizophrenia-like syndrome is considered to be rare prior 1800 [3] though the description of uncontrolled behavior and psychosis was common in ancient Greek and Roman. Avicenna described some symptoms of schizophrenia. ...
... His autobiographical work describes his mental disease characterized by mania, self-deprecation, and depression. [3] More recent case of schizophrenia-like disorder was described by German sculptor Franz Xaver Messerschmitt in the 18 th century. During the Messerschmitt life, his thinking was considered as bizarre and implausible, his behavior included social isolation, loss of employment, mania, and depression. ...
... He is famous for the collection of busts called "character heads" with extreme facial expressions that may confirm mental disorder. [3] Rare cases of schizophrenia-related symptoms before 1800 confirm that this mental disease became widespread only beginning from the 19 th century. Possibly, it was caused by the development of particular social conditions affecting human behavior. ...
Article
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Schizophrenia is still one of the most mysterious mental disorders that are characterized by delusions, hallucinations, and impaired social behavior. Symptoms of schizophrenia emerge in adolescence and early adulthood while their description is controlled by conventional criteria. The incidence of the mental disorder varies across cultures and migrant groups. Genetic vulnerability overlaps with environmental factors causing individual symptoms and course. This review article focuses on definitions, symptoms, causes, etiology, epidemiology prognosis, history, mechanisms, diagnostics, pathophysiology, possible treatment, and prevention of schizophrenia.
... The illness is found all over the world and 0.7-0.8% of the population will be diagnosed with schizophrenia some time during their life course 13 . Schizophrenia and schizophrenia-like symptoms have consistently been described in the literature over the last two centuries 14,15 , but many believe that the disease has been present for much longer [16][17][18] . Over these last two centuries, society has undergone great changes with respect to industrialization, migration and urbanization, factors which possibly could affect the occurrence of schizophrenia 19,20 . ...
... An analogy is drawn to Huntington's Chorea, another genetic disease that has survived over evolutionary history because symptoms are not presented until after the patient has finished his or her reproductive period. It is true that we cannot draw conclusions about ancestral fertility in schizophrenia based on modern fertility, especially since schizophrenia itself only has a recorded history dating back to the 1800s 16 . ...
... The history of schizophrenia is obscure possibly due to the heterogeneous nature of the disorder and consequent difficulty in formal classification. Earliest case reports date back to the 1800s [3]. Despite an abundance of research, the pathogenesis and etiology of this often highly disabling disorder remains unclear. ...
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The field of proteomics has made leaps and bounds in the last 10 years particularly in the fields of oncology and cardiovascular medicine. In comparison, neuroproteomics is still playing catch up mainly due to the relative complexity of neurological disorders. Schizophrenia is one such disorder, believed to be the results of multiple factors both genetic and environmental. Affecting over 2 million people in the US alone, it has become a major clinical and public health concern worldwide. This paper gives an update of schizophrenia biomarker research as reviewed by Lakhan in 2006 and gives us a rundown of the progress made during the last two years. Several studies demonstrate the potential of cerebrospinal fluid as a source of neuro-specific biomarkers. Genetic association studies are making headway in identifying candidate genes for schizophrenia. In addition, metabonomics, bioinformatics, and neuroimaging techniques are aiming to complete the picture by filling in knowledge gaps. International cooperation in the form of genomics and protein databases and brain banks is facilitating research efforts. While none of the recent developments described here in qualifies as biomarker discovery, many are likely to be stepping stones towards that goal.
... Another limitation is the risk of presentism that is viewing the past with the lens of present (Heinrichs, 2003). Our present attitudes and concepts dominates one's stance towards past. ...
Conference Paper
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Usually it is proclaimed by the contemporary intellectuals that for the first time momentous sub categorization of depression was made by Robert Burton, impetuously not acknowledging the accomplishments made by the Muslim philosophers of golden era. Here in this study we attempt to divulge the forsaken expositions of Muslim thinkers particularly Zayd Al Balkhi regarding his contributions in depression its types and treatments thus providing us with the framework which is significantly influenced by the Islamic thought. For this purpose numerous articles and books were reviewed and screened before inclusion in study. The analysis of DSM V symptoms of depression, ideas proposed by balkhi and assertions made by contemporary intellectuals evidently state reasonable comparability between them with subtle variances, moreover examination of classifications and treatment modalities suggested by balkhi in light of modern scientific studies favors his approach to be one of the most earliest refined and sophisticated attempt towards categorization and classification of depression as a psychopathology. This work would aid in recognizing the discarded findings of Muslims consequently providing contemporary Muslim psychologists a model that is not subservient to the secularized conceptions.
... Plus intéressant peut-être est le cas d'une femme de 32 ans présentant, en 1737, des manifestations évoquant fortement une schizophrénie paranoïde (Encadré 4). Ce cas, qui répond aux critères diagnostiques de la schizophrénie du DSM-IV-TR [15], plaide en faveur de l'ancienneté de cette pathologie, qui fut longtemps contestée [31,32], et de l'importance des déterminants biologiques dans la pathogenèse de cette maladie, à l'instar des troubles bipolaires et des dépressions majeures aux expressions en grande partie inchangées depuis l'Antiquité [33,34]. Plus généralement, l'analyse historique des cas de maladies confirme l'intérêt de distinguer la souffrance ressentie par le sujet atteint de celle qui est reconnue par la société dans laquelle il vit, et de celle qui est prise en charge par la médecine. ...
Article
Full-text available
History of illnesses and diseases contributes to the study of pathological phenomena, for it provides data on their dynamics, their emergence and spread, and their relationships with the physical and human environment. It also shed light on how states or conditions have been labeled as "diseases", and questions the universality of pathological categories used by medicine. Like cross-cultural studies, research on ancient medical writings allows to identify consistent as well as variable expressions of illnesses ; this may in turn allow to discriminate whether pathogenesis is based mainly on a biological nature or on a socio-cultural nature. We will describe case studies from the eighteenth-century in France to illustrate the usefulness of studying history of illnesses and diseases for contemporary medicine and public health. © 2015 médecine/sciences – Inserm.
... Only in the late 19th century did Emil Kraepelin define 'dementia praecox' more closely, and shortly thereafter, in the early 20th century, Eugen Bleuler introduced the term 'schizophrenia'. Before this introduction, schizophrenic symptoms may have been classed under more general concepts like 'madness' or even just 'insanity' (Bürgy, 2008;Heinrichs, 2003). This makes it difficult to trace the use of therapeutic vestibular stimulation in patients with schizophrenia through time. ...
