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PubMed2004

Delusions of gender?: Lay identification and clinical diagnosis of insanity in Victorian England.

This chapter examines the lay identification and medical diagnosis of patients admitted to public mental hospitals in Victorian England through an analysis of over 1,500 admissions to the Buckinghamshire Lunatic Asylum. It demonstrates three things: women were institutionalised in numbers commensurate with their representation in the adult population; the certification of the insane was not dominated by male informants; and there is no empirical evidence to suggest that gender played a dominant role in the decision over the selection of particular psychiatric diagnoses. This chapter suggests future areas of research for a new historical epidemiology of mental symptoms.

Commitment of Persons with Psychiatric Disorders↗
PubMed1975

Family interactions as etiological factors in mental disorders: An analysis of the American Journal of Insanity, 1844-1848.

A review of the first four volumes of the American Journal of Insanity indicated that the primary etiological factor noted by authors during that period was disturbed brain functioning, although emotional factors were often mentioned as additional explanations for mental illness. The influence of familial factors and interactions on the development of mental illness was rarely explored. The author concludes that psychiatry at this time did not yet recognize the importance of the dynamics of and interpersonal stresses within family relationships.

Family↗
PubMed1979

"Folk" criteria for the diagnosis of mental illness in rural Laos: on being insane in sane places.

"Folk" criteria for identifying the mentally ill, as distinguished from folk theories about the causes of mental illness, have been comparatively neglected in cultural psychiatry. The authors describe the criteria by which villagers in Laos labeled 35 subjects as baa (insane). Unprovoked assaultive or destructive behavior, social isolation, self-endangerment due to neglect of personal needs, nonviolent but socially disruptive or inappropriate behavior, and inability to do productive work were found to be important folk criteria. The authors emphasize that folk criteria for mental illness are determined primarily by the persistence of socially dysfunctional behavior rather than by disturbances in thought and affect.

Adult↗
PubMed1979

The apprenticeship of Philippe Pinel: a new document, "observations of Citizen Pussin on the insane".

Philippe Pinel is usually pictured in histories of psychiatry and of medicine as the man who first liberated the insane from their chains. The document presented here, discovered in 1978 in the Archives nationales in Paris, reveals the crucial role of Jean-Baptiste Pussin, the "governor" of mental patients at Bicêtre. It was Pussin who initiated Pinel to psychological methods (the famous traitement moral) in dealing with hospitalized mental patients. Further, in 1797, Pussin first replaced chains with straitjackets. Pinel later obtained Pussin's transfer to the Salpêtrière to help him reorganize that huge hospital.

France↗
PubMed1995

Effect of therapeutic innovation on perception of disease and the doctor-patient relationship: a history of general paralysis of the insane and malaria fever therapy, 1910-1950.

OBJECTIVE: The purpose of this study was to examine the effect of therapeutic innovation on the interpersonal style of physicians by using the historical example of the treatment of general paralysis of the insane by malaria fever therapy. METHOD: The study employed historical qualitative and descriptive methods to analyze medical and popular literature and medical records. These medical records were from a single institution and contained verbatim transcripts of patient interviews and doctors' conferences. The author examined records of patients diagnosed with neurosyphilis from the periods before (1910-1928) and after (1928-1950) the introduction of malaria fever therapy. RESULTS: Before the introduction of malaria fever therapy, physicians saw their neurosyphilitic patients as "hopeless," "immoral," and "stupid" paretics--objects to be acted upon, a view consistent with the cultural belief that syphilitic patients were sinful and depraved. After the introduction of malaria fever therapy, doctors wrote more positively and empathically about their neurosyphilitic patients, allowing patients to become active participants in their therapeutic regimens. Patients with neurosyphilis voluntarily sought admission specifically for fever therapy, seeing the asylum as a place of cure rather than as an institution of confinement. CONCLUSIONS: This history illustrates that biological therapies can powerfully affect physicians' perceptions of patients and need not remove them from patients' subjective experiences. Instead, biological treatments may enhance physicians' ability to empathize with their patients' suffering.

