New Issue of History of the Human Sciences

The most recent issue of History of the Human Sciences has Scott Vrecko as guest editor and is dedicated to Neuroscience, Power and Culture Contents. Two articles adresses more specifically the use of drugs inside psychiatry.

The persistence of the subjective in neuropsychopharmacology: observations of contemporary hallucinogen research by Nicolas Langlitz (Department of Anthropology, New School for Social Research). The abstract reads:

The elimination of subjectivity through brain research and the replacement of so-called ‘folk psychology’ by aneuroscientifically enlightened worldview and self-conception has been both hoped for and feared. But this cultural revolutionis still pending. Based on nine months of fieldwork on the revival of hallucinogen research since the ‘Decade of the Brain,’this paper examines how subjective experience appears as epistemic object and practical problem in a psychopharmacological laboratory. In the quest for neural correlates of (drug-induced altered states of) consciousness, introspective accounts of test subjects play a crucial role in neuroimaging studies. Firsthand knowledge of the drugs’ flamboyant effects provides researchers with a personal knowledge not communicated in scientific publications, but key to the conduct of their experiments. In many cases, the ‘psychedelic experience’ draws scientists into the field and continues to inspire their self-image and way of life. By exploring these domains the paper points to a persistence of the subjective in contemporary neuropsychopharmacology.

Profitable failure: antidepressant drugs and the triumph of flawed experiments by Linsey McGoey (Saïd Business School, University of Oxford). The abstract reads:

Drawing on an analysis of Irving Kirsch and colleagues’ controversial 2008 article in PLoS [Public Library of Science]Medicine on the efficacy of SSRI antidepressant drugs such as Prozac, I examine flaws within the methodologies of randomized controlled trials (RCTs) that have made it difficult for regulators, clinicians and patients to determine the therapeutic value of this class of drug. I then argue, drawing analogies to work by Pierre Bourdieu and Michael Power, that it is the very limitations of RCTs — their inadequacies in producing reliable evidence of clinical effects — that help to strengthen assumptions of their superiority as methodological tools. Finally, I suggest that the case of RCTs helps to explore the question of why failure is often useful in consolidating the authority of those who have presided over that failure, and why systems widely recognized to be ineffective tend to assume greater authority at the very moment when people speak of their malfunction.


New Issue of Psychiatrie, sciences humaines, neurosciences

The latest issue of Psychiatrie, sciences humaines, neurosciences is dedicated to psychiatry in a colonial context. One article is specifically dedicated to the history of the notion of obsession in Germany.

Psychiatrie au-delà du Rhin: obsessions et compulsions dans la psychiatrie de langue allemande by M. Géraud (Centre hospitalier Charles-Perrens, Bordeaux). The abstract reads:

The notion of obsession was built late in France. The same is true in German-speaking countries (first occurring in 1867). But obsessional disorders have kept a more autonomous nosographic position in these latter countries than in France, where obsession has long been connected with the idea of degeneration, which is not given emphasis in Germany. Mentioned for the first time by Krafft-Ebing in 1867 and by Griesinger in 1868, obsession (Zwangsvorstellung) has been the subject of an exemplary clinical description by Westphal, in 1877, who defined it as an autonomous pathology radically different to “paranoia” (Verrücktheit) and melancholia; according to him, obsessions never change into delusions. This field has varied considerably in its symptomatic area: some authors going so far as to introduce the idea of obsession, sensations, feelings, impulses, and actions; obsession, according to Löwenfeld, encompass the intellectual, emotional, and motor functional spheres. Other authors, notably Bumke, keep to a more strictly defined area, within the direction defined by Westphal. Fundamental emotional disorders are either rejected or identified with anxiety. Connections with other illnesses have given rise to a number of concepts. Considered autonomous by Westphal and Bumke, obsessional symptomatology has been thought of, by other authors as primary or secondary to other pathologies, originating in melancholia or changing into it. The nosographic position varies. Either obsession is considered an autonomous illness or it is connected to other pathologies (neurasthenia, degeneration, Verrücktheit). Connections with other illnesses are dominated by relationships to melancholia; connections to paranoia are much more problematic; those with hysteria are seldom mentioned. After setting up frameworks for manic-depressive psychosis and schizophrenia (Kraepelin, Bleuler) and for hysteric neurosis (Freud), the nosographic position of obsessions, which have become “obsessional neurosis”, varies according to these pathologies and becomes complex. Kraepelin has it as an anxiety disorder connected to phobias but links some obsessions with “manic-depressive insanity”. The followers of Kraepelin insist on the connection with manic-depressive illness. Bleuler connects the obsessions to schizophrenia-schizothymia. These relations between obsession and schizophrenia give rise to abundant literature. Their links are located at a psychopathological level (“Spaltung,” the defense, slowing down, repairing and recovery from schizophrenia), at a symptomatological level (pedantry-mannerism, schizophrenic autism-closed aspect of the obsessed, their motor disorders-catatonia), or at a clinical level (obsession-schizophrenia association). Obsessions are considered by other authors as personality disorders. Notably by Kretschmer (sensitive reaction) or by Schneider as a psychopathic personality: anancastics, second subgroup of the self uncertain psychopaths. As for the anthropological-existential point of view, it tackles the patient with obsessive disorders in his or her totality and analyses the transcendental constitution of his or her world.