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Although the discovery and understanding of the function of the vestibular system date back only to the 19th century, strategies that involve vestibular stimulation were used long before to calm, soothe and even cure people. While such stimulation was classically achieved with various motion devices, like Cox’s chair or Hallaran’s swing, the development of caloric and galvanic vestibular stimulation has opened up new possibilities in the 20th century.With the increasing knowledge and recognition of vestibular contributions to various perceptual, motor, cognitive, and emotional processes, vestibular stimulation has been suggested as a powerful and non-invasive treatment for a range of psychiatric, neurological and neurodevelopmental conditions. Yet, the therapeutic interventions were, and still are, often not hypothesis-driven as broader theories remain scarce and underlying neurophysiological mechanisms are often vague. We aim to critically review the literature on vestibular stimulation as a form of therapy in various selected disorders and present its successes, expectations, and drawbacks from a historical perspective.
... Se caracteriza por alteración sostenida de varios aspectos del funcionamiento psíquico del individuo, principalmente de conciencia de la realidad, y una desorganización neuropsicológica más o menos compleja, en especial de las funciones ejecutivas. 8 Estudios citogenéticos y moleculares han permitido conocer un gran número de aberraciones cromosómicas en individuos con esquizofrenia que involucran tanto cromosomas autosómicos como sexuales. 9 Los objetivos de este trabajo estuvieron dirigidos a identificar heteromorfismos en el cromosoma 9 y evaluar la frecuencia de estos, en individuos de la población cubana con esquizofrenia. ...
Article
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The finding of a heteromorfism or chromosomic variant during the cytogenetic study constitute a problem to diagnose and the process of genetic expert advice due to difficulties that can exist to differentiate between a pathogenic alteration and a structural variation without adverse effects in the patients' phenotype. There various authors that associate the heteromorfic variants present in the chromosome 9 with infertility, spontaneous miscarriage and mental disorders specifically the schizophrenia and affective bypolar disorder. The schizophrenia is a mental disorder that affects the world population with a prevalence of 1% and 80% of inheritance. Objective: To identify heteromorfisms in chromosome 9 with a possible association to schizophrenia in individuals of the Cuban population. Methods: A transversal and descriptive study was carried out. The sample had 263 individuals with schizophrenia. Lymphocytes culture technique was used in high resolution to obtain useful metaphases for the study. Results: Twenty individuals with heteromorfism of chromosome 9 were identify, 13 pericentric inversions of the heterochromatic zone inv (9) (p11q13). Seven with an increase in the heterochromatic region (9qh+). Conclusions: The higher frequency of pericentric inversion ((p11q13) in this population and the increase of the heterochromatic region of the chromosome 9 shows its implication as a possible locus of sensitivity for schizophrenia that could be located in one of the implicated rupture points.
... However, his "symptoms" as shown by Roy Porter, are understood in terms of a "psychomachia" between God and Satan typical of the times, more a religious crisis than a proper crisis of the Self (Porter, 1989, Chapter 5; see also Hare, 1988). With regard to the cases proposed by Heinrichs (2003), one from the 18th century and another from the 14th, the first with persecutory and grandiose delusions and hallucinations, is not out of keeping with the origin of schizophrenia at that time, while the "symptoms" of the second are difficult to see as separate from the religious and allegorical conceptions of the preceding Middle Ages. As Jerome Kroll and Bernard Bachrach justifiably argue: "we find that modern attempts to diagnose medieval mystics and ascetics out of context to their environment and disregarding a commitment to God that constituted the urgent and central feature of their lives is an exercise in cultural insensitivity and conceit. ...
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We know a great deal about schizophrenia, but the current state of the art is one of uncertainty. Researchers are confused, and patients feel misunderstood. This situation has been identified as due largely to the fact that the dominant neurobiological perspective leaves out the person. The aim of the present article is to review and integrate a series of clinical, phenomenological, historical, cultural, epidemiological, developmental, epigenetic, and therapeutic phenomena in support of a suggestion that schizophrenia is above all a disorder of the person rather than of the brain. Specifically, we review seven phenomena, beginning with the conception of schizophrenia as a particular disorder of the self. We continue by looking at its recent origin, as a modern phenomenon, its juvenile onset, related to the formation of the self, the better prognosis in developing countries compared to developed countries, and the high incidence of the disorder among migrants. In the context of these phenomena of a marked socio-cultural nature, we consider the so-called “genetic myth,” according to which schizophrenia would have a genetic origin. On reviewing the current genetic emphasis in the light of epigenetics, it emerges that the environment and behavior recover their prominent role in the vicissitudes of development. The seventh reason, which closes the circle of the argument, concerns the role of interpersonal “chemistry” in recovery of the sense of self.
... Their argumentation is twofold. For one thing, they say, there actually do exist a number of historical descriptions of schizophrenia (Jeste et al. 1985; Heinrichs 2003). At the same time, they admit that, for various reasons, these descriptions are rare. ...
Article
Evolutionary psychiatrists invariably consider schizophrenia to be a paradox: how come natural selection has not yet eliminated the infamous ‘genes for schizophrenia’ if the disorder simply crushes the reproductive success of its carriers, if it has been around for thousands of years already, and if it has a uniform prevalence throughout the world? Usually, the answer is that the schizophrenic genotype is subject to some kind of balancing selection: the benefits it confers would then outbalance the obvious damage it does. In this paper, however, I will show that the assumptions underlying such evolutionary accounts of schizophrenia are at least implausible, and sometimes even erroneous. First of all, I will examine some factual assumptions, in particular about schizophrenia’s impact on reproductive success, its genetics, its history, and its epidemiology. Secondly, I will take a critical look at a major philosophical assumption in evolutionary psychiatric explanations of schizophrenia. Indeed, evolutionary psychiatrists take it for granted that schizophrenia is a natural kind, i.e. a bounded and objectively real entity with discrete biological causes. My refutation of this natural kind view suggests that schizophrenia is in fact a reified umbrella concept, covering a heterogeneous group of disorders. Therefore, schizophrenia, as we now know it, simply doesn’t have an evolutionary history.
