20 Major Milestones in Psychiatric History

February 5, 2012 | Psychiatric History, Psychiatry

Although psychiatric investigations and treatments began well before 1667, it was in that year that behavioral patterns became associated with the brain and explained with neurological theories. From that point, the logical steps toward today’s psychiatry practice included medicine, surgery, and other forms of methodologies that affected how people behave. While this progress seems notable, the end note is a lawsuit against a pharmaceutical company for its lack of transparency about side affects of a certain drug. While procedures today are less invasive than before, the treatments still remain sketchy and highly controversial.

    Psycho-Neurotic Treatments

  1. 1667Thomas Willis, one of the fathers of neuroscience, described in detail the anatomy of the brain and nervous system. He developed theories relating to neurological explanations for psychiatric illnesses.
  2. 1798Philippe Pinel contributed to psychiatry by beginning a trend to categorize the different illnesses which people suffered from in a more detailed way than had previously been done. Many more of these nosologies were developed, and today psychiatrists use the WHO ICD 10 and APA SMD-IV to define and classify illnesses. In 1801, he led a revolutionary movement to remove asylum patients from chains and dungeons.
  3. 1808 — German physician Johann Christian Reil coined the term “psychiatrist,” based on the Greek word meaning “healing the soul.” in his 118-page paper, “On the term of medicine and its branches, especially with regard to the rectification of the topic in psychiatry.” Reil’s work was mainly theoretical, with little direct clinical experience.
  4. 1811 — It was in Leipzig this year that the first chair of psychiatry/psychotherapy in the western world was established and given to Johann Heinroth. Heinroth did not leave any significant scientific contributions, however, since his work focused on the reform of the mental health care system.
  5. 1822Antoine-Laurent Bayle, a French physician, attributed the psychiatric symptoms of neurosyphilis to a chronic inflammation of the meninges, making him the first person to discover a psychiatric disease with definite organicity. The causative organism, Treponema pallidum, was first identified by Fritz Schaudinn and Erich Hoffmann in 1905. The first effective treatment (Salvarsan) was developed in 1910 by Paul Ehrlich, which was followed by trials of penicillin and confirmation of its effectiveness in 1943.
  6. 1834 — Anna Marsh, a physician’s widow, deeded the funds to build her country’s first financially-stable private asylum. The Brattleboro Retreat marked the beginning of America’s private psychiatric hospitals challenging state institutions for patients, funding, and influence. Today, the Brattleboro retreat serves as a regional specialty mental health and addictions treatment center.
  7. 1838 — France passed a law that established its modern asylum system [PDF]; other countries like England, Germany, and the U.S. quickly followed suit. In the U.S., there were almost 140 of such institutions caring for nearly 41,000 patients by 1880.
  8. 1841 — the Royal College of Psychiatrists was founded and was initially known as the Association of Medical Officers of Asylums and Hospitals for the Insane, and the Pedico-Psychological Association (1866-1925). The association was granted a Royal Charter in 1926 and finally became the Royal College of Psychiatrists in 1971. It is the UK’s professional and educational body for psychiatrists.
  9. 1888 — the Swiss psychiatrist Gottlieb Burckhardt performed the first attempts at psychosurgery this year. Six chronic schizophrenic patients underwent localized cerebral cortical excisions. Most patients showed improvement and became easier to manage, although one died from the procedure and several had aphasia or seizures.
  10. Straightjacket

  11. 1900Sigmund Freud‘s book, The Interpretation of Dreams was published, and the book popularized his theory of psychoanalysis. A neurologist by training, Freud developed his theories about the unconscious mind. He is regarded as the founder of psychotherapy and introduced the concepts of id, ego, and superego.
  12. 1912 — Initially a follower of Freud, Carl Jung eventually disagreed with Freud’s ideas and developed his own framework of the unconscious mind. His work led to the beginnings of the Analytical Psychotherapy tradition. In 1912, Jung published his groundbreaking book, Psychology of the Unconscious, a study of the transformations and symbolisms of the libido. It was revised in 1952 as Symbols of Transformation, Collected Works Vol.5.
  13. 1927Manfred Sakel, a Polish neurophysiologist and psychiatrist, was the discoverer of insulin shock therapy for schizophrenics and other mental patients in 1927.
  14. 1938 — Electro-convulsive therapy (ECT), also known as “shock therapy,” was first used, and would continue until the 21st century. Ugo Cerletti was the first to deliver the treatment. The fact that it quickly and effectively improved symptoms in many patients with severe depression renewed hope that physical treatments could cure mental illnesses.
  15. 1951 — Paul Charpentier, building on Henri Laborit’s work, formulated ‘compound 4650RP’ (later renamed Chlorpromazine, brand name Thorazine) for use as an anaesthetic adjunct. In 1952, Jean Delay was the first psychiatrist to recognize the therapeutic value of chlorpromazine in the treatment of schizophrenia. He invented the word “psychopharmacology.” The introduction of neuroleptics had an enormous impact, as it was a major factor in the clearing and opening of the psychiatric wards, allowing many inpatients to function effectively as outpatients. In 1952, German-born Canadian psychiatrist Heinz Lehmann administered chlorpromazine, a “mood-calming” drug, to 70 patients; it was licensed in the U.S a year later. It also marked the advent of the pharmaceutical industry’s burgeoning clout in mental health care.
  16. 1961Michel Foucault‘s Madness and Civilization was published, reflecting the growing counter-cultural backlash against psychiatry. Foucault is best known for his critical studies of social institutions, most notably psychiatry, medicine, the human sciences, and the prison system, as well as for his work on the history of human sexuality.
  17. 1971 — Computed axial tomography (CAT scans), and later MRI (magnetic resonance imaging), began to show the living brain in greater detail than ever before, allowing psychiatrists a way to view the subtleties of the brain without surgery.
  18. PROZAC

  19. 1979 — Senator Ted Kennedy chaired U.S. congressional hearings on the increase in tranquilizer use. Other prominent figures, such as Gloria Steinem and former first lady Betty Ford, spoke out about drug and alcohol addiction, which became rampant in the 1970s and 80s. Surprisingly, despite the fears of counterculture use and drug addiction, a study showed that, in the late 1960s, middle-class mothers were the highest consumers of tranquilizers.
  20. 1980DSM-III, psychiatry’s “bible,” marks the shift in clinical psychiatry from a largely Freudian approach to a more biological orientation. The fifth edition of the DSM (DSM-5) is scheduled to be published in 2013, and its development is suspected to be of significant interest to many medical fields.
  21. 1999PROZAC became the third best-selling prescription drug in America. This drug was approved for release in 1987, and its impact on the treatment of depression was extraordinary. Today, PROZAC is used for the treatment of major depressive disorder in patients from eight to eighteen-years-old, and as a treatment for obsessive-compulsive disorder in patients from seven to seventeen-years-old. It is used for a multitude of adult disorders.
  22. 2007 — The overwhelming use of drugs to treat various psychiatric disorders has built to a disturbing crescendo. Eli Lilly, for instance, was engaged in a decade-long effort to minimize the effects of Zyprexa, its best-selling medication for schizophrenia. Eli Lilly agreed on January 4, 2007 to pay up to $500 million to settle 18,000 lawsuits from people who claimed they developed diabetes or other diseases after taking Zyprexa. Including earlier settlements over Zyprexa, Lilly has now agreed to pay at least $1.2 billion to 28,500 people who claim they were injured by the drug.

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