New Issue of the International Review of Psychiatry

The latest issue of International Review of Psychiatry is dedicated to psychiatry in a colonial context.

Titles, authors and abstracts are listed below.

History of psychiatry in West Africa by F. Oyebode (Department of Psychiatry, University of Birmingham, Birmingham, UK). The abstract reads:

This paper explores the social context of the development of mental asylums in colonial Nigeria. The characteristics of the medical leadership is described, as is the environmental condition of the asylums. The colonial period produced conceptualizations of the African mind and of the pattern and distribution of mental illness in Africans. These conceptualizations are critically examined.

Psychiatry in the East African colonies: A background to confinement by Sloan Mahone (University of Oxford, Oxford, UK). The abstract reads:

This article is concerned with the discipline of psychiatry in colonial East Africa as it emerged out of the crime and disorder problem to become an intellectually significant ‘East African School’ of psychiatry. The process of lunacy certification, in particular, provides a snapshot of the medical and political tensions that existed among the medical establishment, the prison system and the colonial courts, all of whom sought to define collective African behaviour. This historical article utilises archaic terminology, such as ‘lunatic’ or ‘lunacy’, as these categories were in use at the time.

Modern psychiatry in India: The British role in establishing an Asian system, 1858-1947 by J. Mills (Centre for the Social History of Health and Healthcare Glasgow, Department of History, University of Strathclyde, Strathclyde, Glasgow, UK). The abstract reads:

Four broad phases can be traced in the development of modern psychiatry in India. After briefly considering the outline of each of these phases this article will focus its attention on the second and third. It will be argued through tracing the trends in patient admission, treatment regimes and the organisation of the asylum system in these years that the foundations of modern psychiatry were laid in India in the period 1858 to 1947 and that the modern psychiatric system in India as it is today, although it has evolved since Independence in 1947, continues in significant ways to be shaped by the colonial period.

Madmen and specialists: The clientele and the staff of the Lunatic Asylum, Bangalore by Sanjeer Jain and P. Murthy (Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India). The abstract reads:

The history of the asylum has proven to be an invaluable resource for exploring the interface between science, medicine, religion and social and political processes. The definitions of insanity have troubled humans for centuries, as have the methods for treatment. Diverse, and often conflicting, ideological positions are quite common. Documenting the specific histories of the staff and patients of an asylum can thus help us understand the evolution of the physical and the intellectual growth of psychiatry in India. In this endeavour, we have used the records of the Lunatic Asylum, Bangalore (later the All India Institute of Mental Health and subsequently the National Institute of Mental Health and Neurosciences [NIMHANS]) to explore the history of psychiatry in India. The only asylum maintained by a ‘Native Kingdom’, it exemplifies the dynamics of the growth of mental health services in the country. We trace the changes in administrative control of the Asylum, the changes in medical practice and some aspects of the social history of the region. This article traces the history of psychiatry at one institution, which, at the micro level, is a mirror to the understanding of the historical trends of psychiatric services in India.