... However, his " symptoms " as shown by Roy Porter, are understood in terms of a " psychomachia " between God and Satan typical of the times, more a religious crisis than a proper crisis of the Self (Porter, 1989, Chapter 5; see also Hare, 1988). With regard to the cases proposed by Heinrichs (2003), one from the 18th century and another from the 14th, the first with persecutory and grandiose delusions and hallucinations, is not out of keeping with the origin of schizophrenia at that time, while the " symptoms " of the second are difficult to see as separate from the religious and allegorical conceptions of the preceding Middle Ages. As Jerome Kroll and Bernard Bachrach justifiably argue: " we find that modern attempts to diagnose medieval mystics and ascetics out of context to their environment and disregarding a commitment to God that constituted the urgent and central feature of their lives is an exercise in cultural insensitivity and conceit. ...
... However, his "symptoms" as shown by Roy Porter, are understood in terms of a "psychomachia" between God and Satan typical of the times, more a religious crisis than a proper crisis of the Self (Porter, 1989, Chapter 5; see also Hare, 1988). With regard to the cases proposed by Heinrichs (2003), one from the 18th century and another from the 14th, the first with persecutory and grandiose delusions and hallucinations, is not out of keeping with the origin of schizophrenia at that time, while the "symptoms" of the second are difficult to see as separate from the religious and allegorical conceptions of the preceding Middle Ages. As Jerome Kroll and Bernard Bachrach justifiably argue: "we find that modern attempts to diagnose medieval mystics and ascetics out of context to their environment and disregarding a commitment to God that constituted the urgent and central feature of their lives is an exercise in cultural insensitivity and conceit. ...
... Before this introduction, schizophrenic symptoms may have been classed under more general concepts like 'madness' or even just 'insanity' (Bürgy, 2008;Heinrichs, 2003 Harsch, 2006), reports using the rotating bed during acute episodes of 'raving madness'. But again, given the changing understanding of terms and definitions, interpretations are difficult. ...
... social withdrawal, anhedonia). Patients usually present a confused mental state, disruption of social engagement and emotional expression, and lack of motivation (Heinrichs, 2003;Jenkins 2013;Nasyrova et al., 2015). As important regulators of inflammatory response and redox activity, changes in taurine and glutathione (GSH) metabolism are involved in the pathophysiology of schizophrenia (Schuller- Levis and Park, 2003;Haddad and Harb, 2005). ...
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Taurine is a highly abundant "amino acid" in the brain. Despite the potential neuroactive role of taurine in vertebrates has long been recognized, the underlying molecular mechanisms related to its pleiotropic effects in the brain remain poorly understood. Due to the genetic tractability, rich behavioral repertoire, neurochemical conservation, and small size, the zebrafish (Danio rerio) has emerged as a powerful candidate for neuropsychopharmacology investigation and in vivo drug screening. Here, we summarize the main physiological roles of taurine in mammals, including neuromodulation, osmoregulation, membrane stabilization, and antioxidant action. In this context, we also highlight how zebrafish models of brain disorders may present interesting approaches to assess molecular mechanisms underlying positive effects of taurine in the brain. Finally, we outline recent advances in zebrafish drug screening that significantly improve neuropsychiatric translational researches and small molecule screens.
... Schizophrenia was first described as the separation of function between personality, thinking, memory and perception (Bleuler, 1908). Positive (e.g., hallucinations, delusions) and negative symptoms (e.g., social withdrawal, anhedonia) are both present in schizophrenia, as patients usually display a confused mental state, social and emotional disengagement, the loss of motivation, pleasure and interest, as well as hallucinations (Heinrichs, 2003;Jenkins, 2013;Nasyrova et al., 2015). Schizophrenic patients also often have additional comorbidities (e.g., with anxiety spectrum disorders, major depressive illness, or drug abuse) (Buckley et al., 2009;Nasyrova et al., 2015). ...
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Zebrafish (Danio rerio) have become a powerful tool in neuroscience research due to their genetic tractability, molecular/physiological conservation, small body size, ease of experimental manipulations in vivo, and rich behavioral repertoire. Zebrafish models and tests are particularly useful in genetics research, neurophenotyping, CNS drug screening, as well as modeling complex neurological and psychiatric disorders. Here, we discuss selected examples of successful application of zebrafish models to mimicking various aspects of brain pathology, and emphasize their developing utility for studying the underlying molecular and genetic mechanisms. We also summarize recent advances in zebrafish-based CNS disease modeling, and outline new research strategies that may significantly improve translational neuroscience and experimental neurology research, and drug discovery.
... social withdrawal, anhedonia). Patients usually present a confused mental state, disruption of social engagement and emotional expression, and the lack of motivation (Heinrichs, 2003, Jenkins 2013Nasyrova et al., 2015). Modulating inflammatory response and redox activity, changes in taurine and glutathione (GSH) metabolism are involved in the pathophysiology of schizophrenia (Schuller- Levis and Park, 2003;Haddad and Harb, 2005). ...
Article
Taurine is a highly abundant "amino acid" in the brain. Although the potential neuroactive role of taurine in vertebrates has long been recognized, the underlying molecular mechanisms related to its pleiotropic effects in the brain remain poorly understood. Due to the genetic tractability, rich behavioral repertoire, neurochemical conservation, and small size, the zebrafish (Danio rerio) has emerged as a powerful candidate for neuropsychopharmacology investigation and in vivo drug screening. Here, we summarize the main physiological roles of taurine in mammals, including neuromodulation, osmoregulation, membrane stabilization, and antioxidant action. In this context, we also highlight how zebrafish models of brain disorders may present interesting approaches to assess molecular mechanisms underlying positive effects of taurine in the brain. Finally, we outline recent advances in zebrafish drug screening that significantly improve neuropsychiatric translational research and small molecule screens.
... There are those who argue that the use of the term, in 1852, of démence précoce by the French doctor Bénédict Morel was the medical discovery of schizophrenia. However, this consideration does not take into account the fact that there is little data linking Morel's descriptive use of the term and the autonomous development of the concept of the disease called early dementia, which occurred at the end of the 19th century [21][22][23][24][25][26]. Despite the etymology of the term, however, schizophrenia does not in itself imply any "double personality" or "multiple personality disorder", a condition with which it is often mistakenly confused in common language and which is instead present in some dissociative syndromes; rather, the term indicates the "separation of mental functions" typical of the symptomatic presentation of the disease [27]. ...
