Wilhelm Mayer's follow-up study of Kraepelin's cases of paraphrenia: diagnostic validity in 1921.

As part of his lifelong effort to develop optimal nosologic categories for the non-affective delusional syndromes, in the 1913 8th edition of his textbook, Kraepelin proposed a new diagnosis of paraphrenia presenting with extensive bizarre delusions and auditory hallucinations but no prominent negative symptoms or personality deterioration. He tentatively suggested it was distinct from dementia praecox (DP). His proposal was met with controversy. In an attempt to resolve this matter, Wilhelm Mayer, working with Kraepelin in Munich, published in 1921 the result of a follow-up study of the 78 cases of paraphrenia on the basis of which Kraepelin had developed his new diagnosis. In the 74 cases with adequate follow-up, Mayer's final diagnoses were 43% DP, 38% paraphrenia, and 18% other. He also presented limited family data, suggesting co-aggregation of DP and paraphrenia. On the basis of these results, Mayer argued that paraphrenia was likely better considered to represent a form of DP and not an independent disorder. His opinion was accepted by nearly all subsequent authors. Mayer's work appeared nearly a half-century before the proposal of Robin and Guze for the validation of psychiatric disorders by follow-up and family studies. The idea of deciding psychiatric questions on empirical grounds-rather than on the prestige of debating parties-is not a recent discovery but can be traced to the roots of our current diagnostic system in the work of Emil Kraepelin and his associates.

Slavery and Its Afterlives in US Psychiatry.

Antecedents of racist treatments of Black patients by the psychiatric profession in the United States affect the way they view treatment today. Specifically, in this essay, we explore the enduring consequences of racial science on various treatment practices. We examined a range of primary sources on the history of racial theories about the mind, medical and psychiatric publications, and hospitals. We contextualize this analysis by examining the secondary literature in the history and sociology of psychiatry. Through analyzing racial thinking from the antebellum through the Jim Crow periods, we show how US medicine and psychiatry have roots in antebellum racial science and how carceral logics underpinned the past and present politics of Black mental health. Changing this trajectory requires practitioners to interrogate the historical foundations of racist psychiatric concepts. This essay urges them to reject biological racial realism, which bears reminiscences to 19th-century racial science, and embrace the variable of race as a social construct to study social inequalities in health as a first step toward moving away from the legacies of past injustices in medicine. (Am J Public Health. 2024;114(S3):S250-S257. https://doi.org/10.2105/AJPH.2023.307554).

Hans Berger (1873-1941): the German psychiatrist who recorded the first electrical brain signal in humans 100 years ago.

In 1924, at the University Hospital of Jena, Hans Berger first recorded an electrical brain signal in humans. This discovery revolutionized clinical neuroscience and neurotechnology, as it contributed to both electrophysiology and the development of the electroencephalogram (EEG). This article provides a historical overview of Hans Berger's seminal contributions, highlighting the importance of his early recordings, the motivations that drove him, and the scientific problems he had to initiate and solve, in a historical context of profoundly changing circumstances. He also faced low acceptance of his works initially, and only belatedly did they become accepted by the scientific community. Berger was known to be a humble but tenacious person who believed in his convictions to the core, and this strength of will is an example of passion for students and scholars of neuroscience.NEW & NOTEWORTHY In 1924, at the University Hospital in Jena, Hans Berger first recorded human brain electrical signals, revolutionizing clinical neurophysiology and neurotechnology. He developed the electroencephalogram (EEG) and identified alpha waves in the human scalp. Although initially met with skepticism, his work was later recognized as fundamental. Berger's perseverance and conviction in his research serve as an inspiring example of dedication for students and scientists in neuroscience.

[Medical practice in classical Greece : The neurological and psychiatric case reports of the Hippocratic Corpus]. / Medizinische Praxis im klassischen Griechenland : Die neurologischen und psychiatrischen Fallberichte des Corpus Hippocraticum.