Animals↗
PubMed1986

The Canton Asylum for Insane Indians: an example of institutional neglect.

Based on archival data, the author chronicles the history of the Canton (S.D.) Asylum for Insane Indians, which was established by Congress in 1903 and was closed in 1934 because of inadequate conditions. In 1926 a nationwide survey found that patients at Canton received minimal care. The rates of patient death and discharge at Canton reported in a 1931 survey compared unfavorably to those at other mental institutions in the U.S. The 1929 and 1933 inspection reports of psychiatrist Samuel Silk, which documented the hospital's outmoded custodial care and questioned the necessity of institutionalization for 35 to 40 of Canton's 90 patients, played a key role in the decision to close the asylum. The author attributes the decline of the Canton Asylum to gradual neglect by its superintendent and various government agencies.

Female↗
PubMed1994

The early case for caring for the insane in general hospitals.

The early argument for caring for the insane in general hospitals arose in the late 1800s in the context of criticisms of the asylum made by neurologists and some psychiatrists. The movement in support of general hospital psychiatry gained ground within psychiatry as the modernization of the general hospital made it a more attractive work site for physicians. By the second decade of this century, a newly independent discipline of hospital administration was providing an audience for psychiatrists who wanted to make the medical and financial case for the value of psychiatric care in the general hospital. Although in the 1930s only a fraction of general hospitals included a "department for mental patients," general hospital psychiatric treatment had ceased to be only a rhetorical or experimental concept and was fast becoming a practical program of treatment.

History, 19th Century↗
PubMed1975

Insanity proceedings and black-white state hospital admission rate differences.

This study attempted to determine if the higher state hospital admission rates of blacks are due to greater proportions of blacks being adjudicated incompetent at county insanity hearings. The records of 2,264 cases from 12 Florida counties in 1969 and observations and interviews in the county courts were used to answer this question. With the exception of a slight difference in middle-sized counties, the higher rates of state hospital admission were found to be due to initial differences in petitioning to the court rather than to adjudication differences. The lack of difference is due to the fact that the proportion competent, when refined, proves to be very small for both blacks and whites, thus allowing for little variation by ethnicity. The operation of a racial stereotype was, however, demonstrated in a detailed analysis of one large county.

Adolescent↗
PubMed1994

Women, families and the Provincial Hospital for the Insane, British Columbia, 1905-1915.

The article examines the role of the family in the lives of women in a turn-of-the-century psychiatric institution in British Columbia, Canada. The continued connection between institutionalized women and their families is highlighted. Evidence drawn from the psychiatric case files of 774 women patients at British Columbia's Provincial Hospital for the Insane show that families significantly influenced such factors of institutional life as the conditions of care, the timing of discharge and the possibility of readmission. Conclusions presented here underscore the negotiated and conflictual nature of asylum practice.

Canada↗
PubMed1975

A follow-up of patients found "unfit to stand trial" or "not guilty" because of insanity.

Fifty-six patients who were found unfit to stand trial or not guilty by reason of insanity were followed up after their release from a maximum security psychiatric institution. At the time of follow-up 50 percent lived in the community, 43 percent were in psychiatric facilities and 5 percent were in correctional facilities -- 9 percent of the patients were either returned to the maximum security hospital or had committed new offences. The twenty-seven ex-patients who were interviewed generally exhibited little psychiatric symptomatology and there was evidence that they had adjusted well to the psychiatric facility or community in which they lived. As a group they appeared to have made a better vocational than social adjustment.

Adult↗
PubMed1978

Insanity in bar of trial in Scotland: a State Hospital study.

Legal findings of unfitness to stand trial are returned ten times more frequently in Scotland than in England and Wales. Sixty-five patients in the State Hospital who had been found insane in bar of trial were compared with a control group of 64 offender patients. They showed a significantly greater incidence of homicidal crimes and diagnoses of psychotic disorders, 19 per cent of which later proved to be unstable. They had also been detained longer at the State Hospital. These findings are discussed and particular reference is made to the tendency for psychotic offenders to be almost automatically regarded as unfit to plead. A brief comparison is made with the situation in England, and some modifications in forensic psychiatric procedure are suggested.

