University Psychiatry

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University psychiatry is psychiatry carried out in theory and practice at universities. In this respect, Uwe Henrik Peters has to agree when he writes about the practical and historically significant part of psychiatry in the 19th century: " European psychiatry had first developed as institutional psychiatry from around 1800 until the leadership was transferred to the universities from 1850-1860, from where all innovations since then originated. “This presentation does not take into account the theoretical influence that extended to Europe and the USA, particularly from the Scottish University of Edinburgh and its representatives Robert Whytt (1714–1766), his successor William Cullen (1710–1790) and his pupil John Brown (1735–1788) went out in the 18th century. This had an impact on the founding of many institutional psychiatrics as well as on an increasingly empirical research direction in the future. The founders and masterminds of institutional psychiatry, influenced by the Scottish School, were William Battie (1703–1776) and Thomas Arnold (1742–1816) in England , Philippe Pinel (1745–1826) in France , Vincenzo Chiarugi (1759–1820) in Italy , in Germany Johann Christian Reil (1759-1813) and in the USA Benjamin Rush (1745-1813).

Development in Germany

Spread of university psychiatry

In Germany, scientific progress was initiated by the somatics and was first initiated by Johann Christian Reil (1759–1813) as a pioneer of romantic medicine, including somatic research, who called for the establishment of psychiatric institutes associated with professorships. Heinrich Damerow (1798–1866), Christian Roller (1802–1878) and the Illenau School that originated from him , which with Heinrich Schüle (1840–1916) and Richard von Krafft-Ebing (1840–1903 ), implemented this idea in Germany ) gained scientific importance. Johann Gottfried Langermann (1768-1832), on the other hand, was more of a proponent of moral treatment . Nevertheless, his theory of the psychogenic causation of mental illness can be traced back to the influence of Georg Ernst Stahl (1660–1734), who developed his theory of nerves from 1694 as a professor at the newly founded University of Halle. Besides Johann Christian Reil, Langermann is one of the few authors who wrote treatises on mental illness in Germany at the time. The teachings of GE Stahl and Albrecht von Haller were by no means alien to the Scottish School of the University of Edinburgh . Wilhelm Griesinger (1817–1868) was not only a pioneer of university psychiatry in Germany, with his reform plans as a proponent of so-called urban asylums , he re-triggered the old dispute, which Damerow had painstakingly settled, about the care system or the “relative affiliated institutions ”. The question was whether severe chronic and mild acute cases should be accommodated in common institutions or separately. In contrast to institutional psychiatry, university psychiatry has mainly concentrated on acute psychiatric illnesses. This causes a certain methodological restriction in the presentations of the psychiatry department, if one takes into account that these are now mainly based on university scholars. It was also recognized that the rural institutions were leading to social uprooting and thus to hospitalism . The classical German psychiatry has historically mainly University psychiatry. It culminated in an emphasis on somatic psychiatric aspects, sometimes in an absolutization of these aspects, for example in questions of euthanasia .

Outlasting institutional psychiatry

The anti- psychiatry movement in the years 1968–1980 was marked by a common rejection of classical German psychiatry. This was mostly associated with criticism of the somatic disease model . Furthermore, the criticism aimed at a lack of consideration of social factors on the part of university psychiatry. The social commitment of many institutional psychiatrists continues in the activities of various psychiatric aid associations and community psychiatric welfare offices, the so-called external welfare until the beginnings of social psychiatry .

Karl Jaspers

Karl Jaspers , who, according to EH Ackerknecht, coined the pair of terms “institutional psychiatry - university psychiatry”, sees it as an advantage of university psychiatry that it has become a “ purer science ”, that “ a continuous development is emerging in some areas ” and that " Area of ​​investigation extraordinarily expanded ". Among these extensions, Jaspers counts the “ penetration into the medical consultation hour ” ( consultation hour psychiatry ), the role of psychiatry in sociological questions and the approach to psychology , initially primarily to experimental psychopathology . However, since the beginning of the 20th century there has also been a more general opening towards the psychological field. Jaspers' main points of contact with sociology are criminal investigations ( forensic psychiatry ). The mentioned continuous development in small, sometimes even “ petty ” appearing steps, stands in contrast to the “ generous viewpoints ” of institutional psychiatry, which, however, are often enough limited to a philosophy “ without any real depth ” and thus remain “ unclear ”. Karl Jaspers sees no reason to give preference to either of the two areas, university psychiatry or institutional psychiatry. Even against voices that claim that institutional psychiatry can no longer achieve anything scientific, Jaspers sees the importance of institutional psychiatry in no way diminished. He sees them in their means and their material called to continue to build on the questions of their “ glorious past ”. Jaspers refers in this context to the Dobrick and Weber controversy. The tendency towards opening up towards psychiatric consultation has been explained and confirmed in particular by K. Dörner using Wilhelm Griesinger as an example. Since mental illness was viewed as a physical illness, it also made sense to support the no-restraint movement and to outlaw punitive measures in psychiatry.

Belgium

Joseph Guislain (1797–1860) can be seen as an early representative of university psychiatry in Belgium .

Individual evidence

  1. ↑ a b Peters, Uwe Henrik : Dictionary of Psychiatry and Medical Psychology . Urban & Schwarzenberg, Munich 3 1984; (a) to Dictionary-Stw. “University Psychiatry”: page 586; (b) to dictionary-stw. “Langermann, Johann Gottfried”: page 326
  2. ↑ a b c 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. “Scots School Broadcasting”: pp. 62–65; (b) Re. “Polyclinical impulses of the university psychiatry demanded by Griesinger”: page 316 f .; (c) Re. “Supporting the no restraint movement”: page 316
  3. ↑ a b c d Degkwitz, Rudolf et al. (Ed.): Mentally ill . Introduction to Psychiatry for Clinical Study. Urban & Schwarzenberg, Munich 1982, ISBN 3-541-09911-9 ; Columns indicated below with ~: - (a) Re. "All keywords" University psychiatry "": Pages 201, 268 f., 351, 354, 360 f., 438, 440; (b) on Stw. “Griesinger's Reform Plans”: Pages 267-2, 268-1; (c) Re. “Distribution of chronic and acute cases in university and institutional psychiatry”: pages 201-2, 351-1, 438-2; (d) to district “Psychiatry and Antipsychiatry”: Pages 436-1 and “Continuation of the social commitment of institutional psychiatry up to the beginnings of social psychiatry”: Pages 267-1
  4. ↑ a b Jaspers, Karl : Allgemeine Psychopathologie . Springer, Berlin 9 1973, ISBN 3-540-03340-8 , Appendix § 4 Historical on psychopathology as a science. - Institutional and university psychiatry. Page 705 f.
  5. ↑ a b c d Ackerknecht, Erwin H .: Brief history of psychiatry . Enke, Stuttgart 3 1985, ISBN 3-432-80043-6 ; (a) Re. “Theory of psychogenic causation”: page 35 f .; (b) Re. “Psychiatric Authors”: page 39 .; (c) on Stw. “Haller and Stahl's nerve theory as a pacemaker in medical research and the relationship to the Scottish school”: page 36 f .; (d) on Stw. “Use of the term» University Psychiatry «in Ackerknecht”: pages 62, 72
  6. ↑ Reil, Johann Christian : Rhapsodies about the application of the psychic spa method on mental disruptions . (1803)
  7. ^ Langermann, Johann Gottfried : De methodo cognoscendi curandique animi morbos stabilienda . (1797)
  8. ^ Dobrick and Weber: Psychiatr. Wschr. 12 , 383, 393, 437, 465