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History of Mental Illness : Barry

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Robin Barry

on 28 August 2015

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Transcript of History of Mental Illness : Barry

Hippocrates
Greece (460 - 377 B.C.E.)
Plato
Greece (429 - 347 B.C.E.)
Studied mentally disturbed criminals
"not responsible"
Community care of mentally ill
Psychological phenomena - response of whole organism
Intellect
Socio-cultural influences
Hospitals for mentally ill
Conversations - health of soul
Aristotle
Greece (384 - 322 B.C.E.)
Plato's student
Considered hypotheses that psychological processes (frustration, conflict) could cause mental illness and rejected
Greece/Roman
Sanatoria for mentally ill
Pleasant surroundings
Enjoyable activities
Diet, exercise, education
bleeding, purging, restraints
Chinese Medicine
Natural rather than supernatural causes
yin and yang (positive and negative forces) - want balance
Chung Ching
China (200 C.E)
Wrote well-known medical texts
Based his views on clinical observations
Organic causes for mental illness
Could be influenced by environment
Treatments: drugs & activities to restore balance
Middle Ages, 500 C.E. - 1500 C.E
First(?) Mental Hospital Established
Baghdad (792 C.E.)
Humane treatment
Avicenna
Persia (980 - 1037 C.E.)
Wrote The Canon of Medicine
Referred to several mental illnesses
Europe
Middle Ages
Supernatural causes for mental disorders
Mass Madness (Mass hysteria still occurs): group behavior disorders
Dancing manias (e.g., Tarantism; Saint Vitus's dance)
Lycanthropy
Clergy primarily cares for mentally ill
Exorcisms
Witchcraft (?)
Paracelsus
Swiss physician (1490 - 1541 C.E.)
Advocated disease hypothesis over demonic possession
Johann Weyer
Germany (1515 - 1588 C.E.)
Studied and argued against imprisonment, torture & burning of accused witches, many mentally/physically ill
St. Vincent de Paul
(1576 - 1660)
"Mental disease is no different than bodily disease..."
Argued for humane treatment
Asylums
Places of refuge
Remove from society
Provide care
Most filthy, cruel
Mexico (1566)
France (1641)
Pennsylvania Hospital in Philadelphia (1756)
Intimidate patients into "choosing sanity"
Drugs, bleeding, shocks,
First Asylum in Europe established
Spain (1409)
St. Mary of Bethlehem [A.K.A. Bedlam]
London (1547)
Patients exhibited to public for profit
Poor conditions & practices
Philippe Pinel
France (1745-1826)
1792 Removed chains from some mental patient inmates: successful experiment, conditions improved
William Tuke
England (1732 - 1822)
1796 established York Retreat
Humane conditions
Improving hospital conditions
England
1841 Samuel Hitch introduced trained staff
1842 Lunacy Inquiry Act: monitoring of conditions
1845 Country Asylums Act: required counties to provide care
More humane treatment spread to the colonies (Australia, Canada, India, West Indies, South Africa, etc.)
Benjamin Rush
U.S. (1745 - 1813)
Moral Management (1833 - 1853): social, individual, occupational rehab
Highly effective compared to prior and later treatments
Mental hygiene movement & advances in biomedical science contributed to it's demise
Benjamin Franklin
U.S. (1706 - 1790)
Electrical experiments: proposed using shock to treat melancholia
Shock not used in treatment until 19th and 20th centuries
Dorothea Dix
U.S. (1802 - 1887)
Champion of poor & "forgotten"
1841 - 1881 Campaigned for better treatment for mentally ill
Raised money and public support for suitable mental health hospitals
"Alienists" (psychiatrists)
Early 1800's
Emotional problems caused by exhaustion
Few effective treatments
Clifford Beers
U.S. (1876 - 1943)
1908 published A Mind that Found Itself
Described his mental collapse
Treatment in mental hospital
Recovery
Raised public awareness
U.S. By 1940
Over 400,000 patients housed in public mental hospitals
Primarily severe disorders
lengthy stays (many years)
Often harsh treatment
Mary Jane Ward
U.S.
1946 published The Snake Pit
Later became a movie
Attention to experience of mental patients
Raised public awareness/concern
U.S. (1946)
Government support for research and training
Hill-Burton Act
U.S. 1946
Funding for community mental health hospitals
Community Health Services Act of 1963
U.S. (1963)
Outpatient psychiatric clinics, inpatient facilities in general hospitals, community consultation & rehab
Erving Goffman
U.S. Sociologist
1961 published Asylums
exposed inhumane treatment
1948, Lithium to treat Bipolar
Antipsychotics
Deinstitutionalization
International
Community care for mentally ill
Efforts made to close down mental hospitals
Effective psychopharmaceuticals
Originally seemed more humane
Issues with homelessness for some
General Paresis & Syphilis
1825 A.L.J. Bayle identified General Paresis as a specific type of mental disorder
1897 Richard von Krafft-Ebbing linked General Paresis with Syphilis
Suggested a biological cause for mental disorder
1906 August von Wasserman: blood test for Syphilis
1917

