Lamessende individualpsychologie: sur le rôle de l’expérimentation psychologique dans la psychiatrie d’Emil Kraepelin (seconde partie)

Contemporary historical investigations on Emil Kraepelin’s experimental work have argued variously that the psychological experiment had either no influence on his nosology, or that it was the very precondition of the nosology, or that it skewed the nosology in favor of organic disorders. The first part of this article considered Kraepelin’s experimental research in Wilhelm Wundt’s laboratory in Leipzig during the 1880s. This second part deals with Kraepelin’s work in Heidelberg in the 1890s. It emphasizes the role of the psychological experiment in stabilizing the professional and scientific legitimacy of psychiatry vis-à-vis general medicine and jurisprudence. Above all, it argues that Kraepelin’s experimental research agenda had not just nosological aims, but also clinico-diagnostic aims. Kraepelin believed that his research would help to develop a battery of diagnostic tools that could reveal prodromal symptoms, speed up diagnostic procedures, alleviate institutional overcrowding, and both generate and stabilize psychiatric norms.     

Lamessende Individualpsychologie: sur le rôle de l’expérimentation psychologique dans la psychiatrie d’Emil Kraepelin (première partie)

Recent studies on Emil Kraepelin’s experimental work have focused on the relationship between the psychological experiment and his nosological delineation of dementia praecox and manic-depressive disorders. Interpreters have argued variously that the psychological experiment had either no influence on the nosology, or that it was the very precondition of the nosology, or that it biased the nosology in favor of organic disorders. This article calls into question this historiographic affiliation of experiment and nosology. It argues that by framing Kraepelin’s experimental research agenda solely in terms of his nosology, interpreters have overlooked other important personal, institutional, diagnostic, and professional motives governing that research. Kraepelin’s early career crisis, his frustrations working in overcrowded institutions, and his efforts to enhance the professional stature of psychiatry all influenced his experimental research agenda of amessende Individualpsychologie and the historical significance of that agenda in Kraepelinian psychiatry.     

The Gentleman and the Rogue: The Collaboration Between Charles Darwin and Carl Vogt

This paper investigates the relationship between the eminent 19th-century naturalists Charles Darwin and Carl Vogt. On two separate occasions, Vogt asked Darwin for permission to translate some of the latter’s books into German, and in both cases Darwin refused. It has generally been assumed that Darwin turned down Vogt as a translator because of the latter’s reputation as a radical libertine who was extremely outspoken in his defence of scientific materialism and atheism. However, this explanation does not fit the facts, since, on closer investigation, Darwin not only gave serious consideration to engaging Vogt as the German translator of two of his books, albeit ultimately rejecting him, but he also collaborated with Vogt on the French editions of his works. In this paper we argue that this was not because Darwin was unaware of Vogt’s personality and blunt writing style; rather, Darwin seems to have decided that the benefits he would gain from their association would clearly outweigh the risk of offending some of his readers: in working with Vogt, who was not only a knowledgeable scientist but also an avowed adherent of Darwinism, Darwin could be assured of the scientific quality of the translation and of an edition that would not distort his central concepts – both of which were by no means matters of course in 19th-century translations of scientific works.     

Ernst Rüdin: Hitler’s Racial Hygiene Mastermind

Ernst Rüdin (1874–1952) was the founder of psychiatric genetics and was also a founder of the German racial hygiene movement. Throughout his long career he played a major role in promoting eugenic ideas and policies in Germany, including helping formulate the 1933 Nazi eugenic sterilization law and other governmental policies directed against the alleged carriers of genetic defects. In the 1940s Rüdin supported the killing of children and mental patients under a Nazi program euphemistically called “Euthanasia.” The authors document these crimes and discuss their implications, and also present translations of two publications Rüdin co-authored in 1938 showing his strong support for Hitler and his policies. The authors also document what they see as revisionist historical accounts by leading psychiatric genetic authors. They outline three categories of contemporary psychiatric genetic accounts of Rüdin and his work: (A) those who write about German psychiatric genetics in the Nazi period, but either fail to mention Rüdin at all, or cast him in a favorable light; (B) those who acknowledge that Rüdin helped promote eugenic sterilization and/or may have worked with the Nazis, but generally paint a positive picture of Rüdin’s research and fail to mention his participation in the “euthanasia” killing program; and (C) those who have written that Rüdin committed and supported unspeakable atrocities. The authors conclude by calling on the leaders of psychiatric genetics to produce a detailed and complete account of their field’s history, including all of the documented crimes committed by Rüdin and his associates.     

