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How Was Schizophrenia Treated In The Past

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Mental Health Treatment Today

What is schizophrenia? – Anees Bahji

As we learn more about the causes and pathology of various mental disorders, the mental health community has developed effective, safe treatments in place of these dangerous, outdated practices. Today, those experiencing mental disorders can benefit from psychotherapy, along with biomedical treatment and increased access to care. As this study of the history of mental illness care shows, treatments will continue to change along with scientific and research developments and as mental health professionals gain more insight.

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The History Of Schizophrenia

What does the word schizophrenia mean? How old is schizophrenia? Who first named the condition and how has our view on it evolved? Let us take a journey thought time to learn more about this serious mental illness.

The word schizophrenia comes from the Greek words schizo meaning split, and phrene meaning mind, to describe fragmented thinking. In an article published on PsychologyToday.com, it states that the term was not meant to convey the idea of split personality, a common misunderstanding by the public. Since then the definition of schizophrenia has continued to change, as scientists attempt to more accurately classify the different types of mental diseases. In Greek mythology mental illness was thought of as punishment from the gods. In fact, it was not until 460-377 BC, the time of the Greek physician Hippocrates, mental illness became the object of scientific speculation.

According to an article on schizophrenia.com, written documents identifying schizophrenia can be traced to Egypt, as far back as the second millennium BC. Depression, dementia, as well as thought disturbances that are typical in schizophrenia are described in detail in the Egyptian Book of Hearts. The Heart and the mind seem to have been synonymous in ancient Egypt.

Divine Madness: A History Of Schizophrenia

The label schizophrenia is a recent term, first used in 1908 by Eugen Bleuler, a Swiss psychiatrist, and was meant to describe the disunity of functioning between personality, perception, thinking and memory. Whilst the label is new, accounts of schizophrenia-like symptoms can be found in ancient texts dating back to 2000 BC, and across a number of cultural contexts. The oldest of these texts is the ancient Egyptian Ebers papyrus, around two millennia old.

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There are descriptions of illnesses marked by bizarre behaviour and lack of self-control in the Hindu Arthava Veda, dating approximately 1400 BC, and a Chinese text from approximately 1000 BC called The Yellow Emperors Classic of Internal Medicine, which attributes insanity and seizures to supernatural and demonic forces.

The Greeks and Romans are also found to have a general awareness of psychotic illnesses. Plato, who lived in the fourth and fifth centuries BC, spoke of a madness of divine origin, which could inspire poets and create prophets. Demonic possession and supernatural forces as the cause of mental illness are a common theme in the ancient literature.

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How Is Schizophrenia Treated

Schizophrenia is more treatable than ever before. Many people recover completely whereas others might have episodes of schizophrenia that come and go. There are a number of different treatments to help people manage their symptoms and help them to flourish in all areas of life.

Treatment should be under the care of a psychiatrist, but may involve a team of different mental health professionals, including a doctor, mental health nurse, social worker, occupational therapist and clinical psychologist. Treatments are tailored according to the needs of the individual.

Research has shown that early treatment can be more effective, before the illness has time to cause damage. There are early intervention programs in most major cities in Australia.

Schizophrenia: 100 Years Of Bad Treatment

History of Psychology timeline

Imagine for a minute what life might have been like if you’d been diagnosed with schizophrenia in 1911. Shunned by society, you would have been treated with fear and suspicion by many.

With no known cure, you would be subjected to treatment by trial and error, some of which would have gruesome side-effects. Detained by the state, you could expect to be monitored by overworked, underpaid staff and going to church might have been suggested as a way to calm your chaotic mind.

A lot has changed in the 100 years since the term “schizophrenia” was first coined, but perhaps not quite as much as you might think. People living with schizophrenia still experience many of the same problems today.

In 1910, Winston Churchill summed up contemporary attitudes when he wrote to the prime minister, Herbert Asquith, arguing for the mass sterilisation of people with severe mental illness.

Churchill warned that the “feeble-minded and insane classes” constituted a “danger which it is impossible to exaggerate”, and that “the source from which the stream of madness is fed should be cut off and sealed up before another year has passed.”

While views like these are no longer part of mainstream debate, the stigma and discrimination people with schizophrenia still face can be worse than the symptoms of the illness itself. Sensationalist media reporting has helped paint a picture of “schizos” who are wild, dangerous and need to be controlled.

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What Is Paranoid Schizophrenia

Paranoid schizophrenia is one type of schizophrenia. In this type, the person’s false beliefs are mainly about being persecuted or being punished by someone. The person may hear the voice of someone he or she believes is punishing them. The person may believe that he or she has been specially chosen to complete a secret mission. These are just a few examples of any number of false beliefs a person with this disorder may have.

Other types of schizophrenia include “catatonic” schizophrenia and “disorganized” schizophrenia. Different types of schizophrenia may have some of the same symptoms.