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The psychotic spectrum is the category that groups together a series of disorders linked to symptomatology in which we witness the fragmentation of the plane of reality until it is completely broken. According to the DSM-V nosography, the disorders under examination are schizophrenia, delusional disorder, paranoid disorder, schizoid disorder, schizotypic disorder, schizoaffective disorder, brief psychotic disorder, psychotic break and catatonia. In this work, theoretical and practical profiles were analysed, paying attention to neurobiological content and therapeutic profiles, both psychotherapeutic and psychopharmacological. A note of disappointment has been made in the nosographic categorisation of dissociative disorders that currently would not be included in the psychotic spectrum disorders, although from the elements that emerged it would be interesting to revise them, precisely because of the clinical nature of the psychopathological category.
... Whatever the nature of the illness, it unquestionably altered Opicinus's state of consciousness, bending it more excitedly toward the mystical. Contemporary investigations recognize elements of the psychotic (Heinrichs, 2003;Laharie & Roux, 1997), borne out of intense suffering (psychic, legal, financial) and conflict (Nuss, 2015) and located at the unstable intersection of art, religion, and madness. ...
... Their argumentation is twofold. For one thing, they say, there actually do exist a number of historical descriptions of schizophrenia [20,25]. At the same time, they admit that, for various reasons , these descriptions are rare. ...
Article
Evolutionary psychiatrists often consider schizophrenia to be an enigma: how come natural selection has not yet eliminated the so-called 'schizophrenia genes' if the disorder is fairly common, heritable and harmful for the reproductive success of its carriers? Usually, the answer is that the schizophrenic genotype is subject to some kind of balancing selection: the benefits it confers would then outbalance the obvious damage it does. However, in this paper I will show that the assumptions underlying such resolution are at least implausible, and sometimes even erroneous. First of all, I will examine some factual assumptions, in particular about schizophrenia's impact on reproductive success, its genetics, its history, and its epidemiology. Secondly, I will take a critical look at a major philosophical assumption in evolutionary psychiatric explanations of schizophrenia. Indeed, evolutionary psychiatrists take it for granted that schizophrenia is a natural kind, i.e. a bounded and objectively real entity with discrete biological causes. My refutation of this natural kind view suggests that schizophrenia is in fact a reified umbrella concept, constructed by psychiatry to cover a heterogeneous group of disorders. Therefore, schizophrenia, as we now know it, simply does not have an evolutionary history.
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In this article, I outline a general framework for the evolutionary analysis of mental disorders based on the concepts of life history theory. I synthesize and extend a large body of work showing that individual differences in life history strategy set the stage for the development of psychopathology. My analysis centers on the novel distinction between fast spectrum and slow spectrum disorders. I describe four main causal pathways from life history strategies to psychopathology, argue that psychopathology can arise at both ends of the fast–slow continuum of life history variation, and provide heuristic criteria for classifying disorders as fast or slow spectrum pathologies. I then apply the fast–slow distinction to a diverse sample of common mental disorders: externalizing disorders, schizophrenia and autism spectrum disorders, obsessive-compulsive disorders, eating disorders, and depression. The framework integrates previously disconnected models of psychopathology within a common frame of reference and has far-reaching implications for the classification of mental disorders.
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Like the guildsmen of old, 19th century Alienists (now psychiatrists) also realized that a pantheon of proceres would be useful to their trade and social standing: by the 1850s, national pantheons had already been constituted and by the early 20th century, a well-populated international Valhalla was in existence. Ever since it has been required that the anniversaries of the pantheonized be dutifully posted (In relation to Bleuler’s anniversaries, see, for example, the note by Fusar-Poli and Politi1 posted in the American Journal of Psychiatry.).This notwithstanding, the rules for pantheonization remain unclear and their enactors shadowy. To do justice to Eugen Bleuler’s place in the pantheon of psychiatry, this obscurity needs some illumination.
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Background: Whether schizophrenia existed before the 19th century is an important issue within the history of psychiatry. Written records or other documents that could identify this psychopathology are extremely rare and must therefore be subjected to meticulous historical and psychopathologic analysis. Methods: A previously unknown heraldic sheet, with accompanying text, was subjected to historical, heraldic, and psychopathologic analysis. The contemporary inscription "by the mad paynter Bayer" was found on the back of the painting. The phenomenologic analysis emphasized the phenomenology of Jaspers for the formal criteria of a psychosis. Results: Many of the characteristics as seen typical psychopathologic of presumably schizophrenic psychoses by some authors can be found in the formal features of the work. Moreover, a precise historic and heraldic investigation (blazon) allowed us to assign this previously anonymous work to an artist of the period around 1720 to 1740, Abraham Beurer, and to find his contemporary portrait. Conclusions: This is one of the earliest works that can be unambiguously assigned to the psychopathology of expression (art brut). The formal features of schizophrenia appear to be remarkably typical, timeless, and stable, although the objective features are strictly historical. The work provides further evidence that there were individual cases of schizophrenia even before the 18th century. The external designation as "mad" provides important additional support for this view.
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Schizophrenia and Alzheimer’s disease are two disorders that, while conceptualized as pathophysiologically and clinically distinct, cause substantial cognitive and behavioral impairment worldwide, and target apparently similar — or nearby — circuitry in regions such as the temporal and frontal lobes. We review the salient differences and similarities from selected historical, nosological and putative mechanistic viewpoints, as a means to help both clinicians and researchers gain a better insight into these intriguing disorders, for which over a century of research and translational development was needed to begin yielding treatments that are objectively effective, but still very far from entirely satisfactory. Ongoing comparison and “cross-pollination” among these approaches to disorders that produce similar deficits is likely to continue improving both our insight into the mechanisms at play, and the development of biotechnological approaches to tackle both conditions — and related disorders — more rapidly and efficaciously.
