Physicians in Ancient Greece sought to explain and treat mental disturbance, notably melancholy and hysteria, but medieval thought focused on the concept of demonic possession or supernatural spirits. The first hospital wards for the mentally disturbed opened from the 8th century in the Middle East, notably at Baghdad Hospital under Rhazes, with the first dedicated asylums opening from the 15th Century in Egypt, Spain and then the rest of Europe, notoriously at Bedlam in England.
In the 16th century, Johann Weyer famously argued that some cases of alleged witchcraft were actually mental illness, as others had argued before him. Different categories of mental illness became systematically considered by physicians in the context of neurology, a term coined in the 17th century from the work of Thomas Willis. In 1758, William Battie gave impetus to the study and treatment of mental disturbance as a medical speciality. From the late 18th Century, the moral treatment movement sought to make asylums more humane and therapeutic as well as custodial, an approach developed partly from the work of physicians, notably Philippe Pinel, who also developed new ways of categorizing mental disorders.
Psychiatry developed as a clinical and academic profession in the early 19th Century, particularly in Germany. The field sought to systematically apply concepts and tools from general medicine and neurology to the study and treatment of abnormal mental distress and disorder. The term psychiatry was coined in 1808 by Johann Christian Reil, from the Greek “psyche” (soul) and “iatros” (doctor). Official teaching first began in Leipzig in 1811, with the first psychiatric department established in Berlin in 1865. Benjamin Rush pioneered the approach in the United States. The American Psychiatric Association was founded in 1844. Psychiatric nursing developed as a profession.
Early in the 20th Century, neurologist Sigmund Freud developed the field of psychoanalysis and Carl Jung popularized related ideas. Meanwhile Emil Kraepelin developed the foundations of the modern psychiatric classification and diagnosis of mental illnesses. Others who notably developed this approach included Karl Jaspers, Eugen Bleuler, Kurt Schneider and Karl Leonhard. Adolf Meyer was an influential figure in the first half of the twentieth century, combining biological and psychological approaches. Women were admitted as members of the profession and as patients, too
Psychiatry was used by some totalitarian regimes as part of a system to enforce political control, for example in Nazi Germany [4], the Soviet Union under Psikhushka, and the apartheid system in South Africa [5]. For many years during the mid-20th century, Freudian and neo-Freudian thinking dominated psychiatric thinking. Social Psychiatry developed.
From the 1930s, a number of treatment practices came in to widespread use in psychiatry, including inducing seizures (by ECT, insulin or other drugs) or cutting connections between parts of the brain (leucotomy or lobotomy). In the 1950s and 1960s, lithium carbonate, chlorpromazine and other typical antipsychotics and early antidepressant and anxiolytic medications were discovered, and psychiatric medication came in to widespread use by psychiatrists and general physicians.
Coming to the fore in the 1960s, the field attracted an anti-psychiatry movement challenging its theoretical, clinical and legal legitimacy. Psychiatrists notably associated with critical challenges to mainstream psychiatry included R.D. Laing and Thomas Szasz.
Along with the development of fields such as genetics and tools such as neuroimaging, psychiatry moved away from psychoanalysis back to a focus on physical medicine and neurology[6] and to search for the causes of mental illnesses within the genome and the neurochemistry of the brain. Social psychiatry became marginalised relative to biopsychiatry. “Neo-Kraepelinian” categories were codified in diagnostic manuals, notably the ICD and DSM, which became widely adopted. Robert Spitzer was notable in this development. Psychiatry became more closely linked to pharmaceutical companies. New drugs came in to common use, notably SSRI antidepressants and atypical antipsychotics.
Psychiatry was involved in the development of psychotherapies. Neo-Freudian ideas continued, but there was a trend away from long-term psychoanalysis to more cost-effective or evidence-based approaches, particularly cognitive therapy from the work of Aaron Beck. Other mental health professions, particularly clinical psychology, were becoming more established and competing with or working with psychiatry.
During the last third the 20th century, the institutional confinement of people diagnosed with mental illness steadily declined, particularly in more developed countries. Among the reasons for this trend of deinstitutionalization were pressure for more humane care and greater social inclusion, advances in psychopharmacology, increases in public financial assistance for people with disabilities, and the Consumer/Survivor Movement. Developments in community services followed, for example psychiatric rehabilitation and Assertive Community Treatment.
It has been argued that different methods of historical analysis, for example focusing on individual/technical achievements or focusing on social factors and social constructs, can lead to different histories of psychiatry
No comments:
Post a Comment