A Paradigm Shift To Facilitate Drug Discovery

Heterogeneity in the manifestations and course of schizophrenia has long been observed. Within the disease entity paradigm, various aspects of pathology were viewed as emerging from the same latent structure. A unifying pathophysiology was expected, with neuroanatomic locations of the pathology perhaps determining symptom expression. The syphilitic insanities provided a compelling model, and knowledge of brainbehavior relations could account for different symptom patterns between cases. This view was challenged by work in the early 1970s suggesting an almost orthogonal relationship between symptom complexes and a lack of predictive relationships between symptom domains . Further, pathologic manifestations within a domain were closely linked across time so that negative symptoms predicted future negative symptoms, past social functioning predicted future functioning, etc . On the basis of these data, schizophrenia was reconceptualized as a tripartite construct with positive psychotic symptoms, negative symptoms, and pathology in interpersonal relating, constituting separate domains. It was envisioned that each domain would be a separate target for etiologic and treatment discovery .

Table 1 MATRICS: Provisional Consensus Cognitive Battery

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How Was Mental Illness Viewed In The 1960s

In the mid-1960s, the deinstitutionalization movement gained support and asylums were closed, enabling people with mental illness to return home and receive treatment in their own communities. Some did go to their family homes, but many became homeless due to a lack of resources and support mechanisms.

Schizophrenia And Early Psychiatry

Treatment History Series: Episode One – Schizophrenia

It is not until the middle of the 19th century that European psychiatrists begin to describe a disease, of unknown origin, typically with an adolescent onset and with a propensity towards chronic deterioration. Emil Kraeplin, a German psychiatrist, utilised the term dementia praecox to describe a variety of previously separately recognised illnesses, such as adolescent insanity and catatonia syndrome.

Kraeplins long term studies of a large number of cases led him to believe that despite the diversity of clinical presentations, the commonalities in the progression of the illness meant they could be categorised under the singular heading of dementia praecox. Later, he suggested nine categories of the disorder.

This leads us to Eugen Bleuler, who coined the term schizophrenia, meaning split mind, replacing the previous terminology dementia praecox. Bleulers schizophrenia incorporated an understanding that the disorder was a group of illnesses, and did not always deteriorate into a permanent state of dementia as was previously considered by Kraeplin to be a hallmark of the disease.

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Further, Bleuler suggested schizophrenia had four main symptoms, known as the 4 As: blunted Affect a reduction in emotional response to stimuli, loosening of Associations and disordered pattern of thought, Ambivalence, or difficulty making decisions, and Autism, by which he meant a loss of awareness of external events and preoccupation with ones own thoughts.

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How Was Mental Illness Treated In The 1940s

The use of certain treatments for mental illness changed with every medical advance. Although hydrotherapy, metrazol convulsion, and insulin shock therapy were popular in the 1930s, these methods gave way to psychotherapy in the 1940s. By the 1950s, doctors favored artificial fever therapy and electroshock therapy.

How Mental Illness Was Treated In The Past

Isolation and Asylums Overcrowding and poor sanitation were serious issues in asylums, which led to movements to improve care quality and awareness. At the time, the medical community often treated mental illness with physical methods. This is why brutal tactics like ice water baths and restraint were often used.

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What Does Mental Health Care Look Like Now

Treatment for mental illness has come a long way throughout history. With the first approaches to treatment resembling torture as well as the earlier incredulity of the existence of mental illness, its easy to feel as though there might not be a good treatment method mental health care.

However, our modern look at mental illness has improved tremendously. Former activists like Dorothea Dix and current mental health awareness movements on social media have changed the conversation. Now, treatments handle mental illness knowledgeably, effectively, and morally.

The programs offered at Baton Rouge Behavioral Hospital provide up-to-date treatment methods to patients in the Louisiana and Southern Mississippi regions. Most importantly, our dedicated staff will collaborate with patients and their families to create a collective approach to healing.

Voluntary And Compulsory Detention

Schizophrenia case history

More serious acute schizophrenic episodes may require admission to a psychiatric ward at a hospital or clinic. You can admit yourself voluntarily to hospital if your psychiatrist agrees it’s necessary.

People can also be compulsorily detained at a hospital under the Mental Health Act , but this is rare.

It’s only possible for someone to be compulsorily detained at a hospital if they have a severe mental disorder and if detention is necessary:

  • in the interests of the person’s own health and safety
  • to protect others

People with schizophrenia who are compulsorily detained may need to be kept in locked wards.

All people being treated in hospital will stay only as long as is absolutely necessary for them to receive appropriate treatment and arrange aftercare.

An independent panel will regularly review your case and progress. Once they feel you’re no longer a danger to yourself and others, you’ll be discharged from hospital. However, your care team may recommend you remain in hospital voluntarily.

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How Was Mental Health Treated In The Past

TREATMENT IN THE PAST For much of history, the mentally ill have been treated very poorly. It was believed that mental illness was caused by demonic possession, witchcraft, or an angry god . For example, in medieval times, abnormal behaviors were viewed as a sign that a person was possessed by demons.

Employment And Financial Support

Avoid too much stress, including work-related stress. If you are employed, you may be able to work shorter hours or in a more flexible way.

Under the Equality Act 2010, all employers must make reasonable adjustments for people with disabilities, including people diagnosed with schizophrenia or other mental illnesses.