Psychiatry in General Practice

Psychiatrists should include the family doctor in their plans for future psychiatric services. The general practitioner now treats most of the patients who seek help for psychiatric disorder and he could not give up his psychiatric practice even if he wanted to. Furthermore, there are not now nor will there ever be enough psychiatrists to take over all patients with mental ills. Most emotionally disturbed patients can be better handled by their family physicians than by a specialist.To provide the best care for emotionally disturbed people the communication between family doctors and psychiatrists must be improved. The specialist must acknowledge the importance of the general practitioner''s role in psychiatric diagnosis and treatment and give him more help. Medical schools must provide better undergraduate and postgraduate psychiatric training for the students who will become family doctors. Health plans and other prepayment agencies should properly compensate the general practitioner for giving psychiatric treatment. The specialist in psychiatry should consult more readily with the general practitioner and help him carry out some of the therapy. General hospitals should permit family doctors to admit mental patients to psychiatric wards in a general hospital and to carry out psychiatric treatment with the help of the specialist in psychiatry.     

From presentation to representation in E. B. Wilson'sThe Cell

Diagrams make it possible to present scientific facts in more abstract and generalized form. While some detail is lost, simplified and accessible knowledge is gained. E. B. Wilson's work in cytology provides a case study of changing uses of diagrams and accompanying abstraction. In his early work, Wilson presented his data in photographs, which he saw as coming closest to “fact.” As he gained confidence in his interpretations, and as he sought to provide a generalized textbook account of cell development, he relied on increasingly abstract diagrams. In addition, he came to see that highly abstract and even schematic drawings could provide more than pictures directly from life.     

The Evolving Classification of Dementia: Placing the DSM-V in a Meaningful Historical and Cultural Context and Pondering the Future of “Alzheimer’s”

Alzheimer’s disease is a 100-year-old concept. As a diagnostic label, it has evolved over the 20th and 21st centuries from a rare diagnosis in younger patients to a worldwide epidemic common in the elderly, said to affect over 35 million people worldwide. In this opinion piece, we use a constructivist approach to review the early history of the terms “Alzheimer’s disease” and related concepts such as dementia, as well as the more recent nosological changes that have occurred in the four major editions of the Diagnostic and Statistical Manual since 1952. A critical engagement of the history of Alzheimer’s disease and dementia, specifically the evolution of those concepts in the DSM over the past 100 years, raises a number of questions about how those labels and emergent diagnoses, such as Neurocognitive Disorders and Mild Cognitive Impairment, might continue to evolve in the DSM-V, due for release in 2013.     

Eric Kandel: the future of memory

Watching ice floes glide by on the Hudson River from Eric Kandel's office, one gets a sense of placid reflection tempered by constant action-an apt analogy for Kandel's ability to calmly manage several ongoing projects and commitments at once. In addition to his well-lauded, ongoing research at Columbia University Medical Center's New York State Psychiatric Institute, Kandel has written several books on neurobiology, behavior, and memory. In addition to being a Nobel Laureate Scientist, he is well-known as an editor of the seminal textbook Principles of Neural Science. He and his colleagues are in the midst of working on a new edition of Principles, and he is working on a scientific autobiography. MI sat down with Dr. Kandel and discussed with him a range of topics including childhood and early career influences, intramural research at the NIH, the HHMI, ethical considerations of altering memory and, of course, Aplysia.     