A brief history of psychiatry in Singapore by B. -Y. Ng (Department of Psychiatry, Singapore General Hospital) and K. -T. Chee (Woodbridge Hospital and Institute of Mental Health, Singapore). The abstract reads:

The development of psychiatric services in Singapore during the last 150 years can be divided into four distinct, albeit overlapping, phases: (1) the origins of the Lunatic Asylum; (2) the interruption caused by the Japanese Occupation, and the post-war years; (3) the training of local psychiatrists and mental health professionals; and (4) the development of general hospital psychiatry and community mental health services. Early psychiatry in Singapore was essentially British psychiatry as an outpost but modified by local conditions. Modern psychiatry in Singapore has its roots in Singapore’s colonial past and is strongly influenced by Western psychiatry. It has come a long way since its humble beginnings when the first mental hospital was established in 1841.

The development of psychiatry in Indonesia: From colonial to modern times by H. Pols (Unit for History and Philosophy of Science, University of Sydney, Sydney, Australia). The abstract reads:

During the colonial period, mental health care policy in the Dutch East Indies was centred on the mental hospital, which provided custodial care. In 1949, independent Indonesia inherited four very large mental hospitals, about 10 acute-care clinics in the major cities, and an agricultural colony. During the 1950s, mental hospital care remained largely custodial. In 1966, the Directorate of Mental Health adopted the three-fold principles of prevention, treatment, and rehabilitation as the foundation of a comprehensive mental health care system. During the 1970s and 1980s, the number of mental hospitals in Indonesia doubled and a variety of treatment methods were introduced. Special attention was given to the care provided by dukuns, or indigenous healers.

Psychiatry and its institutions in Australia and New Zealand: An overview by Catharine Coleborne (Department of History, The University of Waikato, Hamilton, New Zealand) and Dolly MacKinnon (Department of History, University of Melbourne, Australia).

New Issue of History of Psychiatry

The first issue of the History of Psychiatry for 2010 has been released online. Included in this issue are seven articles, which address the madness of King George III, Philipp Pinel, Danish psychiatrist August Wimmer, Jean-Marc Gaspard Itard, William Saunders Hallaran and John Jackson.

Titles, authors and abstracts are listed below.

King George III and porphyria: a clinical re-examination of the historical evidence by Timothy J Peters (Institute of Archaeology and Antiquity, University of Birmingham) and D. Wilkinson (Institute of Education, University of London). The abstract reads:

« The diagnosis that George III suffered from acute porphyria has gained widespread acceptance, but re-examination of the evidence suggests it is unlikely that he had porphyria.The porphyria diagnosis was advanced by Ida Macalpine and Richard Hunter, whose clinical symptomatology and historical methodology were flawed. They highlighted selected symptoms, while ignoring, dismissing or suppressing counter-evidence. Their claims about peripheral neuropathy, cataracts, vocal hoarseness and abdominal pains are re- evaluated; and it is also demonstrated that evidence of discoloured urine is exceedingly weak. Macalpine and Hunter believed that mental illnesses were primarily caused by physical diseases, and their diagnosis of George III formed part of a wider agenda to promote controversial views about past, contemporary and future methods in psychiatry. »

The madness of King George III: a psychiatric re-assessment by Timothy J Peters (Institute of Archaeology and Antiquity, University of Birmingham) and Allan Beveridge (Queen Margaret Hospital, Dunfermline, UK). The abstract reads:

« This research, based on a study of King George III’s medical records and of contemporary diaries of his courtiers and equerries, further confirms the considerable doubt on the claim of Richard Hunter and Ida Macalpine that the King suffered from recurrent attacks of acute porphyria. The present study examines the above records from a psychiatric viewpoint, together with some additional reports, to re-assess the nature of the King’s maladies. It concludes that he suffered from recurrent mania (four episodes), with chronic mania and possibly a degree of fatuity during the last decade of his life. This is in agreement with previous reports that he suffered from manic-depressive psychosis. »