Adult↗
PubMed1990

Claimed simulation of insanity. A coping strategy in mania.

The coping strategy of claimed simulation of insanity observed at the onset of psychotic episodes in a manic patient is reported here. There is a need for systematic research on coping strategies in affective psychosis in order to develop techniques to help contain or prevent relapses.

Acting Out↗
PubMed1981

Is uncle Sen insane? Pride, humor, and clique formation in a Northern Thai home for the elderly.

Called a flirt, rascal, buffoon, and disgrace, Uncle Sen created considerable confusion among staff and patients at Chiangmai city's only home for the elderly. Whether to label him insane or not loomed as an issue that divided his aged peers into two cliques. Behind these reactions are isolated two adaptive styles of the Northern Thai elderly to a rapidly changing traditional social system.

Aged↗
PubMed1997

Accounts of abuse of patients at the Toronto Hospital for the Insane 1883-1937.

In an effort to uncover the experiences and perspectives of patients about abuse in institutions, this article will present the writings of asylum inmates and third-party observers, including relatives and staff, on this topic. These documents consist almost entirely of material from the Toronto Hospital for the Insane, from the late nineteenth and early twentieth centuries. References include physical, verbal, and sexual abuse. Methodological challenges when coming across this evidence will be addressed, most notably the problem of verification when charges of abuse are denied or are met with silence by hospital officials. Furthermore, this topic will include a discussion of inmates abusing other patients in an effort to compare how these episodes were reported in contrast to incidents that involved staff.

Canada↗
PubMed2001

[Chapters in the history of psychiatry in Israel and its surroundings: B). The Asfouriyeh hospital for the insane in Lebanon].

This is the second of a series of articles dealing with the history of psychiatry in Eretz-Israel and its surroundings. After a brief survey of the Ottoman medicine and Islamic hospitals, this article presents a short description of the treatment for mentally ill patients in the Ottoman Empire. We describe the historical background and the establishment of the Asfouriyeh hospital for the insane in Lebanon towards the end of 19th century, as well as other mental hospitals in this land. We outline some similarities in initiative and administration during the foundation of Ezrath-Nashim hospital in Jerusalem at that time.

History, 15th Century↗
PubMed1996

[An unpublished letter from Joseph Daquin: the draft of a diary on the insanes].

The author presents an unpublished letter from Joseph Daquin, a savoyard physician contemporary of Philippe Pinel to the minister Chaptal. This letter gives and outline of the practical researches lead by this other pioneer of psychiatry, on the relation to establish with the insane on one hand, on the influence of the moon on madness on the other hand.

France↗
PubMed1994

[An adventure in the insane asylum: the life of Franco Basaglia].

The process of change in the mental health field and psychiatric reforms bear a close relationship to practical and theoretical issues stemming from Franco Basaglia's experience. This article is intended as a reflection on Basaglia's career, stressing the main concepts and theoretical references he worked with and seeking to trace the unique nature of his contributions to the current project for de-institutionalizing psychiatry. Basaglia produces a break by profoundly challenging psychiatric knowledge and institutions, thus allowing for a new epistemological framework (a framework that was thus also new in relation to culture and mental health care) in dealing with insanity. Based on the observation that Basaglia's work is little known, this article attempts to revisit his thinking, highlighting the unique nature of his contributions and stressing the need for a better understanding of his work by those who are devoted to the field of mental health and social institutions.

History, 20th Century↗
PubMed2003

Death at the Hiawatha Asylum for Insane Indians.

From 1903 to 1933, the Hiawatha Asylum for Insane Indians housed hundreds of inmates in Canton, SD. It closed in 1933 in a cloud of scandal and controversy. Death certificate data from deceased inmates were analyzed for diagnostic cause of death and for age. These findings were compared to a sample of non-Asylum adult deaths for the same years in the same county. The inmates died younger (average age-42), and of tuberculosis (63 of 182 deaths). The historical import of this is discussed.

Adult↗