Classic German psychiatry
Classic (German) Psychiatry is a name for the psychiatric history began prevailing scientific trends in psychiatry from the second half of the 19th century to assume a pioneering role as the German psychiatry. The hallmarks of this psychiatry are positivistic philosophy and the establishment of a psychiatric disease systematics, as well as phenomenology , which was the starting point for a psychopathological assessment .
Well-known representatives of classical German psychiatry were Emil Kraepelin (1856–1926), Karl Jaspers (1883–1969) and Kurt Schneider (1887–1967). Accordingly, the publication of the 6th edition of Kraepelin's textbook in 1899 is often seen as the beginning of this epoch. Psychopharmacology , which began around 1955, marked the end of classical psychiatry. Initially, this drug therapy seemed to confirm the assumptions of German classical psychiatry and to solidify the structures of large hospitals (see also endogenous psychoses # psychotropic drugs ). But it turned out that acute cases could now be treated more quickly and the existence of so-called "custodial facilities" (protective institutional facilities) no longer required.
Psychotropic therapy and psychotherapy
The structures of large psychiatric hospitals were mainly characterized by a high percentage of the chronically ill. This caused their dual character as sanatoriums and nursing homes. The effectiveness of psychotropic drugs made it possible to discharge acute patients earlier and thus to reduce the proportion of chronically ill patients. However, high readmission rates indicated still unresolved problems. With the introduction of psychotherapy as a treatment concept for the chronically mentally ill, a successful attempt has been made to further reduce these figures. Psychotherapy must not be limited to helping to adapt to life in the institution (institution socialization, sociotherapy).
The success of psychopharmaceutical therapy and the demand for psychotherapy gave the anti-psychiatric movement, which emerged around 1960, its anti-institutional character. Through the use of psychotropic drugs, the dissolution of the large hospitals was practically initiated and implemented. The end of classical psychiatry is therefore definitely the 1970s and 1980s. The psychiatry inquiry commissioned in 1971 on the state of psychiatry in the Federal Republic of Germany revealed considerable shortcomings, both in the field of psychiatric hospitals and homes as well as in outpatient and community-based services.
History of Psychiatry
Klaus Dörner notes that scientific thinking, as it was common in psychiatry in the 19th century (and ultimately found its highest expression in university psychiatry ), had already been exposed to considerable criticism since the 1920s and even more clearly since 1945. The objectifying, disposing and atomizing tendencies were deplored.
The question was also asked whether causal analytical research is appropriate to the self- image of psychiatry and whether more is lost with a purely scientific approach than is gained with it. By pushing back the paternalistic element to a certain extent, social psychiatry, especially in Germany, was once again able to become aware of its long European traditions and role models.
Ideological disputes
- Main article : Endogenous psychosis
Ideological one-sidedness resulted from disputes that arose between psychics and somatics initially in the 19th century and most recently in the 1970s and 1980s between supporters of antipsychiatry and classical psychiatry. In intellectual history, classical psychiatry is essentially shaped by Neo-Kantianism as its representative in psychiatry, in addition to Emil Kraepelin (1856–1926), above all Karl Ludwig Kahlbaum (1828–1899), Heinrich Schüle (1840–1916) and Richard von Krafft- Ebing (1840–1902) should be mentioned.
change of direction
If in the days of classical German psychiatry the universities were mainly a place of scientific psychiatric research, since 1955 the interest has now concentrated on the complementary social psychiatric services at health authorities and counseling centers with a wide range of tasks that are developing outside of these clinics . The contrast between university and institutional psychiatry was intensified.
Individual evidence
- ^ A b Peters, Uwe Henrik : Lexicon of Psychiatry, Psychotherapy, Medical Psychology . Urban & Fischer, Munich 6 2007; ISBN 978-3-437-15061-6 ; (a) on lexicon article “Psychiatrie, classic (German)”: page 428; (b) to the lexicon articles “Psychiatrie-Inquête”: page 427, Action for the mentally ill: page 16; "Working groups, psychosocial": page 48, "Enquete-Psychiatrie": page 162 (online)
- ↑ a b Eikelmann, Bernd : Basic social psychiatric knowledge . Enke, Stuttgart 1997, ISBN 3-432-27801-2 ; (a) Re. “ Epidemiology of the chronically mentally ill”: page 23 ff .; (b) Re. “Contrast between pharmacology and psychotherapy”: pages 118, 178 ff.
- ↑ a b Finzen, Asmus : The end of the institution. From the arduous everyday life of reform psychiatry. Psychiatrie-Verlag, Bonn 1985, ISBN 3-88414-061-2 ; (a) Re. “Dissolution of hospital wards for the chronically mentally ill and the role of psychotropic drugs”: page 69; (b) Re. “University and institutional psychiatry”: page 36 f.
- ↑ a b c d Dörner, Klaus : 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) Re. “Relevance of scientific approaches to the history of psychiatry”: page 16 f .; (b) Re. “Social Psychiatry”: pages 113, 202; (c) on taxonomy “Psychics and Somatics”: page 281 ff .; (d) Re. “Neo-Kantianism”: page 208
- ^ Dörner, Klaus and Ursula Plog: To err is human or textbook of psychiatry / psychotherapy. Psychiatrie-Verlag Rehburg-Loccum 7 1983, ISBN 3-88414-001-9 ; Re. “Antipsychiatry”: page 439, Re. “Psychiatrie-Inquête”: Page 12, Re. “Absolute claims in psychiatry”: Page 440.