Mental illness


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Classification according to ICD-10
F29 Unspecified inorganic psychosis
ICD-10 online (WHO version 2019)

In the past, different patterns of behavior and illnesses were referred to as mental illness or mental disorder , which are expressed through forms of behavior that are not accepted in society (see chapter on state medicine ). Both terms are rarely used today.

“Mental illnesses” can now be understood as a generic term for any type of mental disorder or, more specifically, as a psychosis (i.e. as a group of diseases with more severe symptoms and a rather unfavorable prognosis).

Use of the term today

In legal parlance, and especially in forensic psychiatry , the term continues to be used for mental disorders of a considerable extent (such as schizophrenia or also for intellectual disabilities ) and certain personality disorders , such as in childcare law , incapacitation and guilty incapacity .

In medical and psychological parlance, however, the term mental illness is rarely used today because of difficulties in defining it. Griesinger's sentence in particular ensured the historical spread of the term: "Mental illnesses are brain diseases" (see historical roots of the term ). The attempts to define the term can now be viewed as rather inadequate.

Instead of mental illnesses, people today usually speak of mental disorders or mental illnesses . But the historical legacy is still noticeable in this choice of words (see also historical roots of the term ). Of the mental illnesses, the mental illnesses were distinguished as circumscribed affective psychoses and the mental weakness as a disorder with clinically less pronounced symptoms.

Historical roots of the term

According to Klaus Dörner , the term mental illness was largely coined by Friedrich Wilhelm Schelling and his identity philosophy around 1800. Schelling turned against Hegel here , claiming that the soul cannot become ill because it is of divine origin: “It is not the spirit that is infected by the body, but, conversely, the body by the spirit.” This is where the origins of the German doctrine of endogeneity lie and the French doctrine of degeneration as well as its presumed anticipation of physical justifiability. It was the psychic's view that sin and moral wrongdoing are the main causes of mental illness. It had to be left open whether the soul or the spirit became ill. In the 19th century the term mental illness prevailed for mental illness , and for mental illness from 1845 the term psychosis . However, this was also the point at which the general validity of psychics began to falter. Mental disorder also means the scientifically defined term of illness, cf. the distinction between psyche and soul and the term psychiatry coined by Johann Christian Reil .

The conclusion "Mental illnesses are brain diseases" announced by Wilhelm Griesinger in his textbook Pathology and Therapy of Mental Illnesses in 1845 required a rethinking of psychiatry in the sense of somatics . With this, however, the research really got on the track of a search for somatic findings in psychoses , as represented above all in classical German psychiatry . Freud's point of view and the neuroses he treated therefore seemed like a relapse into romantic medicine . Sociopolitical references were not made in this way, but the doctors mostly asserted a purely scientific paradigm without social commitment, see Chap. State medicine . A triadic system of psychiatry and the multiconditional approach associated with it ( Ernst Kretschmer ) only gradually emerged. The view that mental illnesses are also caused by physical and emotional factors, as represented by psychosomatic medicine with model ideas of psychophysical correlation , is only a comparatively young development step in the two centuries of history of research into mental illnesses.

State medicine

Charles Louis Müller (1820–1895) Pinel frees the mad from their chains

In Germany, the beginnings of institutional psychiatry in the 19th century were largely determined by state medicine, which borrowed its ideological borrowings from the moral teachings of philosophy and religion, but which, as industrialization began, increasingly included socio-economic aspects in state-political considerations. The presence of state presence seemed especially therefore essential because of the basic assumption of Uneinfühlbarkeit and incomprehensibility ran out of active behavior in mental diseases, in particular on the risk of mania . This caused the mentally ill to be viewed as potentially dangerous to the public , partly in continuation of the absolutist exclusion of unreason - for example through the methods of the Hôpital général . The basic assumption that there was a danger to the community favored the advocacy of coercive measures .

Philippe Pinel (1745-1826) is widely praised for having freed the sick from their chains, because he overthrew the basic assumption of the common danger and against the Jacobin terror husband Georges Couthon argued before the inmates, the maniacs are so aggressive because they for the sake Coercive measures would have adopted this behavior. A real liberation from chains by Pinel cannot be proven. The term mental illness therefore also played a decisive role in legal terms. Until the end of 1991, the term "mental illness" was anchored in the text of § 6 BGB .

Situation since the 1980s

Assumptions from the 1960s and 1970s that psychiatric patients do not pose a higher risk to the general public than other citizens have been called into question by numerous psychiatric and epidemiological studies in Northern Europe, Great Britain and North America since the 1980s .

Regardless of the findings of criminal statistics, the protection of the general public is regulated by law in modern constitutional states for specific dangers in individual cases, for example in Germany through the implementation of measures and in Austria through the implementation of measures .