OBJECTIVE: Which theoretical and practical competences do the neurological and psychiatric case histories of the Hippocratic Corpus convey? MATERIAL AND METHODS: The 431 Hippocratic case histories have been studied for reports and communication on the diagnostics, treatment and prognosis of single persons and groups of patients suffering from neurological and psychiatric diseases. RESULTS: In the 7 books of the Hippocratic Epidemics, a total of 128 patients with neurological and psychiatric symptoms are described. Epidemic fever and its variants were the leading predisposing conditions and the main symptoms were delirium, coma, insomnia, headache, speech disorders and convulsions. A number of patients with phrenitis and opisthotonos are also reported. The majority of the sick persons were male, were teenagers or adults and 47 of them are mentioned by name. The patient's information about the course is often just as informative as the doctor's observations. Treatment was limited to physical and dietary measures. DISCUSSION: The Hippocratic physician diagnosed and attempted to treat a large number of neurological and psychiatric diseases. The often almost continuous observations of the patients led to astonishingly precise predictions of the course and the prospects of recovery. Numerous symptoms described in the case studies, including carphologia and opisthotonus, have entered the neurological vocabulary. The retrospective etiological analysis of the reports leads to the almost explicit identification of neurosyphilis and encephalitis lethargica. The therapeutic measures described by the author were, as the changeable course of the diseases shows, only of limited effectiveness despite a very differentiated application over time, both against the underlying diseases and the neurological and psychiatric complications.

[Historical comments on ethics in psychiatry : Challenges in the 19th century]. / Historische Anmerkungen zur Ethik in der Psychiatrie : Herausforderungen im 19. Jahrhundert.

With the emergence of an early psychiatry around 1800, a number of questions arose on dealing with a group of persons whose "alien", irritating and disruptive behavior was considered to be a phenomenon of being sick. In the context of the growing importance of human rights, the term humanitarianism attained a high relevance as the reference for early psychiatrists. Based on historical sources it is shown that despite a multitude of psychiatric beliefs on humanitarianism the established psychiatric practice was dominated by patriarchal order regimes up to the first decade of the twentieth century, later superimposed by the challenges of somatophysiological and experimental research as well as perceptions of biological racism. The associated new ethical questions were partially addressed within psychiatry but did not prevent an increase in the assessment of the mentally ill as "inferior".

[Historical aspects of ethics in psychiatry : From the end of humanitarianism up to the Human Rights Convention]. / Historisches zur Ethik in der Psychiatrie : Vom Ende der Humanität zur Menschenrechtskonvention.

The establishment of academic psychiatry was completed around 1900. Simultaneously, in view of the societal crisis phenomenon the professional self-concept of the psychiatrist was shifted to a self-image, according to which psychiatry had to place its expertise at the service of the people and the country. This was particularly expressed in World War I in the brutal dealing with the so-called war neurotics. In association with the so-called death by starvation of ca. 70,000 institution inmates, in the post-war period Karl Bonhoeffer debated a transformation of the term humanitarianism. The worst consequence of the rejection of humanitarian thoughts are the murders of invalids under National Socialism; however, legitimization of such crimes by alluding to collective ethics, as attempted by Karl Brandt, seems to be less than convincing. The reform of psychiatry initiated in the 1960s and the United Nations Convention on the Rights of Persons with Disabilities, which came into force in 2008, have achieved prerequisites for a supportive psychiatry with reduced coercion, whereby many questions also in the legal and social systems must still be clarified.

Opacity, difference and not knowing: what can psychiatry learn from the work of Édouard Glissant?

