History of psychiatry

Meet the paper — twice

3 September 1949, the Medical Journal of Australia. A psychiatrist at a Victorian repatriation mental hospital publishes four pages titled "Lithium salts in the treatment of psychotic excitement". John Cade had no pharmaceutical sponsor, no control group and no committee. The oldest continuously used drug in psychiatry entered the world through a small Australian case series.^[3]

Then 1973, in Science. David Rosenhan reports that pseudopatients presented to psychiatric hospitals, were admitted, and were not recognised as well once they had been labelled. The paper detonated public trust and accelerated diagnostic reform. Fifty years later a historian would describe substantial parts of it as successful scientific fraud.^[7][9]

Two papers, two lessons, one exam question: how do you know which landmarks to trust? That question is what the history station is actually testing. Candidates who only recite names fail; candidates who can say why it mattered and what was wrong with it pass.^[2][8][12]

Etymology for viva gold: asylum comes from the Greek asylon, "inviolable" — a sanctuary that could not be seized. Within a century the word for refuge had become the word people feared most, which is the reform-cycle thesis in a single noun.^[2]

References14ShowHide

1. [1]Kendler KS, Tabb K, Wright J The Emergence of Psychiatry: 1650-1850 Am J Psychiatry, 2022.PMID 35331024
2. [2]George P, Jones N, Goldman H, et al. Cycles of reform in the history of psychosis treatment in the United States SSM Ment Health, 2023.PMID 37388405
3. [3]Cade JF Lithium salts in the treatment of psychotic excitement Med J Aust, 1949.PMID 18142718
4. [4]López-Muñoz F, Alamo C, Cuenca E, et al. History of the discovery and clinical introduction of chlorpromazine Ann Clin Psychiatry, 2005.PMID 16433053
5. [5]Ban TA Fifty years chlorpromazine: a historical perspective Neuropsychiatr Dis Treat, 2007.PMID 19300578
6. [6]Gazdag G, Ungvari GS Electroconvulsive therapy: 80 years old and still going strong World J Psychiatry, 2019.PMID 30631748
7. [7]Rosenhan DL On being sane in insane places Science, 1973.PMID 4683124
8. [8]Spitzer RL On pseudoscience in science and the case for psychiatric diagnosis. A critique of Rosenhan's "On Being Sane in Insane Places" Arch Gen Psychiatry, 1976.PMID 938183
9. [9]Scull A Rosenhan revisited: successful scientific fraud Hist Psychiatry, 2023.PMID 36737877
10. [10]Spitzer RL, Endicott J, Robins E Research diagnostic criteria: rationale and reliability Arch Gen Psychiatry, 1978.PMID 655775
11. [11]Wilson M DSM-III and the transformation of American psychiatry: a history Am J Psychiatry, 1993.PMID 8434655
12. [12]Shorter E The history of nosology and the rise of the Diagnostic and Statistical Manual of Mental Disorders Dialogues Clin Neurosci, 2015.PMID 25987864
13. [13]Kendell R, Jablensky A Distinguishing between the validity and utility of psychiatric diagnoses Am J Psychiatry, 2003.PMID 12505793
14. [14]Jacob KS Recovery model of mental illness: a complementary approach to psychiatric care Indian J Psychol Med, 2015.PMID 25969592