Psychiatric wards of Soochow Elizabeth Blake Hospital (1898-1937): a missing piece in the history of modern Chinese psychiatry.

The history of modern psychiatry in China began at the end of the nineteenth century, as a result of the work of missionaries. Soochow was one of the first cities to establish a hospital for the treatment of mental patients, but historians knew little about it. It provided a valuable service from 1898 to 1937. In the 1930s, there were 200 beds in the psychiatry and neurology section, making it the most influential psychiatric hospital in East China. After Soochow was occupied by the Japanese army in 1937, the hospital was destroyed and shut down.

One Hundred Years of Psychiatry at Johns Hopkins: A Story of Meyer to McHugh.

This article describes a history of clinical methods and constructs that guide Psychiatry at Johns Hopkins Phipps Clinic today. The contributions of Adolf Meyer and Paul McHugh are central and closely connected. Both emphasize the clinical examination as the central practice of psychiatry as a specialty within medicine. Meyer's comprehensive examination of the patient became the centerpiece of his approach and was the standard for psychiatrists in the English-speaking world. McHugh, with Phillip Slavney, developed a pluralistic and practical framework for interpreting that history and examination. Both argued against the uncritical use of the modern disease construct. McHugh argues that the disease construct, although fundamental, is but one of four useful "perspectives of psychiatry" and is, thus, an insufficient basis for psychiatric practice. The perspectives could be used as an organizing framework by all physicians who seek a practical and truly personalized approach to the care of patients.

Adolf Meyer: His Achievements and Legacy.

This lecture, given to celebrate the centennial of the founding of the Henry Phipps Psychiatric Service at Johns Hopkins, addresses the career and contributions to psychiatry and neurology of Adolf Meyer, the first Phipps Professor. It reviews his achievements historically describing the bleak clinical situation of psychiatry when he began as a neuropathologist at Kankakee Hospital in Illinois in 1892, what he did to address them, the sources of help he found and exploited from leading figures in the emerging Progressive Era (1890-1917) in American life, and how he confronted and overcame resistances to his empirical, psychobiological conceptions of mental illness as he advanced. His legacy is reflected in the signal contributions of four leaders of American psychiatry (Drs. Leo Kanner, Alexander Leighton, Jerome Frank, and Paul Lemkau) who had been his residents and in those aspects of contemporary teaching and research at Hopkins that reflect his thought.

[Coercive Measures in Child and Adolescent Psychiatry in Post-war Germany, Using the Example of the "Pflege- und Beobachtungsstation" in the State Psychiatric Hospital Weissenau (1951-1966)]. / Zwangsmaßnahmen in der Kinder- und Jugendpsychiatrie in der Nachkriegszeit am Beispiel der Pflege- und Beobachtungsstation des Psychiatrischen Landeskrankenhauses Weissenau (1951-1966).

Coercive Measures in Child and Adolescent Psychiatry in Post-war Germany, Using the Example of the "Pflege- und Beobachtungsstation" in the State Psychiatric Hospital Weissenau (1951-1966) The patient admissions at the children's ward of the State Psychiatric Hospital Weissenau in the years 1951, 1956, 1961 and 1966 were analyzed regarding documented coercive measures. Shortage of staff, mainly inadequately skilled personnel, a mixing of age groups in the patient cohort, neurological and psychiatric disorders and of patients who were in need of nursing and of those who needed treatment constituted the general work environment. Coercive measures against patients, mostly disproportionate isolations, were a constant part of daily life on the ward. This affected in particular patients who had to stay longer at the hospital and whose stay was financed by public authority. The uselessness of such measures was known, which can be seen e. g. in the Caretaker's Handbook of that time and the comments in the patient files. The situation still escalated in some cases (for example by transfer to an adult ward). For a long time, coercive measures against patients were part of everyday life at the children's ward of the Weissenau; the actual figures are suspected to be much higher.

Joint geriatric and old-age psychiatric wards in the U.K., 1940s-early 1990s: a historical study.

OBJECTIVE: This study aims to investigate the history of joint geriatric-psychiatric units. For policy making and planning of high-quality clinical service models, clinical and social contexts need to be considered. Longitudinal, contextual information can be provided by historical analyses, including the successes and failures of earlier, similar services. Historical analyses complement clinical, randomised controlled studies and may contribute to ensuring optimum outcomes for future schemes. METHODS: Standard historical methodology was used, including searching published sources and institutional and personal archives and conducting a 'witness seminar' and individual oral history interviews. RESULTS: Proposals to create joint units have existed since 1947. Most clinically successful units were led by enthusiastic, dedicated clinicians. Joint units had the potential to provide appropriate assessment and treatment for patients with multiple disorders and education for staff and students. Joint units never became widespread. CONCLUSIONS: Reasons for the limited success of joint geriatric-psychiatric units might have included personalities of individuals, administrative boundaries separating geriatrics and medicine, unequal numbers of geriatricians and old-age psychiatrists, varying professional ideologies about the meaning of 'integrated' services, lack of reciprocity for each other's inpatients and lack of government support. Identified stumbling blocks need to be considered when planning joint clinical schemes. If current research indicates benefits of integrated wards for patients and their families, there needs to be ways to ensure that personal factors and fashions of management or government re-prioritisation will not lead to their premature termination.

