History of Psychopathology

Ancient Societies

  • Possession
  • Exorcism
  • Trephining occurred during stone age

 

Greeks

  • Supernatural, punishment by the gods
  • Hippocrates (460-360 BC)
    • All illness was due to natural causes

 

Hippocratic Methods:

1)  Observation

2)  Biogenic theory of abnormal behavior

 

4 Humors: 

  • Phlegm (indifferent/sluggish)
  • Blood (excess, labile mood)
  • Black bile (melancholy)
  • Yellow bile (irritable, aggressive-choleric)

 

3)  Classification:

  • Mania
  • Melancholia
  • phrenitis (brain fever)

 

4)  Humane treatment

 

Plato

  • Care of mentally ill a family responsibility
  • Later retreats established

 

Middle Ages

  • Religiosity
  • Shrines
  • Holy water
  • Starvation
  • Flogging to get the devil out

 

Renaissance & Witch Hunts

  • 15-17th century
  • Demanding for religious reform and other protestations
  • Women accused of being in league with the devil
  • Eating children, orgies, etc.
  • 1484 - Pope Innocent VIII
  • Declared church’s intent to root out the offenders
  • Inquisitors
  • Estimated that 100,000 people were executed as witches during this period
  • Joan of arc burned as witch
  • Probably few mentally ill, mostly political enemies

 

Early Community Services

  • Arabs had mental wards in the 8th century
  • Belgium community home care started in the 15th century
  • Some English hospitals in the middle ages and renaissance had mental wards
  • First exclusive mental hospital in Spain in the early 15th century

 

Reformation Of The Asylums

  • 18th-19th centuries
  • Jean Baptiste Pussin superintendent of french hospital’s “incurables” from 1784-1802
    • Told to unchain patients, not beat them

 

Philippe Pinel

  • Became chief physician in 1793
  • Replaced dungeons
  • Talked to patients
  • Did away with violent treatments:
  • Bleeding
  • Purging
  • Cupping
  • Kept records (case history)

 

Jean Esquirol

  • Took over from Pinel
  • Founded 10 new mental hospitals around France

 

William Tuke

  • Quaker
  • 1796 started York retreat in England
  • Moral therapy- ordinary people with extraordinary problems
  • During the first half of the 19th century, at least 70% in mental hospitals improved or recovered

 

Reform in America

 

Benjamin Rush (1745-1813)

  • Physician
  • Father of American Psychiatry”
  • First medical course in psychiatry
  • Mental illness due to excess of blood in brain vessels
  • Bleeding
  • Ice baths     
  • “The tranquilizer chair”

 

Other 19th Century Treatments

  • Shaking Machine

 

Dorothea Dix

  • 1802-1887
  • School teacher
  • Pushed reform
  • Resulted in 32 mental hospitals

 

Tx Changes:

  • Moral therapy declined
  • Too many patients, not enough staff
  • Replaced by custodial care

 

Clifford Beers

  • 1876-1943
  • Yale graduate
  • Bipolar
  • Experienced deplorable hospital conditions
  • Founder of modern mental health movement
  • “A Mind That Found Itself”

 

Rise of Medical Model

  • Promoting “cure”
  • Kept hospitalized

 

Lobotomy - 1935

  • Moniz
  • Won Nobel Prize in 1946
  • By 1955, 40,000 men, women, and children had lobotomies in the US

 

New Meds

  • Beyond tranquilizers
  • Appeared in the mid 20th century
  • Many released from hospitals
  • Or moved to open ward/halfway houses