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Descriptions of irrational, incomprehensible, or unconstrained behavior such as is common nowadays in patients suffering from severe mental disorders can be found in the Bible, in Mesopotamian scripts, in classical Greek and Roman literature, and in the writings of many non-Western cultures. However, the presence of full-blown features of schizophrenia as seen today in psychiatric settings is controversial. Typical symptoms, the expected onset, duration and outcome, the impact of the disease on psychic functioning and the associated disability of the disease are mostly absent in those texts. Torrey (1980) and Hare (1988) have claimed that the disease did not exist before the year 1800 (this is known as the recency hypothesis). This would be the consequence of biological factors such as viruses, genetic or dietary factors or environmental contaminants associated to civilization. Others have put the emphasis on industrialization and its repercussions on social conditions such as family structure and migration. After analyzing the many manifestations of insanity in literary characters, in medical texts and in key historical figures, the arguments presented in this paper tend to support the recency hypothesis. A review of the core characteristics of schizophrenia and its impact on selfhood, intersubjetivity and ipseity, topics relatively neglected in recent psychiatric literature, opens the doors to consider in a second part the relationship between the features of Romanticism, starting by the “discovery of intimacy”, and its articulation with the disturbance of ipseity and selfhood characteristic of the disease.
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The lack of insight into their illness continues to be a significant barrier to treatment for people with schizophrenia. However, some people with the illness do develop insight which then results in stability and recovery from their condition. Having met the criteria of good insight, nineteen participants participated in semi-structured interviews exploring the concept of insight and recovery in the context of their personal experiences. Research design used grounded theory methodology layered with a further narrative analysis. The literature review and theoretical perspectives of care provide the context for the research, thus illuminating the known and determining what mysteries in insight development remain. Study findings revealed a Paradox of Insight within a 3-stage process of insight development: The Period of Chaos, the Dynamic Period, and the Period of Wisdom. An overarching Theory of Dangerousness explains the turning point from illness to recovery. This turning point occurs with a Trinity of Crisis. Within this theory, Four Constructions of Dangerousness explain how the meaning making of dangerousness affects recovery. Additionally, Four Types of Insight support this recovery. The importance, meaning, and relevance of study findings for recovery are the focus of the discussion. Six inter-rator focus groups affirmed the findings. Policy and practice implications are discussed, along with recommendations for further research and the acknowledgement of study limitations.
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The Journal of Critical Psychology, Counselling and Psychotherapy, Vol. 21 (2021), No. 1, pp. 14-21. Today, personal accounts belong to the canon of professional knowledge about the experience of madness. This holds for the rise of consumer/survivor/ex-patient narratives in the context of present ‘user-involvement’ policies in mental health care, as well as for the efforts by historians to explore the lifeworlds of the mad in earlier times. This essay summarises a methodical concept to write a ‘subject-oriented’ history of madness for the pre-psychiatric era before 1800, inspired by Roy Porter’s (1987) medical history ‘from below’, cultural history and methods from qualitative social research.
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I respond to commentaries on my target article “An Evolutionary Life History Framework for Psychopathology.” I start by addressing criticism of my basic assumptions about life history strategies and their implications for individual differences in human behavior. Next, I examine the theoretical structure of the proposed framework and respond to the commentators’ challenges to its generality and flexibility. I show how the framework can be expanded to include multiple levels of analysis and to integrate behavioral control with neurological functionality; I also reinterpret the recent finding of a general factor of psychopathology in the context of the expanded framework. In the last section I discuss specific psychopathological conditions, namely attention deficit/hyperactivity disorder, borderline personality disorder, substance abuse, autism spectrum disorders, schizophrenia spectrum disorders, obsessive-compulsive disorder, eating disorders, and depression. For each condition, I reply to the commentators’ criticism of my life history analysis, integrate their suggestions and insights, highlight the present weaknesses of the theory, and indicate promising directions for future research.
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LSD's short but colorful history in North America carries with it the distinct cachet of counterculture and government experimentation. The truth about this mind-altering chemical cocktail is far more complex—and less controversial—than generally believed. Psychedelic Psychiatry is the tale of medical researchers working to understand LSD’s therapeutic properties just as escalating anxieties about drug abuse in modern society laid the groundwork for the end of experimentation at the edge of psychopharmacology. Historian Erika Dyck deftly recasts our understanding of LSD to show it as an experimental substance, a medical treatment, and a tool for exploring psychotic perspectives—as well as a recreational drug. She recounts the inside story of the early days of LSD research in small-town, prairie Canada, when Humphry Osmond and Abram Hoffer claimed incredible advances in treating alcoholism, understanding schizophrenia and other psychoses, and achieving empathy with their patients. In relating the drug’s short, strange trip, Dyck explains how concerns about countercultural trends led to the criminalization of LSD and other so-called psychedelic drugs—concordantly opening the way for an explosion in legal prescription pharmaceuticals—and points to the recent re-emergence of sanctioned psychotropic research among psychiatric practitioners. This challenge to the prevailing wisdom behind drug regulation and addiction therapy provides a historical corrective to our perception of LSD’s medical efficacy.
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Some argue that the earliest case of Obsessive-Compulsive Disorder (OCD) was reported by Robert Burton in his compendium The Anatomy of Melancholy (1621) and that only in the 19th century did modern concepts of OCD evolve, differentiating it from other types of mental illness. In this paper, we aim to reveal an even earlier presentation of the malady we now call OCD based on the 9th century work, Sustenance of the Body and Soul, written by Abu Zayd al-Balkhi during the Islamic Golden Era. Discovery of this manuscript reveals that Abu Zayd al-Balkhi should be credited with differentiating OCD from other forms of mental illnesses nearly a millennium earlier than is currently claimed by anthologies documenting the history of mental illness. Particular attention is paid to al-Balkhi's classifications, symptom descriptions, predisposing factors, and the treatment modalities for obsessional disorders. Analysis of this manuscript in light of the DSM-5 and modern scientific discoveries reveals transcultural diagnostic consistency of OCD across many centuries. Theoretical and clinical implications of these findings are also discussed. Copyright © 2015 Elsevier B.V. All rights reserved.
