Classifying Madness

This book is about the Diagnostic and Statistical Manual of Mental Disorders, more commonly known as the D.S.M. The D.S.M. is published by the American Psychiatric Association and aims to list and describe all mental disorders. Within its pages can be found diagnostic criteria for types of depression, types of schizophrenia, eating disorders, anxiety disorders, phobias, sleeping disorders, and so on. Also included are less familiar, and more controversial, conditions: Mathematics Disorder, Caffeine Intoxication, Nicotine Dependence, Nightmare Disorder. It must be admitted that the D.S.M. is not an exciting read. Its pages follow a standard format: Each disorder has a numerical code. This is followed by a description of the disorder, which includes information regarding prevalence, course, and differential diagnosis. Finally explicit criteria that patients must meet to receive the diagnosis are listed. These generally include lists of the symptoms that must be present, restrictions as to the length of time that the symptoms must have been troublesome, and clauses that state that the symptoms must not be better accounted for by some other condition.

This volume explores the history and historiography of madness from the ancient and medieval worlds to the present day. Covering Africa, Asia and South America as well as Europe and North America, chapters discuss broad topics such as the representation of madness in literature and the visual arts, the material culture of madness, madness within life histories and the increased globalization of knowledge and treatment practices. Chronologically and geographically wide-ranging and providing a fascinating overview of the current state of the field, this is essential reading for all students of the history of madness, mental health, psychiatry and medicine.

In 1895 there was not a single case of dementia praecox reported in the United States. By 1912 there were tens of thousands of people with this diagnosis locked up in asylums, hospitals, and jails. By 1927 it was fading away . How could such a terrible disease be discovered, affect so many lives, and then turn out to be something else? In vivid detail, Richard Noll describes how the discovery of this mysterious disorder gave hope to the overworked asylum doctors that they could at last explain—though they could not cure—the miserable patients surrounding them. The story of dementia praecox, and its eventual replacement by the new concept of schizophrenia, also reveals how asylum physicians fought for their own respectability. If what they were observing was a disease, then this biological reality was amenable to scientific research. In the early twentieth century, dementia praecox was psychiatry’s key into an increasingly science-focused medical profession. But for the moment, nothing could be done to help the sufferers. When the concept of schizophrenia offered a fresh understanding of this disorder, and hope for a cure, psychiatry abandoned the old disease for the new. In this dramatic story of a vanished diagnosis, Noll shows the co-dependency between a disease and the scientific status of the profession that treats it. The ghost of dementia praecox haunts today’s debates about the latest generation of psychiatric disorders.

Systems of Classification in Premodern Medical Cultures puts historical disease concepts in cross-cultural perspective, investigating perceptions, constructions and experiences of health and illness from antiquity to the seventeenth century. Focusing on the systematisation and classification of illness in its multiple forms, manifestations and causes, this volume examines case studies ranging from popular concepts of illness through to specialist discourses on it. Using philological, historical and anthropological approaches, the contributions cover perspectives across time from East Asian, Middle Eastern and Mediterranean cultures, spanning ancient Egypt, Mesopotamia, Greece and Rome to Tibet and China. They aim to capture the multiplicity of disease concepts and medical traditions within specific societies, and to investigate the historical dynamics of stability and change linked to such concepts. Providing useful material for comparative research, the volume is a key resource for researchers studying the cultural conceptualisation of illness, including anthropologists, historians and classicists, among others.

Madness: A History is a thorough and accessible account of madness from antiquity to modern times, offering a large-scale yet nuanced picture of mental illness and its varieties in western civilization. The book opens by considering perceptions and experiences of madness starting in Biblical times, Ancient history and Hippocratic medicine to the Age of Enlightenment, before moving on to developments from the late 18th century to the late 20th century and the Cold War era. Petteri Pietikäinen looks at issues such as 18th century asylums, the rise of psychiatry, the history of diagnoses, the experiences of mental health patients, the emergence of neuroses, the impact of eugenics, the development of different treatments, and the late 20th century emergence of anti-psychiatry and the modern malaise of the worried well. The book examines the history of madness at the different levels of micro-, meso- and macro: the social and cultural forces shaping the medical and lay perspectives on madness, the invention and development of diagnoses as well as the theories and treatment methods by physicians, and the patient experiences inside and outside of the mental institution. Drawing extensively from primary records written by psychiatrists and accounts by mental health patients themselves, it also gives readers a thorough grounding in the secondary literature addressing the history of madness. An essential read for all students of the history of mental illness, medicine and society more broadly.

Today most of us accept the consensus that madness is a medical condition: an illness, which can be identified, classified and treated with drugs like any other. In this ground breaking and controversial work Richard Bentall shatters the myths that surround madness. He shows there is no reassuring dividing line between mental health and mental illness. Severe mental disorders can no longer be reduced to brain chemistry, but must be understood psychologically, as part of normal behaviour andhuman nature. Bentall argues that we need a radically new way of thinking about psychosis and its treatment. Could it be that it is a fear of madness, rather than the madness itself, that is our problem?

Psychiatric and psychological practice and research is critically dependent on diagnosis. Yet the nature of psychiatric diagnosis and the rules by which disorders should be created and organized have been highly controversial for over 100 years. Unlike simple medical disorders (like infectious diseases), psychiatric disorders cannot be traced to one simple etiologic agent. The last two generations have seen major conceptual shifts in the approach to diagnosis with the rise of operationalized criteria and an emphasis on a descriptive rather than etiological approach to diagnosis. The interest in psychiatric diagnoses is particularly heightened now because both of the major psychiatric classifications in the world - DSM and ICD - are now undergoing major revisions. What makes psychiatric nosology so interesting is that it sits at the intersection of philosophy, empirical psychiatric/psychological research, measurement theory, historical tradition and policy. This makes the field fertile for a conceptual analysis. This book brings together established experts in the wide range of disciplines that have an interest in psychiatric nosology. The contributors include philosophers, psychologists, psychiatrists, historians and representatives of the efforts of DSM-III, DSM-IV and DSM-V. Some of the questions addressed include i) what is the nature of psychiatric illness? Can it be clearly defined and if so how? ii) What is the impact of facts versus values in psychiatric classification? iii) How have concepts of psychiatric diagnosis changed over time? iv) How can we best conceptualize the central idea of diagnostic validity? And v) Can psychiatric classification be a cumulative enterprise seeking improvements at each iteration of the diagnostic manual? Each individual chapter is introduced by the editors and is followed by a commentary, resulting in a dynamic discussion about the nature of psychiatric disorders. This book will be valuable for psychiatrists, psychologists and other mental health trainees and professionals with an interest in the questions and problems of psychiatric diagnosis, as well as philosophers and philosophy students interested in the problems posed by psychiatry, particularly those working in the philosophy of science.