Psych Vivas · Foundations — historiography
History of psychiatry — structured clinical viva
Fellowship viva on history of psychiatry landmarks, reform cycles, nosology, and clinical communication.
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Target exams
FRANZCPMRCPsychABPNMD-DNB
Prompt
Examiner: 'Psychiatry’s past is only chains and asylums — modern manuals prove we are scientific now, so history is irrelevant.' Using a 45-year-old man with bipolar mania referred for lithium education, and a family terrified of 'shock treatment' and lifelong hospitalisation, defend a sophisticated historical account: moral treatment, landmarks (ECT, lithium, chlorpromazine), deinstitutionalisation, Rosenhan/DSM-III, validity vs utility, recovery, and ethical dark history — linking each to contemporary practice.
Interpretation
Reveal interpretationShowHide
Reject both presentist arrogance (“history irrelevant”) and nihilism (“only chains”). Markers want dated landmarks, multi-causal deinstitutionalisation, DSM-III as reliability project, Rosenhan plus critique awareness, validity/utility split, recovery complementarity, and ethical ownership of eugenics/coercion — all tied to lithium education and ECT stigma in this case.[2][5][6][7]
References9ShowHide
- [1]Kendler KS, Tabb K, Wright J The Emergence of Psychiatry: 1650-1850 Am J Psychiatry, 2022.PMID 35331024
- [2]Cade JF Lithium salts in the treatment of psychotic excitement Med J Aust, 1949.PMID 18142718
- [3]López-Muñoz F, Alamo C, Cuenca E, et al. History of the discovery and clinical introduction of chlorpromazine Ann Clin Psychiatry, 2005.PMID 16433053
- [4]Gazdag G, Ungvari GS Electroconvulsive therapy: 80 years old and still going strong World J Psychiatry, 2019.PMID 30631748
- [5]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
- [6]Wilson M DSM-III and the transformation of American psychiatry: a history Am J Psychiatry, 1993.PMID 8434655
- [7]Kendell R, Jablensky A Distinguishing between the validity and utility of psychiatric diagnoses Am J Psychiatry, 2003.PMID 12505793
- [8]Jacob KS Recovery model of mental illness: a complementary approach to psychiatric care Indian J Psychol Med, 2015.PMID 25969592
- [9]Rosenhan DL On being sane in insane places Science, 1973.PMID 4683124