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Context: Cholecystokinin A receptor (CCK-AR) gene polymorphism is being increasingly reported in schizophrenia. It varies among different population groups but is associated with several complications of schizophrenia. Aims: The present study was undertaken to assess whether the CCK-AR polymorphism is stabilized and is more consistently associated with schizophrenia in an Eastern Indian sub-population. Settings and design: It was carried out as a cross-sectional, observational, hospital-based study on 95 schizophrenia patients and 138 control subjects selected by the method of convenience. Materials and methods: Single-nucleotide polymorphisms located in the regulatory region of the CCK-AR gene were assessed by restriction fragment length polymorphism (RFLP) in the polymerase chain reaction (PCR) amplified product of CCK-AR gene in study subjects. RFLP was done by the digestion of the PCR product by the restriction enzyme Pst-1 followed by gel electrophoresis. Statistical analysis: Assessment of the stability of C/T polymorphism in the study population was done by applying Hardy-Weinberg equilibrium rule. The significance of difference in the allelic distribution between case and controls was analyzed by Chi-square (χ(2)) test and odds ratio (OR) analysis. Result: CCK-R polymorphism was in Hardy-Weinberg equilibrium in both groups. Distribution of the C allele of this gene was significantly higher in schizophrenia patients (χ(2) = 4.35, OR = 1.51; confidence interval at 95% =1.04-2.20). Conclusion: C/T polymorphism of the CCK-R gene is a stable polymorphism in our study population. Moreover, the C allele is significantly more abundant in schizophrenia patients imparting them a greater risk of development of complications like auditory hallucination.
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This chapter discusses the meaning of health. It looks at the difficulties in determining what is or is not a sickness and how understandings of that can change over time. It also criticises the emphasis on autonomy and independence in our understanding of health and promotes a view that seeks to find health in communities and relationships, rather than in individuals.
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Neuroscience and schizophrenia are densely entangled and mutually supporting, such that a critical evaluation of schizophrenia is, effectively, an evaluation of applied aspects of contemporary neuroscience. A critical historical account of the development of schizophrenia is therefore followed by an overview of current issues and debates. A summary of possible future research directions then identifies a range of extant research strategies which already undercut or exceed this diagnosis. It is concluded that the example of schizophrenia functions more generally to illustrate how neuroscience need not rely upon poorly supported psychiatric concepts of mental illness.
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In a sense, psychosis, loosely defined as “loss of contact with reality,” is a state of being that happens to all of us each night when we fall asleep. The association between psychosis and sleep is even further strengthened when one considers that psychosis implies not simply a lack of connection with external reality, but a bizarre transformation of consciousness where the mind sees what is not there, emotional content is intensified, the flow of information or time is disjointed, and the sense of one’s self is confused. This is what usually happens when we dream.
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Clinicians throughout history have painstakingly provided us with classification and nomenclature of the several movement disorders that obscure diagnosis. As we come to understand, several of these movement disorders overlap with one another as part of the course of the syndrome or illness.
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György Nagy was a 18th century merchant and nobleman from the Jászság region, and his diary from the period between 1759 and 1769 gives insights into his identity. Even though it is not explicitly stated, the document is infused with a sense of being an outsider. The study attempts to find the bases of this sentiment using methods of cultural psychology, and seeks to explore the particular responses to conflicts that arose in this individual’s life. Four factors can be identified which made the diary’s author an outcast. He originated from outside the Jászság region; his university-level education and profession distinguished his lifestyle from that of the majority: most people in the area were landed peasants. His identity as the member of lower nobility was significant. These components had to occur all at once to make him a reject. Individualistic and collectivistic traits combined to make up György Nagy’s identity. Collectivist as his ancestry principally determined his self-image and influenced his decisions (loans, etc.). Other factors (his decision to move, intellectual tendencies) speak of his individuality. This dichotomy is present in the very act of keeping a diary as well: even though he worked for the good of a broader group (his family), the urge to preserve a piece of his self is apparent from his writing. As for his descendants, these qualities declined; they integrated into society as the sources of otherness disappeared. The only exception was his youngest son, a legal expert (the grandfather of Iván Nagy, a genealogist), who continued keeping the diary, and so did his offspring. Thus, atypical tendencies were preserved by the atypical.
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György Nagy was an eighteenth-century merchant and nobleman in the Jászság region, and his diary for the period 1759 to 1769 gives insights into his self-identity. Even though it is not explicitly stated, the document is infused with a sense of being an outsider. This study attempts to find the bases of this sentiment and seeks to explore his particular responses to conflicts that arose in his life. Four factors can be identified which made the diary's author an outcast: (i) Nagy came from outside the Jászság region; (ii) his university-level education and profession distinguished his lifestyle from that of the landed peasant majority; (iii) his identity as a member of lower nobility; (iv) the conjunction and combination of these circumstances all at once. It was Nagy's ancestry which was the principal determinant his self-image and exercised the greatest influence over his decisions (loans, etc.). Other factors (his decision to move to the region, his intellectual tendencies) speak of his individuality. This dichotomy is present in the very act of keeping a diary as well: even though he was working for the good of a broader group (his family), the urge to preserve a piece of his self is apparent from his writing. As for Nagy's descendants, the importance of these qualities declined; they integrated into local society as the sources of otherness disappeared. The only exception was his youngest son, a Law graduate (the grandfather of Iván Nagy, a genealogist), who continued to keep the diary, as did his offspring. Thus, atypical tendencies were preserved by the atypical.
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The author poses a hypothesis which strives to interpret the bizarre late work (character heads) of the Austrian sculptor F. X. Messerschmidt (1736–1783). After a promising career at the court of the Empress Maria Theresa, his life took a dramatic downturn in his 33rd year. He settled in Pressburg (Bratislava) where he lived until his death at the age of 47 (1783). Most of his time there he dedicated to the creation of busts with grotesque expressions, whose sense has remained a puzzle for art historians up to now. The author calls attention to a probable occurrence of a psychiatric and neurological disease. The expressions of the statues resemble facial dystonia. The author at the same time draws attention to a conviction (proven by documentation to have been held by Messerschmidt) that it is possible to have control of somebody by imposing certain features upon his face. The author coins a hypothesis that Messerschmidt himself suffered from dystonia as a symptom of his schizophrenia. The involuntary movements of his face he interpreted as being caused by ghosts who tried to gain control over him by imposing upon him the same facial features as they themselves possessed. The exact record of his own dystonia as a proportion of the “ghosts” represented the sculptor’s defence against them. Messerschmidt’s work thus would not have been only an artistic act but also a way of struggling with his own hallucinations and delusions. The extrapyramidal manifestations featuring in the work would explain why all attempts to adequately interpret the expressions he gave to his sculptures have so far failed.