[History of Jagiellonian University Clinic for Nervous and Mental Diseases in 100 anniversary]. / Zarys historii Kliniki Neurologiczno- Psychiatrycznej w 100 rocznice powstania.

In the paper there have been presented the creation and activities of the Clinic of Neuropsychiatry in the period of 1914-1950 and the scientific and organizational work of professor J. Piltz (1870-1930).

Shell shock at Maghull and the Maudsley: models of psychological medicine in the UK.

The shell-shock epidemic of 1915 challenged the capacity and expertise of the British Army's medical services. What appeared to be a novel and complex disorder raised questions of causation and treatment. To address these pressing issues, Moss Side Military Hospital at Maghull became a focus for experiment in the developing field of psychological medicine as clinicians from diverse backgrounds and disciplines were recruited and trained at this specialist treatment unit. By contrast, the Maudsley wing of 4th London General Hospital expanded from the neurology department of King's College Medical School and drew upon the neuropathology research of Frederick Mott at Claybury Asylum. By focusing on the psychodynamics of environmental factors, doctors at Maghull offered an alternative to the physicalist hypotheses (heredity and neuropathy acquired as a result of disease or aberrant behavior) explored at the Maudsley. To understand the cause and pathology of shell shock, both institutions admitted a diverse range of patients and experimented with treatments. The individual attention offered to service patients who were not psychotic allowed psychiatry to develop in a way that had not been possible in the county asylum system. The design and operation of Maghull and the Maudsley provided models for departments of psychological medicine in the post-war period.

[The establishment of SUMC (Severance Union Medical College) Psychiatry Department and the formation of humanistic tradition].

Psychiatry is a branch of medicine which deals with the problem of mental health. Although psychiatric concept and treatment is not absent in traditional medicine in Korea, it was not regarded as an independent discipline of medicine. Modern psychiatry was introduced into Korea as modern Western medicine w as introduced in 19th century. The American medical missionary Dr. Allen and Dr. Heron gave the first classification of mental diseases of Korean patients in their first year report of Jejoongwon hospital. The statistics are characterized by relatively high rate of hysteria patients among the patients with mental disorders. It was Dr. Mclaren who took the charge of the Psychiatric Department of Severance hospital, the successor of Jejoongwon hospital. As a psychiatrist, Dr. Mclaren had a deep interest in human nature and mind. His thinking on the subjects was based on his Christian faith and philosophy. He claimed that Christian faith plays an important role in curing mental diseases. And several medical students decided to become a psychiatrist under his influence. Among them is Dr. Lee Chung Chul who took the charge of the Department of Psychiatry after Mclaren. After graduation in 1927, Dr. Lee studied in Peking Union Medical College, Australia, and Japan. His main research interests were focused on the biological aspects of mental disorders, and he published several important papers on the subject. But his unexpected early resignation and subsequent expulsion of Dr. Mclaren from Korea by Japanese colonial government hindered further development of psychiatry in Severance Union Medical College until the Liberation from Japanese occupation in 1945. But some of their students specialized in psychiatry during the hard period of early 1940s and they played an important role in the development of modem psychiatry in Korea after the Liberation.

Holistic-medical foundations of American psychiatry: a bicentennial.

American psychiatry has reached its bicentennial. Holistic-medical foundations have been its hallmark, inspiration, and source of preeminence. Incorporated by psychobiology, the American school, they enabled the growth of psychiatry as a medical specialty and scientific discipline and stimulated unparalleled growth of general hospital psychiatry, psychiatric research and teaching, and psychosomatic medicine and liaison psychiatry. Holistic conceptions, a product of a democratic system and the liberal mind, continue to provide the best framework for psychiatry and an antidote to dogma and fanaticism.

History of the general hospital psychiatric inpatient unit. 1947 to 1986.

Thirty-five years ago, the Mount Sinai unit was considered the state of the art for inpatient psychiatry. Now, short-term hospitalization, active management techniques, and quick dispositions are the practice. At the rate at which neurophysiology and psychiatry are expanding, I have to anticipate that inpatient psychiatric care will again change radically, and long before another 35 years. I doubt that the psychiatric unit of today that I have described will still be recognizable in 10 years.

General hospital psychiatry: are its roles and functions adjunctive or pivotal?