The nature of psychiatric disorders

A foundational question for the discipline of psychiatry is the nature of psychiatric disorders. What kinds of things are they? In this paper, I review and critique three major relevant theories: realism, pragmatism and constructivism. Realism assumes that the content of science is real and independent of human activities. I distinguish two “flavors” of realism: chemistry‐based, for which the paradigmatic example is elements of the periodic table, and biology‐based, for which the paradigm is species. The latter is a much better fit for psychiatry. Pragmatism articulates a sensible approach to psychiatric disorders just seeking categories that perform well in the world. But it makes no claim about the reality of those disorders. This is problematic, because we have a duty to advocate for our profession and our patients against other physicians who never doubt the reality of the disorders they treat. Constructivism has been associated with anti‐psychiatry activists, but we should admit that social forces play a role in the creation of our diagnoses, as they do in many sciences. However, truly socially constructed psychiatric disorders are rare. I then describe powerful arguments against a realist theory of psychiatric disorders. Because so many prior psychiatric diagnoses have been proposed and then abandoned, can we really claim that our current nosologies have it right? Much of our current nosology arose from a series of historical figures and events which could have gone differently. If we re‐run the tape of history over and over again, the DSM and ICD would not likely have the same categories on every iteration. Therefore, we should argue more confidently for the reality of broader constructs of psychiatric illness rather than our current diagnostic categories, which remain tentative. Finally, instead of thinking that our disorders are true because they correspond to clear entities in the world, we should consider a coherence theory of truth by which disorders become more true when they fit better into what else we know about the world. In our ongoing project to study and justify the nature of psychiatric disorders, we ought to be broadly pragmatic but not lose sight of an underlying commitment, despite the associated difficulties, to the reality of psychiatric illness.     

A penalized structural equation modeling method accounting for secondary phenotypes for variable selection on genetically regulated expression from PrediXcan for Alzheimer's disease

As the global burden of mental illness is estimated to become a severe issue in the near future, it demands the development of more effective treatments. Most psychiatric diseases are moderately to highly heritable and believed to involve many genes. Development of new treatment options demands more knowledge on the molecular basis of psychiatric diseases. Toward this end, we propose to develop new statistical methods with improved sensitivity and accuracy to identify disease‐related genes specialized for psychiatric diseases. The qualitative psychiatric diagnoses such as case control often suffer from high rates of misdiagnosis and oversimplify the disease phenotypes. Our proposed method utilizes endophenotypes, the quantitative traits hypothesized to underlie disease syndromes, to better characterize the heterogeneous phenotypes of psychiatric diseases. We employ the structural equation modeling using the liability‐index model to link multiple genetically regulated expressions from PrediXcan and the manifest variables including endophenotypes and case‐control status. The proposed method can be considered as a general method for multivariate regression, which is particularly helpful for psychiatric diseases. We derive penalized retrospective likelihood estimators to deal with the typical small sample size issue. Simulation results demonstrate the advantages of the proposed method and the real data analysis of Alzheimer's disease illustrates the practical utility of the techniques. Data used in preparation of this article were obtained from the Alzheimer's Disease Neuroimaging Initiative database.     

The Short-Doyle Act; California community mental health services program: background and status after one year

The Short-Doyle Act seeks to encourage the treatment of a patient suffering from a psychiatric disorder in his home community, with the assistance of local medical resources. One corollary of this program is the closer working together of the psychiatrist and the rest of the medical profession.A second goal of the act is the application of the public health principles to mental illnesses and mental retardation. Educational and consultative services provide implementation of these principles.     

THE SHORT-DOYLE ACT—California Community Mental Health Services Program: Background and Status After One Year

The Short-Doyle Act seeks to encourage the treatment of a patient suffering from a psychiatric disorder in his home community, with the assistance of local medical resources. One corollary of this program is the closer working together of the psychiatrist and the rest of the medical profession.A second goal of the act is the application of the public health principles to mental illnesses and mental retardation. Educational and consultative services provide implementation of these principles.     