Science and morals in the affective psychopathology of Philippe Pinel by Louis C Charland (University of Western Ontario, Canada). The abstract reads:

« Building on what he believed was a new ‘medico-philosophical’ method, Philippe Pinel made a bold theoretical attempt to find a place for the passions and other affective posits in psychopathology. However, his courageous attempt to steer affectivity onto the high seas of medical science ran aground on two great reefs that still threaten the scientific status of affectivity today. Epistemologically, there is the elusive nature of the signs and symptoms of affectivity. Ethically, there is the stubborn manner in which fact and value are intermingled in affectivity. Both obstacles posed insuperable difficulties for Pinel, who never really managed to extricate his affective psychopathology from the confines of the Lockean intellectual paradigm. »

Wimmer’s concept of psychogenic psychosis revisited by Augusto C Castagnini (University of Cambridge). The abstract reads:

« In the early twentieth century the Danish psychiatrist August Wimmer (1872—1937) developed the concept of psychogenic psychosis (PP) as a category of mental disorders separate from schizophrenia and manic depression. It subsumed a variety of clinical conditions with affective, confusional and paranoid features typically triggered by a psychical trauma. Wimmer’s work has established itself as one of the classic texts in Scandinavian psychiatry but, for linguistic reasons, long remained almost unknown in other European countries. Translated into English in 2003, it is now available for historical and psychopathological analyses. This paper describes the original meaning of PP and sets it in context, then discusses the implications arising from the usage of the diagnostic categories introduced to replace PP in modern international classifications. »

J.-M. G. Itard’s 1825 study: movement and the science of the human mind by Sara Newman (Kent State University, USA). The abstract reads:

« Jean-Marc Gaspard Itard’s 1825 ‘Study of several involuntary functions of the apparatus of movement, gripping, and voice’ discusses 10 individuals with uncontrolled movements but no other significant impairments. Thus, otherwise normal people move in inappropriate ways against their better judgement. Although the study contains the first clinical description of Tourette Syndrome, it has received little attention beyond that notice. Examined in its entirety and in its cultural context, Itard’s study characterizes patients’ movements in terms of the will, propriety, animals and gender. Lacking control over their movements, the individuals are underdeveloped humans. Accordingly, sufferers’ facial expression, bodily movements and unplanned vocalizations render them more animal than human and more deviant than normal, although they are neither insane nor evil. »

Hallaran’s circulating swing by Caoimhghín S Breathnach (University College Dublin). The abstract reads:

« William Saunders Hallaran (c.1765—1825) was physician superintendent at the County and City of Cork Lunatic Asylum for 40 years, where he distinguished between mental insanity and organic (systemic) delirium. In treatment he used emetics and purgatives, digitalis and opium, the shower bath and exercise, and argued that patients should be saved from ‘unavoidable sloth’ by mental as well as manual occupation. However, it is as an exponent of the circulating swing, proposed by Erasmus Darwin and used by Joseph Cox, that he is remembered. His best results were achieved, as he recorded in An Enquiry in 1810, by inducing sleep in mania of recent onset, but perhaps his most enduring observation was that some of his patients enjoyed the rotatory experience, and he had enough sense to allow the use of the swing as a mode of amusement. »

The work of John Hughlings Jackson: Part 1 by JM López Piñero by GE Berrios (University of Cambridge). The abstract reads:

« After returning to Spain from a research period in London on a Wellcome Trust scholarship, José Maria López Piñero1 published in 1973 a short book entitled John Hughlings Jackson (1835—1911), Evolucionismo y Neurología (Madrid, Editorial Moneda). Written from the perspective of the classical German medical historiography that the author had imbibed from Werner Leibbrand and Annemarie Wettley, this work truly added to Jacksonian scholarship. Neither hagiographic nor nitpicking, it offered a sober assessment of the contribution of the great Yorkshireman and it was soon to become a minor classic among connoisseurs. Although important additions to Jacksonian scholarship have appeared since 1973, López Piñero’s book has retained its relevance. It will be published in History of Psychiatry in two parts. »

La revue Pratiques sur l'enfermement

The French journal Pratiques publishes an extensive analysis of the confinement’s strategies in psychiatry and prisons. Articles have been written among others by the sociologist Loïc Wacquant and the philosopher Alain Brossat.