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PorterRoy. Mind-Forg'd Manacles: A History of Madness in England from the Restoration to the Regency. Cambridge: Harvard University Press. 1987. Pp. xii, 412. $38.50. PorterRoy and PorterDorothy. In Sickness and in Health: The British Experience 1650-1850. New York: Basil Blackwell, 1988. Pp. 324. $32.95. - Volume 22 Issue 3 - Anita Guerrini
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Information on patients left by a nurse in a large British asylum in 1823 has suggested that the occurrence of schizophrenic symptoms in asylums was not uncommon at that time. This paper presents another nurse's report, this time an unpublished notebook from North America in the 1790s, indicating that schizophrenic symptomatology was rare during this period. The two nurses' accounts differ significantly, the one before 1800 reporting little schizophrenic symptomatology, and the one after reporting much. Nurses' accounts of phenomenology of this period adds evidence to the notion that schizophrenic symptoms were rare before 1800 and common afterwards.
Article
My basic aims in this book are those of exposition and synthesis. There is much to be said about mad people, and how they were regarded and treated in England before the nineteenth century. Who were they? Were they hailed, hated, or harassed? How and why did the handling of mentally abnormal people change? There have been, however, surprisingly few attempts to address these questions in a broad way, integrating the mass of available information within a framework of analysis and interpretation. Combining exact scholarship with chronological sweep, Basil Clarke's "Mental Disorder in Earlier Britain" does just that for the medieval period. The Tudor and Stuart epochs remain curiously ill-researched as a whole, despite the brilliant close-up illumination offered by Michael MacDonald's study of Richard Napier. Here I attempt to survey developments spanning the period roughly from the Civil War to the dawn of the nineteenth century. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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Poses question: "What are those things like which… tend to be endowed with the specific aura which the word ART conveys? What must the men have been like who made those things, and what did their work mean to themselves and to their public?" Collects and reprints 14 papers which deal with the contributions of psychoanalysis to the study of art, the art of the insane, the comic problems of literary criticism, and psychology of creative processes. 20-page bibliography; 79 illustrations. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
The present review examines recent contributions to the evolving field of historical writing in psychiatry. Interest in the history of psychiatry continues to grow, with an increasing emphasis on topics of current interest such as the history of psychopharmacology, electroconvulsive therapy, and the interplay between psychiatry and society. The scope of historical writing in psychiatry as of 2007 is as broad and varied as the discipline itself. More than in other medical specialties such as cardiology or nephrology, treatment and diagnosis in psychiatry are affected by trends in the surrounding culture and society. Studying the history of the discipline provides insights into possible alternatives to the current crop of patent-protected remedies and trend-driven diagnoses.
Article
Synopsis Trosse's account of his life has been described as one of the strangest pieces of realism in the English language. It gives a detailed description of the author's personal experience of three episodes of psychotic disorder during the years 1656–7. The disorder has been considered an early instance of schizophrenia, but evidence is presented here to suggest that a more plausible diagnosis was alcoholic psychosis and affective disorder.
Article
The hypothesis that schizophrenia is a recent disease can explain why descriptions of schizophrenia-like disorders were rare before 1800, why the prevalence of insanity in the Western world increased during the 19th but remained low in the non-Western world until the 20th century, and why schizophrenia has become milder in the West during recent decades. It also explains why schizophrenia has 'persisted' in spite of its associated low fertility. The evidence for the hypothesis is somewhat frail, but perhaps not more so than that for alternative hypotheses.
Article
There is doubt whether schizophrenia, the most common and most devastating serious mental illness, existed much more than 200 years ago. Many authors who have written recently on the history of schizophrenia suggest that it is a disease that first appeared towards the end of the eighteenth century and rapidly increased in prevalence throughout the nineteenth. Cooper & Sartorius (1977) ask “Why are good descriptions of what can now be recognized as chronic schizophrenia so scarce in European medieval and earlier literature?” and they associate schizophrenia with industrialisation. Torrey (1980) argues that although descriptions of madness, including hallucinations and delusions, date to ancient times, schizophrenia as we know it with an onset in early adulthood and progressive deterioration, is not described. He associates schizophrenia with civilisation, and proposes an infectious cause. Hare (1979, 1982) supports this hypothesis, providing detailed evidence for a real increase in hospitalised psychiatric patients who most probably had schizophrenia in the last century (Hare, 1983), and also states that there are no good earlier descriptions of schizophrenia.
Article
Many psychiatrists assume that schizophrenia has existed in its current form throughout history, but recently it has been suggested that schizophrenia, far from being an ancient disorder, is of recent origin and is linked to the spread of civilization. In part this is based on the rarity of historical accounts of schizophrenia in comparison with other mental illnesses. In this article we present evidence that a substantial number of clinical descriptions resembling modern conceptions of schizophrenia exist throughout history. In addition, we discuss reasons why historical descriptions of schizophrenia may be relatively uncommon while the illness itself may have been common in the past.
Article
Assessed the evidence for and against the view that insanity was increasing in Britain during the 2nd half of the 19th century. The author considers the arguments used by the nosocomialists to support their view that the obvious increase in numbers of ascertained insane did not necessarily imply an increase in the incidence of insanity. Two possible reasons are considered as to why the "first-admission" rate to asylums increased during the last 4 decades of the 19th century. The first is that the incidence of insanity increased without any diminution in the severity of the condition. The second is that the increase was due to the admission of increasingly milder cases. During the past decade or two, a great deal of research has suggested an association of schizophrenia with pathological changes in the brain; and 2 etiological hypotheses of a strictly environmental type have been posited, one implicating a dietary factor and the other an infective (viral) factor. The historical evidence, which the author suggests indicates a change in the incidence of a schizophrenic-like disorder in Britain during the 19th century, is compatible with a somatic cause and may be considered as lending support to the etiological hypotheses, particularly the infective one. (76 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
One of the central paradoxes of the Victorian reforms in the treatment of the mentally ill was the curious fact that the “scientific” discovery of mental illness and the adoption of a more rational approach based on this discovery—an approach which aimed at treating and curing the lunatic, rather than neglecting him or incarcerating him in a gaol or workhouse—were associated with an explosive growth in the number of insane people. Edward Hare's recent Maudsley Lecture raises again the interesting question of whether or not this reflects a true increase in the incidence of mental illness in nineteenth century England. As he correctly notes, the aggregate data collected at the time do not allow a “decisive answer”, but I am pleased that his reassessment of the probabilities led him to endorse my prior conclusion that its incidence was indeed increasing. (Scull, 1979).
Article
There is a paper devoted to insanity in an ancient Indian treatise on medicine. The concept of insanity and the rational and empirical elements in this text are discussed with its implications for modern psychiatry.