Edmund Vincent Cowdry and the Making of Gerontology as a Multidisciplinary Scientific Field in the United States

The Canadian–American biologist Edmund Vincent Cowdry played an important role in the birth and development of the science of aging, gerontology. In particular, he contributed to the growth of gerontology as a multidisciplinary scientific field in the United States during the 1930s and 1940s. With the support of the Josiah Macy, Jr. Foundation, he organized the first scientific conference on aging at Woods Hole, Massachusetts, where scientists from various fields gathered to discuss aging as a scientific research topic. He also edited Problems of Ageing (1939), the first handbook on the current state of aging research, to which specialists from diverse disciplines contributed. The authors of this book eventually formed the Gerontological Society in 1945 as a multidisciplinary scientific organization, and some of its members, under Cowdry’s leadership, formed the International Association of Gerontology in 1950. This article historically traces this development by focusing on Cowdry’s ideas and activities. I argue that the social and economic turmoil during the Great Depression along with Cowdry’s training and experience as a biologist – cytologist in particular – and as a textbook editor became an important basis of his efforts to construct gerontology in this direction.     

Risk of suicide,deliberate self‐harm and psychiatric illness after the loss of a close relative: A nationwide cohort study

The loss of a close relative is a common event, yet it is associated with increased risk of serious mental health conditions. No large‐scale study has explored up to now the importance of the bereaved person's relation to the deceased while accounting for gender and age. We performed a nationwide Danish cohort study using register information from 1995 through 2013 on four sub‐cohorts including all persons aged ≥18 years exposed to the loss of a child, spouse, sibling or parent. We identified 1,445,378 bereaved persons, and each was matched by gender, age and family composition to five non‐bereaved persons. Cumulative incidence proportions were calculated to estimate absolute differences in suicide, deliberate self‐harm and psychiatric illness. Cox proportional hazard regression was used to calculate hazard ratios while adjusting for potential confounders. Results revealed that the risk of suicide, deliberate self‐harm and psychiatric illness was increased in the bereaved cohorts for at least 10 years after the loss, particularly during the first year. During that year, the risk difference was 18.9 events in 1,000 persons after loss of a child (95% CI: 17.6‐20.1) and 16.0 events in 1,000 persons after loss of the spouse (95% CI: 15.4‐16.6). Hazard ratios were generally highest after loss of a child, in younger persons, and after sudden loss by suicide, homicide or accident. One in three persons with a previous psychiatric diagnosis experienced suicide, deliberate self‐harm or psychiatric illness within the first year of bereavement. In conclusion, this study shows that the risk of suicide, deliberate self‐harm and psychiatric illness is high after the loss of a close relative, especially in susceptible subgroups. This suggests the need for early identification of high‐risk persons displaying adjustment problems after loss of a close family member, in order to reduce the risk of serious mental health outcomes.     

Do Psychosocial Variables Predict Weight Loss or Mental Health after Obesity Surgery? A Systematic Review

Objective: The objective of this study was to present a systematic review of psychological and psychosocial predictors of weight loss and mental health after bariatric surgery. This systematic review included all controlled and noncontrolled trials of the last 2 decades with either a retrospective or prospective design and a follow‐up period of at least 1 year. Research Methods and Procedures: The relevant literature was identified by a search of computerized databases. All articles published in English and German between 1980 and 2002 were reviewed. Results: Using the above inclusion/exclusion criteria, 29 articles were identified focusing on psychosocial predictors of weight loss and mental health after obesity surgery. Discussion: Personality traits have no predictive value for the postoperative course of weight or mental state. Apart from serious psychiatric disorders including personality disorders, psychiatric comorbidity seems to be of more predictive value for mental and physical well‐being as two essential aspects of quality of life than for weight loss postsurgery. However, depressive and anxiety symptoms as correlates of psychological stress with regard to obesity seem to be positive predictors of weight loss postsurgery. The severity of the symptoms or the disorder is more relevant for the outcome of obesity surgery than the specificity of the symptoms. It is also not solely the consumption of distinct “forbidden” foods, such as sweets or soft drinks, but rather a general hypercaloric eating behavior, either as an expression of the patient's inadequate compliance or a dysregulation in energy balance, which is associated with a poor weight loss postsurgery.     