The website of the journal is here.

The summary of this edition is here.

Anne Cottebrune on Franz Josef Kallmann

In the latest number of the German journal Medizinhistorisches Journal, Anne Cottebrune publishes an article on the trajectory of Franz Josef Kallmann who was one of the founding fathers of psychiatric genetics.

« The founding of the German Research Institute for Psychiatry and its Genealogic-Demographic Department (Genealogisch-Demographische Abteilung; GDA) in 1918 gave the world the first institutional platform for the field of psychiatric genetics. The years between the two World Wars saw the GDA grow in importance with much international respect. The close collaboration between the GDA’s protagonist Ernst Rüdin and the National Socialist regime was certainly not an inhibiting factor for the worldwide recognition of the eugenic research conducted in Munich. Around the mid-1930s, the German psychiatrist émigré Franz Josef Kallmann brought the field of study which had been put into practice in Munich to the United States. He fought an uphill battle to be accepted by the North American scientific community, but finally he was able to establish himself as the main researcher in the field of psychiatric genetics. Interestingly enough, the fact that his kind of research had been heavily supported by the National Socialist regime was not a barrier to his acceptance. The fact that it took him a long time to establish the field of eugenics in the USA is better explained by the psychoanalytic research methods at the time, which gave hereditary transmission short shrift. At the New York State Psychiatric Institute he was able to continue his research, including the examination of race-hygienic motifs, where he designed a research program that was directly based on concepts and methods from Ernst Rüdin’s team of researchers in Munich. The only deviation from the original research was in terms of the use of eugenic prophylaxis where he aligned his research in the context of North American democracy in the post-war era. However, the eugenic goal of elimination of certain categories of peoples remained unchanged. »

This summary and more can be found here.

Nicolas Henckes in Genèses

In a recent number of the French journal of social history, Genèses, Nicolas Henckes publishes an article on the psychiatric hospital reform during the 20th century in France.

The abstract: Borrowing the view of institutions developed by symbolic interactionism and the adopting the point of view of reform process trajectories, this article proposes a framework for analysing psychiatric hospital reform during the 20th century. It objects to the idea that the reform was linked to an institutional crisis and emphasises, on the contrary, the work required to create the conditions under which a certain number of problems can be raised and discussed by the actors at the various moments in history.

Jonathan Goodheart on Insane Poor in Nineteenth-Century Connecticut

In the latest edition of  the Journal of the History of Medicine and Allied Sciences (1/2010) Jonathan Goodheart publishes an article on Insane Poor in Nineteenth-Century Connecticut.

The Abstract: Connecticut was the exception among the Northeastern and Middle Atlantic states in not founding a public institution for the insane until after the Civil War when it opened the Hospital for the Insane at Middletown in 1868, a facility previously neglected by scholars. The state had relied on the expedient of subsidizing the impoverished at the private Hartford Retreat for the Insane that overtaxed that institution and left hundreds untreated. Despite abundant evidence to the contrary, well meaning officials oversold the idea that the Middletown site would promote cures and be cost effective. A number of unanticipated consequences occurred that mirrored fundamental changes in nineteenth-century psychiatry. The new hospital swelled by 1900 to over 2,000 patients, the largest in New England. Custodianship at the monolithic hospital became the norm. The hegemony of monopoly capitalism legitimated the ruling idea that bigger institutions were better and was midwife to the birth of eugenic responses. Class based psychiatry—the few rich at the Retreat and the many poor at Middletown—was standard as it was in other aspects of the Gilded Age. Public policy toward the insane poor in Connecticut represents an outstanding example of the transition from antebellum romanticism to fin de siècle fatalism.