Martinican poet, novelist and cultural theorist Édouard Glissant (1928-2011) rejected contemporary simplistic notions of creole hybridity popularised in the 1980s and 1990s in favour of a unique and explicitly antiessentialist construct of Caribbeanness-a form of being that embraces place while shunning any associated ideas of rootednesss. Throughout his work, there is a constant tension between the local and the global, the particular and the universal, the essentialist and the homogenising, a tension that is never resolved but used creatively to stake out an emergent third position against a backdrop of a metaphorical Caribbean seascape. The purpose of this article is to shed light on a central idea developed by Glissant: the importance of acknowledging opacity in the encounter with the Other, in contrast to idealised notions of transparency as inherently desirable. This 'right to opacity' has been embraced in poststructural theory, postcolonial activism and contemporary art. However, I argue that opacity is also a highly relevant notion in clinical contexts, as an essential resource for understanding concepts such as first-person, second-person and third-person perspectives in the phenomenology of mental health and illness. For illustration, I point to a number of clinical tools and approaches-such as the Cultural Formulation Interview, Therapeutic Assessment and the employment of a not-knowing stance in mentalisation-based treatment-that successfully incorporate a respect for opacity as a core value in the clinician-patient encounter. This article is not an attempt to offer a definitive how-to guide on how to make use of the ideas of Édouard Glissant in the clinic; instead, I hope to inspire further discussion about how various notions of opacity and transparency come into play for mental health practitioners and how acknowledging alterity and difference may contribute to more fruitful and respectful ways of engaging with the patient-as-Other.

A Clinic for the People: Toward an Antiracist Psychiatry at the Tuskegee Institute 1947-1965.

From 1947 until 1963, a small group of psychiatrists from the Tuskegee Veterans Administration Hospital ran a Mental Hygiene Clinic designed to provide outpatient care and education to the Black residents of Macon County, Alabama. In an analysis of the clinic and the work of its Director, Dr. Prince Barker, we see the ways that Black psychiatrists tried to develop an antiracist approach to psychiatry and to develop their own autonomy in segregated Alabama. But there were limitations to this work. Tensions between the state funding body, local politics, and the internal racism of psychiatry itself all made it difficult for Tuskegee psychiatrists to provide alternatives to care beyond the veil of the color line.

Bruno Schulz's 1936 book "Methodology of medical genetic research particularly with regard to psychiatry".

In 1936, Bruno Schulz published the first detailed, book-length review of the methodology of psychiatric genetic research, based on his experiences at the German Research Institute of Psychiatry. Emphasis is placed on proper selection of relatives and the ascertainment corrections required for Mendelian transmission models. Twin studies are considered as is the impact of reduced fertility on patterns of risk. For the field work, Schulz emphasizes the importance of trust-building, confidentiality, collateral informants, and the use of medical and other administrative records, all ideally stored in personal files. Several methods of age-correction are reviewed. Schulz provides detailed algebraic treatments of these and other problems, including tests for etiologic homogeneity, with worked examples. He emphasizes two fundamental concerns in psychiatric genetics research: (i) its inter-dependency with the optimal diagnostic boundaries, which are rarely known and (ii) the genetic homogeneity of clinical samples. Given these problems, he is pessimistic about finding Mendelian transmission patterns. He assesses the predominant 19th-century method of psychiatric genetic investigation-"hereditary burden"-to be crude and biased by family size. Although written at a time of consolidation of Nazi power in Germany, this book nowhere endorses their racial/eugenic policies and can be seen as subtly questioning them.

Social issues relating to Vladimir Bekhterev's concept of reflexology: a hitherto underestimated aspect of his work.

This article investigates the diversity of social and political assertions in the work of Vladimir M Bekhterev. Its findings reveal that he drew social and political conclusions based on his doctrine of reflexology. Moreover, he propagated the use of statistical investigations by scientific and governmental institutions to estimate the social and healthcare needs of the population. These conclusions accord with Bekhterev's desire for a transformation of society that would bring continued progress to people's social and living conditions. Additionally, the findings of this research work also support the idea that Bekhterev should be regarded as an important protagonist of neuroethics, a relatively recent field of research.

'Eccentricity', by DH Tuke (1892).

An astronomical concept up to the eighteenth century, 'eccentricity' started to be used to refer to behaviours considered as odd, strange, rare, extravagant, etc. Once reified into a personality trait, it gained explanatory power. This not only increased its popularity but also facilitated its links with psychopathology and neuropsychology, and, via the shared concept of madness, with the notions of genius and creativity. This Classic Text describes the process whereby Alienism (Psychiatry) medicalized eccentricity. To this day, the latter remains firmly attached to 'psychoticism' and to some personality disorders.

The 'social' in psychiatry and mental health: quantification, mental illness and society in international scientific networks (1920s-1950s).