Several organisations provide support, training and advice for people with schizophrenia who wish to continue working.

Your community mental health team is a good first point of contact to find out what services and support are available for you.

Mental health charities such as Mind or Rethink Mental Illness are also an excellent source of information on training and employment.

If you are unable to work as a result of your mental illness, you are entitled to financial support, such as Incapacity Benefit.

Want to know more?

There are also other places that offer support to people with schizophrenia and other mental illnesses.

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Schizophrenia Through The Ages

What does schizophrenia mean?

In 1910, the Swiss psychiatrist Paul Eugen Bleuler coined the term ‘schizophrenia from the Greek words schizo and phren . Bleuler had intended the term to denote a loosening of thoughts and feelings, but, unfortunately, many people read it to mean a split personality.

What does schizophrenia not mean?

Robert Louis Stevensons novel The Strange Case of Dr Jekyll and Mr Hyde did much to popularize the concept of a split personality, which is sometimes also referred to as multiple personality disorder . However, MPD is a vanishingly rare condition that is entirely unrelated to schizophrenia. The vast majority of psychiatrists, myself included, have never seen a case of MPD, and many if not most suspect that such a condition does not exist. Yes, schizophrenia sufferers may hear various voices, or harbour strange beliefs, but this is not the same as having a split personality. Unlike Dr Jekyll, schizophrenia sufferers do not suddenly mutate into a different, unrecognizable person.

Who discovered schizophrenia?

How was schizophrenia thought of in antiquity?

But the spirit of the Lord departed from Saul, and an evil spirit from the Lord troubled him And it came to pass, when the evil spirit from God was upon Saul, that David took an harp, and played with his hand: so Saul was refreshed, and was well, and the evil spirit departed from him.

When did people first start thinking of schizophrenia as an illness?

How did beliefs change?

What Were Old Asylums Like

Schizophrenia: Treatment Psychiatry | Lecturio

People were either submerged in a bath for hours at a time, mummified in a wrapped pack, or sprayed with a deluge of shockingly cold water in showers. Asylums also relied heavily on mechanical restraints, using straight jackets, manacles, waistcoats, and leather wristlets, sometimes for hours or days at a time.

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What Can Family Friends And Partners Do To Help

Friends, relatives and partners have a vital role in helping people with schizophrenia recover and make a relapse less likely.

It is very important not to blame the person with schizophrenia or tell them to “pull themselves together”, or to blame other people. It is important to stay positive and supportive when dealing with a friend or loved one’s mental illness.

As well as supporting the person with schizophrenia, you may want to get support to cope with your own feelings. Several voluntary organisations provide help and support for carers.

Friends and family should try to understand what schizophrenia is, how it affects people, and how they can help. You can provide emotional and practical support, and encourage people to seek appropriate support and treatment.

As part of someone’s treatment, you may be offered family therapy. This can provide information and support for the person with schizophrenia and their family.

Friends and family can play a major role by monitoring the person’s mental state, watching out for any signs of relapse, and encouraging them to take their medication and attend medical appointments.

If you are the nearest relative of a person who has schizophrenia, you have certain rights that can be used to protect the patient’s interests. These include requesting that the local social services authority ask an approved mental health professional to consider whether the person with schizophrenia should be detained in hospital.

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How Were Mental Health Patients Treated In The Past

Isolation and Asylums Overcrowding and poor sanitation were serious issues in asylums, which led to movements to improve care quality and awareness. At the time, medical practitioners often treated mental illness with physical methods. This approach led to the use of brutal tactics like ice water baths and restraint.

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Schizophrenia: A Brief History

Early references to schizophrenia

Schizophrenia has been around for a long time. References to people who are clearly insane appear in classical writings and the bible, for instance in Mark 5 we hear of the Gerasene Demoniac who, All day and all night among the tombs and in the mountains he would howl and gash himself with stones. In fact the oldest recorded description of an illness like schizophrenia dates back to the Ebers Papyrus of 1550BC from Egypt.1

Descriptions of episodes of madness involving hearing voices, seeing visions and erratic and unruly behaviour start to appear in the literature from the 17th century. It is interesting to note that even then madness was seen as a medical problem rather than some possession by evil spirits although they were denied the effective remedies that we have today.7

First Breakthroughs

Dr Emil Kraepelin who first described schizophrenia in 1896.

Schizophrenia was first described by Dr Emil Krapelin in the 19th century. He was director of the psychiatric clinic at the university in Estonia. He first used the term Dementia Praecox or premature dementia and he believed that the condition always had a steadily worsening course or if there was any improvement over time it would only be partial.

Although Krapelins understanding of schizophrenia was still incomplete his work was pioneering in the way that he distinguished the condition from the other psychotic disorders such as bipolar disorder.5

The Victorian Asylums

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Schizophrenia can develop later in life. Late-onset schizophrenia is diagnosed after the person is 45. People who have it are more likely to have symptoms like delusions and hallucinations. They’re less like to have negative symptoms, disorganized thoughts, impaired learning, or trouble understanding information.

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