fever cure/later penicillin
Albrecht von Haller
(1708 - 1777)
1757 Elementa Physiologae Corporis Humani
Importance of brain in psychic functions
Advocated postmortem disection of brain for insane
Wilhelm Griesinger
Germany (1817 - 1868)
1845 The Pathology and Therapy of Psychic Disorders
Asserted all mental disorders explained in terms of brain pathology
Henry Cotton
U.S. (1876 – 1933)
Theory of mental illness: remove infections to remove disorders (1923)
Surgeries to remove teeth, tonsils, parts of colon, testicles, ovaries
Egas Moniz
Portuguese (1874 - 1955)
1936 published procedures for lobotomy (received Nobel Prize 1949)
1927 developed cerebral angiography
Emil Kraepelin
German (1856 - 1926)
Developed system of classification of mental disorders (1883)
Certain symptom patterns appear together
Emphasized importance of brain pathology
Insisted mental disorders had natural not supernatural causes
Brain pathology (observed those with head injuries)
Described mania, melancholia, phrenitis (brain fever): clinical observations
Ascribed to four humors theory of personality: phlegm, blood, bile, black bile
For melancholia prescribed tranquil life, diet, moderate activity, bleeding
Case of Mass Hysteria suspected
West Bank (1983)
Cass of Mass Hysteria suspected
Nigeria (1990)
Group of men feared their genitals had vanished
Deaths in Exorcism rituals
U.S. (reported 2001 and 2003)
Woman drowned 4-year-old daughter in exorcism ritual
Autistic boy killed in exorcism ritual
China, 2674 B.C.E.
Greece, 460 - 322 B.C.E.
Supernatural hypothesis of mental illness
Timeless
Chinese, Egyptians, Hebrews, Greeks
Demon/god possession
Punishment for sin
Exorcism
Renaissance, 1300 - 1600
China
Later 2nd to
early 19th centuries
Supernatural hypothesis
ghosts/spirits
China, 200 C.E
Europe and U.S., 1700 - 1900
1900 - present
John Cade
Australia (1912 - 1980)
Sigmund Freud
Vienna (1856–1939)
Franz Mesmer
Austria (1734–1815)
(1778) Illness attributed to distribution of magnetic fluids
Ideas associated with later development of hypnosis
THE NANCY SCHOOL
Ambrose August Liébeult
(1823–1904), French
(1866) Hypnosis and hysteria, pain
Led to debate whether mental disorders were caused by psychological or physical problems
"Talk" therapy to treat hysteria (with Joseph Brauer 1893)
Psychoanalysis
Catharsis
Theory of unconscious
Experimental Psychology
Wilhelm Wundt (1832–1920)
and William James (1842–1910)
Lightner Witmer
U.S. (1867–1956)
1896 first psychology clinic University of Pennsylvania
William Healy
U.S. (1869–1963)
1909 Chicago Juvenile Psychopathic Institute
Juvenile delinquency a symptom of urbanization
Environmental causes of mental illness
Ivan Pavlov
(1849–1936)
(1900) Classical conditioning
Began behavioral perspective
John B. Watson
(1878–1958)
Behaviorism (thriving by 1930s)
Classical conditioning to influence human behavior
B. F. Skinner
(1904–1990)
Opperant conditioning (1937)
Consequences of behavior influence likelihood that behavior will be repeated
1879 First lab (Wundt)
Mental Health Parity Act
U.S. (1996 - present)
1996 (Clinton) requires annual/lifetime $ limits on MH benefits be no lower than physical benefits offered by a group health plan (insurers able to circumvent)
2008 (Bush) attempted to close gaps on law
Still unclear: will "non-bio based" illnesses (PTSD, eating disorders) be required to be covered
Exemptions for small employers/increased cost
Modern example of lobotomy: Cingulotomy
(1996)
Rees Cosgrove, Harvard Med School published Magnetic Resonance Image-Guided Stereotactic Cingulotomy for Intractable Psychiatric Disease
1950s Paul Charpentier: Chlorpromazine (Thorazine)
Reserpine
Abridged History of Mental Illness and Treatment
Look for themes, take home points
Ladislas J. Meduna
Hungarian
1934 Convulsive Therapy: seizures to treat schizophrenia
Ugo Cerletti & Lucio Bini
Italian
1937 Electrical shock: seizures for treatment of schizophrenia
Supernatural
Biological
Psychological
Environmental
Multifactorial
Hypothesis of mental illness
Institutionalization
Humane
Inhumane
Full transcript