The post-World War II international mental health movement placed significant emphasis on the concept of the 'social environment', a true paradigm shift in thinking about the causes of mental illness. Rather than focusing on individual risk factors, experts and policy-makers began to consider the interplay between social context and mental health and illness. Also, during this period, quantification gained prominence within the expanding field of Western psychiatry. Eventually, the concept of the 'social' became fragmented into quantifiable social determinants that could be correlated with mental illness and subjected to systematic neutralization. This trajectory paved the way for the prevailing biomedical psychiatric epidemiology. This broader inquiry challenges us to redefine our understanding of the 'social' in the context of mental health research and practice.

Revisiting Emil Kraepelin's eugenic arguments.

It is widely recognized that Emil Kraepelin explicitly advocated for eugenic ideas in his academic works. Given the renewed interest in related concepts such as self-domestication and neo-Lamarckism in different contexts, this article revisits his eugenic arguments by scrutinizing a section of his seminal work, the 8th edition of his textbook published in 1909. Our analysis reveals that Kraepelin's arguments consisted of multiple theories and ideas prevalent at the time (i.e. self-domestication hypothesis, neo-Lamarckism, degeneration theory, social Darwinism, racism and ethnic nationalism), each of which presented individual fundamental claims. Nevertheless, Kraepelin amalgamated them into one combined narrative, which crystallized into an anti-humanistic psychiatry in the next generation. This paper cautions that a similar 'packaging of ideas' might be emerging now.

Cheerfulness in the history of psychiatry.

In 1762, Louis-Antoine Marquis de Caraccioli (1719-1803), a prolific writer of the eighteenth century, dedicated a book to a psychological theme that medicine has forgotten: 'gaité' in French, which we will translate as 'cheerfulness'. At the beginning of the nineteenth century, this work inspired two doctoral theses in medicine, one defended in Montpellier, the other in Paris. In their texts, Louis Monferran (1785-?) and Vincent Rémi Giganon (1794-1857) explored the therapeutic benefits of the medical prescription of cheerfulness. In addition to lifestyle recommendations, they focused on the psychotropic substances available to them: alcohol, coca, hemp and opiates. In an original and novel way, Giganon introduced and recommended 'le gaz oxydule d'azote inspiré', or inhaled nitrous oxide gas.

Ryssia Wolfsohn's 1907 dissertation on "the heredity of dementia praecox".

In the 19th century, psychiatric genetic studies typically utilized a generic category of "insanity." This began to change after 1899, with the publication of Kraepelin's 6th edition containing, among other disorders, his mature concept of dementia praecox (DP). We here review an article published by Ryssia Wolfsohn in 1907 from her dissertation at the University of Zurich entitled "Die Heredität bei Dementia praecox" (The Heredity of Dementia Praecox). This work, performed under the supervision of E. Bleuler, was to our knowledge the first formal genetic study of the then new diagnosis of DP. She investigated 550 DP probands admitted to the Burghölzli hospital with known information about their "heredity burden." For most probands, she had information on parents, siblings, grandparents, and aunts/uncles. Of these patients, only 10% had no psychiatric illness in their families. In the remaining probands, she found rates of the four major categories of psychopathology she investigated: mental illness-56%, nervous disorders-19%, peculiar personalities 12% and alcoholism 13%. Her most novel analyses compared either total familial burden or burden of her four forms of mental disorders on her DP probands divided by subtype and outcome. In neither of these analyses, did she find significant differences.

Whose experts? How federalism shaped psychiatry in the late Habsburg monarchy.

The late Habsburg period (1867-1918) created a constitutional dual monarchy of Austria-Hungary. This paper discusses the role of psychiatry in Cisleithania, both as a developing profession and as a distinct 'policy field'. Tension between psychiatry's academic professionalisation and the creation of public institutions as signature projects by individual crownlands created complex relationships between psychiatry and politics. In federalist Cisleithania, psychiatrists became very 'political': whether employed by the state or a crownland influenced their position on policy, despite claiming that their expert knowledge was 'scientific' and 'objective'. The conflicts between asylum-based and academic psychiatrists mirrored those between the central state and the crownlands. This led to intractable delays in mental health law reform, eventually resolved by Imperial decree in 1916.