Article
It has been claimed that descriptions of schizophrenia-like disorders were rare before 1800 in the Western world. Historical evidence from medieval Islamic society shows that madness was common in that society. Despite the limitations of the evidence, we propose that medieval Islamic physicians probably diagnosed and treated many cases of schizophrenia.
Article
The situation of German psychiatry in the early nineteenth century is of interest as the specialty was developing in a society which was still largely non- industrial. Examination of the literature of the time allows, therefore, a testing of hypotheses concerning schizophrenia as a disease of industrial society. This study presents a number of descriptions of illness resembling schizophrenia derived from textbooks on mental illness and psychiatric journals from the period 1790-1830, as well as a fictional account in a novella by Georg Büchner dating from 1835. These descriptions suggest that schizophrenia did occur not uncommonly in pre-industrial Germany, and that the most detailed descriptions tended to come from non-specialist sources. The implications of this for the non-recognition of schizophrenia before Kraepelin's account of 1896 are discussed.
Article
The historical prevalence of schizophrenia as a persisting medical and social problem has been challenged by a 'recency hypothesis' suggesting that a new form of illness arose in the nineteenth century. The notion of a viral infection has been in the forefront of such claims. Assessment of diagnostic attitudes, the effects of urban industrialism, the economics of asylum care and the forms of illness presentation do not seem to support such a hypothesis. The value of historical evidence in focusing research and clinical care is stressed, as is the need for a conception of aetiology that is not limited to germ theory.
Schizophrenia genesis: the origins of madness Madness in ancient India; Concept of insanity in Charaka Samhita
  • I I Gottesman
Gottesman, I. I. (1991). Schizophrenia genesis: the origins of madness. New York: W. H. Freeman. Haldipur, C. V. (1984). Madness in ancient India; Concept of insanity in Charaka Samhita (1st century A.D.).
Curious cases and amusing actions at law: including some trials of witches in the seventeenth century
  • C Mather
Mather, C. (1916). Curious cases and amusing actions at law: including some trials of witches in the seventeenth century. London: Sweet & Maxwell.
Chapter 3 Stroke and other vascular disorders: clinical section
  • T R Denig
Denig, T. R. (1995). Chapter 3 Stroke and other vascular disorders: clinical section. In G. Berrios & R. Porter (Eds.), A history of clinical psychiatry (pp. 72-85). London: Athlone Press.
The invisible plague: the rise of mental illness from 1750 to the present
  • E F Torrey
  • J Miller
Torrey, E. F., & Miller, J. (2001). The invisible plague: the rise of mental illness from 1750 to the present. New Jersey: Rutgers University Press.
Madness: a brief history Franz Xaver Messerschmidt Zur Beziehung Franz Anton Mesmer-Franz Xaver Messerschmidt
  • R Porter
  • M Pötzl-Malikova
Porter, R. (2002). Madness: a brief history. Oxford: Oxford University Press. Pötzl-Malikova, M. (1982). Franz Xaver Messerschmidt. Vienna: Jugend und Volk. Pötzl-Malikova, M. (1987). Zur Beziehung Franz Anton Mesmer-Franz Xaver Messerschmidt. Wiener Jahrbuch für Kunstgeschichte, Band XL, pp. 257–267.
Reconstructing contexts
  • R D Hume
Hume, R. D. (1999). Reconstructing contexts. New York: Oxford.
Chapter 9 Mental retardation: clinical section II A history of clinical psychiatry Dementia praecox, or the group of schizophrenias New York: International Universities
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Berrios, G. (1995). Chapter 9 Mental retardation: clinical section II. In G. Berrios & R. Porter (Eds.), A history of clinical psychiatry (pp. 225–238). London: Athlone Press. Bleuler, E. (1950). Dementia praecox, or the group of schizophrenias (J. Zinkin, Trans.). New York: International Universities. (Original work published in 1911.) Burr, G. L. (1975). Narratives of the witchcraft cases, 1648–1706.
1809/1976). Observations on madness and melancholy
  • J Haslam
Haslam, J. (1809/1976). Observations on madness and melancholy. New York: Arno Press.
Chapter 13 Schizophrenia: clinical section
  • J Hoenig
Hoenig, J. (1995). Chapter 13 Schizophrenia: clinical section. In G. Berrios & R. Porter (Eds.), A history of clinical psychiatry (pp. 336-348). London: Athlone Press.
Chapter 15 Mood disorders: social section
  • R Porter
Porter, R. (1995). Chapter 15 Mood disorders: social section. In G. Berrios & R. Porter (Eds.), A history of clinical psychiatry (pp. 409-420). London: Athlone Press.
Schizophrenia and civilization
  • E F Torrey
Torrey, E. F. (1980). Schizophrenia and civilization. London: Aronson.
Beschreibung einer Reise durch Deutschland und die Schweiz im Jahre 1781
  • F Nicolai
Nicolai, F. (1785). Beschreibung einer Reise durch Deutschland und die Schweiz im Jahre 1781. Band 6. Leipzig: Author.
Diagnostic and statistical manual of mental disorders
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
Zur Beziehung Franz Anton Mesmer-Franz Xaver Messerschmidt. Wiener Jahrbuch für Kunstgeschichte
  • M Pötzl-Malikova
Pötzl-Malikova, M. (1987). Zur Beziehung Franz Anton Mesmer-Franz Xaver Messerschmidt. Wiener Jahrbuch für Kunstgeschichte, Band XL, pp. 257-267.
Franz Xaver Messerschmidt
  • M Pötzl-Malikova
Pötzl-Malikova, M. (1982). Franz Xaver Messerschmidt. Vienna: Jugend und Volk.
Chapter 9 Mental retardation: clinical section II
  • G Berrios
Berrios, G. (1995). Chapter 9 Mental retardation: clinical section II. In G. Berrios & R. Porter (Eds.), A history of clinical psychiatry (pp. 225-238). London: Athlone Press.
Art et Folie au Moyen Age
  • G Roux
  • Laharie
Roux, G., & Laharie (1997). Art et Folie au Moyen Age. Paris: Le Léopard d'Or.
Schizophrenia genesis: the origins of madness
  • I I Gottesman
Gottesman, I. I. (1991). Schizophrenia genesis: the origins of madness. New York: W. H. Freeman.