Ethical Obligations in the Face of Dilemmas Concerning Patient Privacy and Public Interests: The Sasebo Schoolgirl Murder Case

A murder case that had some features in common with the Tarasoff case occurred in Sasebo City, Japan, in 2014. A 15‐year‐old high school girl was murdered and her 16‐year‐old classmate was arrested on suspicion of homicide. One and a half months before the murder, a psychiatrist who had been examining the girl called a prefectural child consultation centre to warn that she might commit murder, but he did not reveal her name, considering it his professional duty to keep it confidential. Article 134 of the Japanese Criminal Law states that doctors should not disclose patient information obtained in clinical practice without a legitimate reason, but the Japanese Supreme Court has not specified what constitutes a legitimate reason. Mass media and commentators suggested that the murder could have been prevented if the psychiatrist had disclosed the girl's name to the authorities or had isolated her coercively in a psychiatric ward. However, the authors disagree with such claims. This article discusses obligations imposed on concerned individuals and third party members in cases involving ethical dilemmas regarding patient confidentiality and information disclosure. It is concluded that everyone should fulfill their obligations to prevent such tragedies and one should judge the appropriateness of others’ actions based not on the consequences of their actions, but on the processes used to decide on a course of action and their commitment. It is necessary for us to establish a society in which concerned parties can do what they think is ethically best without fearing ungrounded charges.     

What Bateson had in Mind About ‘Mind’?

G. Bateson believed that the scientific school of the future would be ‘ecology of mind’. The first aim of this paper is to understand what he meant by ‘mind’, and the other is to understand how this concept emerged in his thought, i.e., how its meaning would become more flexible throughout his life and work. Furthermore, we will approach the epistemological implications of ecology of mind for scientific education in the West. Bateson’s concept of mind emerged when he became aware (in 1926) of his own way of thinking, i.e., of his immense abductive capacity. This led him to search for patterns of similarity and difference between organisms (like in homology). Later, he identified this thought process as being abstract and formal, relating not just facts but also ideas. Afterwards, Bateson developed criteria for us to consider a system as being mental, with special emphasis on living and cybernetic systems.     

The controversy over the minimum quantum requirement for oxygen evolution

During the early- to mid-twentieth century, a bitter controversy raged among researchers on photosynthesis regarding the minimum number of light quanta required for the evolution of one molecule of oxygen. From 1923 until his death in 1970, Otto Warburg insisted that this value was about three or four quanta. Beginning in the late 1930s, Robert Emerson and others on the opposing side consistently obtained a value of 8–12 quanta. Warburg changed the protocols of his experiments, sometimes in unexplained ways, yet he almost always arrived at a value of four or less, except eight in carbonate/bicarbonate buffer, which he dismissed as “unphysiological”. This paper is largely an abbreviated form of the detailed story on the minimum quantum requirement of photosynthesis, as told by Nickelsen and Govindjee (The maximum quantum yield controversy: Otto Warburg and the “Midwest-Gang”, 2011); we provide here a scientific thread, leaving out the voluminous private correspondence among the principal players that Nickelsen and Govindjee (2011) examined in conjunction with their analysis of the principals’ published papers. We explore the development and course of the controversy and the ultimate resolution in favor of Emerson’s result as the phenomenon of the two-light-reaction, two-pigment-system scheme of photosynthesis came to be understood. In addition, we include a brief discussion of the discovery by Otto Warburg of the requirement for bicarbonate in the Hill reaction.