See also

Web links

Wiktionary: Insanity  - explanations of meanings, word origins, synonyms, translations

Individual evidence

  1. Alphabetical directory for the ICD-10-WHO version 2019, volume 3. German Institute for Medical Documentation and Information (DIMDI), Cologne, 2019, p. 315.
  2. Pschyrembel clinical dictionary , Verlag deGruyter, 267th edition 2017 ( ISBN 978-3-11-049497-6 ). ( Keyword mental illness, online )
  3. a b Uwe Henrik Peters : Dictionary of Psychiatry and Medical Psychology. 3. Edition. Urban & Schwarzenberg, Munich 1984; Lexicon-Stw. "Mental Illness," p. 212; Lexicon-Stw. "Mental Illness", p. 215.
  4. ^ Scientific service Hoffmann-La Roche: Roche Lexicon Medicine. Elsevier, Munich (© Urban & Fischer 2003 - Roche Lexicon Medicine 5th Edition) online (keyword “mental illness” required)
  5. Rolf Kaiser: "Mental illnesses are brain diseases". A historical - critical investigation using the example of "schizophrenia", Pahl-Rugenstein-Verlag 1983
  6. FWJ Schelling: Stuttgart private lectures . (1810) In: »Works«, Ed. Schröter, Munich 1927, Volume IV, p. 360.
  7. a b c d e f Klaus Dörner : Citizens and Irre . On the social history and sociology of science in psychiatry. (1969) Fischer Taschenbuch, Bücher des Wissens, Frankfurt / M 1975, ISBN 3-436-02101-6 ; (a) to district “Geisteskrankheit”, pp. 263 f., 270 f. (Footnote 224); (b) on taxation “Endogeneity”, pp. 56, 58, 98, 178, 260, 288, 339 f .; (c) on taxation “Degenerationslehre”, pp. 187, 214, 267, 271, 309, 327, 329; (d) on tax authority “Staatsmedizin”, pp. 199, 202; (e) on stw. “Exclusion of unreasonableness”, “outgrowing compulsion” etc .: see text on the cover (back) as well as pages 26–36, 43, 49, 55, 57, 73 f., 87–89, 119 , 132, 137 f., 140, 144 f., 155, 164, 190-202, 211, 230, 239, 242-244, 251, 258, 274, 286, 332, 335; (f) to Stw. “Pinel and Crouthon”, p. 159 f.
  8. a b Erwin H. Ackerknecht : Brief history of psychiatry. 3. Edition. Enke, Stuttgart 1985, ISBN 3-432-80043-6 ; (a) Viewpoint of the Psychics, p. 59; (b) Point of view of the somatics, p. 61.
  9. ^ Thure von Uexküll : Basic questions of psychosomatic medicine. Rowohlt Taschenbuch, Reinbek bei Hamburg 1963, Stw. "Geisteskrankheit" pp. 44 ff., 72, 98 f., 215
  10. Karl Jaspers : General Psychopathology. 9th edition. Springer, Berlin 1973, ISBN 3-540-03340-8 , 4th part: The conception of the totality of mental life; § 2 The basic distinctions in the overall area of ​​mental life, II. Essential differences d) Mental illnesses and mental illnesses (natural and schizophrenic mental life) "Impensibility and incomprehensibility", p. 483 f.
  11. ^ Michel Foucault : Madness and Society . (Histoire de la folie. Paris, 1961) A story of madness in the age of reason. Suhrkamp, ​​stw 39, 1973, ISBN 3-518-27639-5 ; The foreword uses terms such as “splintering” , “demarcation” and “history of borders” as common words for the relationship between reason and lack of reason , in order to clarify the concerns of the work, see page 9 in particular
  12. Rudolf Degkwitz et al. (Ed.): Mentally ill . Introduction to Psychiatry for Clinical Study. Urban & Schwarzenberg, Munich 1982, ISBN 3-541-09911-9 ; - (a) Re. “Mental illnesses in the judgment of the professional world and the population” p. 7, column 1; (b) Re. “Danger to the community and forced accommodation”, pp. 402–404.
  13. Magdalena Frühinsfeld: Brief outline of psychiatry. In: Anton Müller. First insane doctor at the Juliusspital in Würzburg: life and work. A short outline of the history of psychiatry up to Anton Müller. Medical dissertation Würzburg 1991, p. 9–80 ( Brief outline of the history of psychiatry ) and 81–96 ( History of psychiatry in Würzburg to Anton Müller ), p. 70.
  14. ^ Hans-Ludwig Kröber, Dieter Dölling, Norbert Leygraf, Henning Saß (eds.): Manual of forensic psychiatry. Volume 4: Criminology and Forensic Psychiatry , Springer-Verlag, 2009, ISBN 9783798517462 , preview Google Books , p. 322 ff.
  15. Jan Volavka: Neurobiology of Violence , 2nd, revised edition. American Psychiatric Publishing, Washington DC 2008, ISBN 9781585627820 , preview Google Books , p. 234 ff.