Landmarks in the history of neurosyphilis: the neglected observations of Vincenzo Chiarugi.

After the emergence of syphilis in Europe in 1495, it would take over 400 years to unpick the full course of the infection, including the involvement of the brain and spinal cord. This syndrome of mental and physical deterioration was called 'general paralysis of the insane' (GPI). Traditionally, the earliest clear description of GPI is attributed to Haslam in 1798. However, here I describe three clear cases and three highly suggestive cases, together with autopsy findings, published in 1794 by the Italian psychiatrist Vincenzo Chiarugi. Historically, Chiarugi's scholarship has been neglected in favour of English- and French-speaking physicians. His observations also give a rare clue regarding the prevalence of syphilis, suggesting a foothold in northern Italy in the late eighteenth century.

Phrenitis and the pathology of the mind in western medical thought (fifth century BCE to twentieth century cE).

Phrenitis is ubiquitous in ancient medicine and philosophy. Galen mentions the disease innumerable times, Patristic authors take it as a favourite allegory of human flaws, and no ancient doctor fails to diagnose it and attempt its cure. Yet the nature of this once famous disease has not been properly understood by scholars. My book provides the first full history of phrenitis. In doing so, it surveys ancient ideas about the interactions between body and soul, both in health and in disease. It also addresses ancient ideas about bodily health, mental soundness and moral 'goodness', and their heritage in contemporary psychiatry, offering a chance to reflect critically on contemporary ideas about what it means to be 'insane'.

"It's a fight - the whole personality of the patient to win." The development of concepts of psychosis in the Jewish Hospital in Warsaw, 1898-1943.

This study investigates the development of concepts of psychosis in the Jewish Hospital in Warsaw, within the context of social and historical processes to which the hospital was the subject and a broader scope of European concepts of psychosis. In the years 1898-1909, the first chief physician of the psychiatric ward, Adam Wizel, focused mainly on hysteria. The interest in psychoses was initiated by Maurycy Bornsztajn, who started to promote psychoanalytic ideas. The second decade of the functioning of the Jewish Hospital's psychiatric ward was marked by issues concerning the classification of psychoses. In the third decade, after Poland regained independence, psychosis became the main focus of the hospital's staff. Newly appointed psychiatrists, Gustaw Bychowski and Wladyslaw Matecki, contributed substantially to the psychoanalytic understanding of psychosis. Bornsztajn continued to develop his psychoanalytically based concept of psychosis. Wizel changed his attitude toward psychoanalysis and acknowledged the importance of Freud's discoveries. Wladyslaw Sterling contributed to the biological understanding of schizophrenia. In the last period, 1931-1943, the Jewish Hospital in Warsaw struggled with the consequences of the economic crisis in Poland, Wizel's death, and Bychowski's departure, which resulted in the reduced number of publications in the field of psychosis. Nevertheless, Bornsztajn managed to further develop his concept of somatopsychic schizophrenia and Matecki introduced the category of pseudo-neurotic schizophrenia. The psychoanalytic approach developed by Wizel, Bornsztajn, Bychowski, and Matecki was supplemented with other influences, especially phenomenology. Wizel, Bychowski, and Matecki were advocates of the psychoanalytic psychotherapy of psychotic patients.

Historical and conceptual features of acute polymorphic psychosis: a myth of European psychiatry from bouffée délirante to ICD-11 acute and transient psychotic disorder.

This paper deals with the history and epistemology of acute polymorphic psychosis. We undertook a comparative study of short-lived psychotic disorders used in different European countries since the late nineteenth century. The theory of degeneration offered a speculative basis to conceptualization of conditions such as bouffée délirante, cycloid psychosis and reactive psychosis, but it seems likely that different factors contributed to the profusion of clinical concepts with adverse effects on both nomenclature and classification. The resulting picture suggests that earlier nosological concepts tend to converge on common descriptive features and challenge the diagnostic categories for short-lived psychotic disorders listed in modern symptom-based psychiatric classifications.