General hospital psychiatric divisions are an important part of the mental health care delivery system; however, in Canada and the United States, their role and function have not been well defined. In most places, the general hospital is peripheral to the mental hospital, and is thus an adjunctive element in the resulting two-tier mental health care delivery system. The adjunctive type of general hospital psychiatric division provides brief treatment to highly selective types of patients, and is relatively inaccessible to a wide variety of patients. In contrast, the general hospital can be central to the mental health care delivery system--in a pivotal position to patients, other mental health facilities, and community agencies. Important features of the pivotal type are: defined catchment areas, broad admitting criteria and effective discharge planning, linkages with extramural and community programs, staff reorientation, appropriate architectural features, and the ability to hear and respond to the needs of the community. The pivotal type of general hospital psychiatric division can provide appropriate levels of inpatient care, as well as the linkages and backup to extramural and community programs for the long-term mentally ill. The mental hospital would no longer be used as a backup for general clinical disorders, involuntary patients, or patients usually rejected by adjunctive hospitals. There would be collaboration with other agencies in developing programs for special clinical groups (low prevalence disorders), as well as for alcoholism, psychogeriatrics, and adolescent disorders. This article reviews the current polemic on the role and function of the general hospital psychiatric division, as part of the mental health care delivery system.

Notes on the history of adolescent inpatient and residential treatment.

This study surveys some of the major theoretical contributions to the evolvement of concepts about adolescence. Historical perspectives regarding the development of inpatient and residential institutions are outlined, followed by brief discussions of follow-up studies evaluating both forms of treatment. Finally, a general overview of outcome research is provided, focusing on the underlying, changing attitudes toward the adolescent phase of development.

[Fifty years of psychosomatic inpatient treatment]. / Fünfzig Jahre psychosomatische Krankenhausbehandlung.

This article is a review of the historical development of psychosomatic inpatient treatment form its first roots to present. The major focus of the article is a description of the present situation of psychosomatic hospitals in Germany, the kind of inpatient treatment in psychosomatic medicine, current concepts, data on lengths of stay, comorbidity, and the spectrum of diagnoses concerning psychosomatic inpatients. Furthermore, data on effectiveness of inpatient treatment and a description of a typical patient sample in psychosomatic inpatient treatment are outlined.

The psychodynamic psychiatry service of the University of Alberta Hospital: a thirty year history.

This paper describes the Psychodynamic Psychiatry Service (PPS) of the University of Alberta Hospital over its 30 years of development. This psychiatric organization consists of three clinical programs-an outpatient clinic and intensive day and evening programs-and an integral evaluation and research unit. The PPS is unique in its group therapy clinical orientation, its psychodynamic theoretical orientation, and its integration of an ongoing research program that establishes empirical validation of its clinical work. The productivity and longevity of this psychiatric organization appear to derive from several strengths, including cooperation between leaders of the clinical and research programs; the institution of staff relations groups in the three clinical programs; the operation of the fully integrated evaluation and research program that serves to provide empirical support for the treatments offered; and a unifying ideology characterized by the valuing of both psychodynamic and group oriented work. Other important factors to the success of the PPS include the strengths of the founder of the service and financial and other support of the academic department in which it is housed. This paper describes the historical development and present structure and functioning of the PPS, the challenges it has been confronted with, and the responses to those challenges. We conclude with factors contributing to its survival and productivity and with thoughts about the future.

[Psychiatric care and its change under the Japanese government in Korea with the special reference to the clinical activities at the Colonial Government Hospital: 'Chosun-Chong-Dok-Bu Ui-Won' (1913-1927)].

The purpose of this is to elucidate the ways of introduction of modern psychiatric care into Korea and to demonstrate the changing patterns of psychiatric care during the time between 1913 and 1927. The study was focused on the clinical activities of the colonial governmental hospital on the basis of the annual reports of the hospital from 1912 to 1928. The investigation has revealed the fact that the first special institution for the care of the mentally ill patients was founded in 1911 in Seoul by the colonial government which was called "Che Saeng Won". It was also confirmed that the first clinical department of the psychiatry in Korea was established in 1913 at the colonial governmental hospital, "Chong-dok-bu Ui-won" which has taken over the role of psychiatric care from Che Saeng Won. The first chairman of the department of pspychiatry was Misuzu Nobuharu and his assistant was Shim Ho-Sub, the first Korean psychiatrist who became assistant professor of psychiatry at Kyongsung medical college in 1916-1917 but moved to Severance hospital and changed his speciality to neurology of internal medicine. The department had two physicians and 4 care persons at the beginning stage and 22 beds for the mentally ill patients in the hospital which had total 330 beds. Later, the department has developed to 54 bed clinic with 4 staff physicians. ...

[Protagonists, conflicts, and interests: Wilhelm Griesinger's trials in the reforming of the psychiatric ward of the Berlin Charité, 1865-1868]. / Akteure, Konflikte, Interessen: Wilhelm Griesingers Reformversuche in der Irrenabteilung der Berliner Charité 1865-1868.

In June 1865, two months after his appointment as head of the Psychiatric Ward of the Berlin Charité hospital, Wilhelm Griesinger (1817-1868) made reform proposals for introducing the method of non-restraint treatment. After tough negotiations, the hospital's administrator, Karl Heinrich Esse, approved only some of Griesinger's proposals. Further conflicts with other relevant agents, such as the ward's inspector and the nursing staff, illustrate the complex "making" of non-restraint psychiatry.