[Social Psychiatric Conceptions in Western and Eastern Germany - a Contrastive Analysis of the Approaches Developed by Karl Peter Kisker, Klaus Weise and Achim Thom]

The study explores the common effort of social psychiatrists in Eastern and Western Germany to help people suffering from mental health issues to gain more self-determination and social participation and to make mental health care more humane from the 1960s onwards. At the same time, it provides a contrastive analysis of the social psychiatric concepts developed by the psychiatrists Karl Peter Kisker, Klaus Weise and the philosopher Achim Thom. A thorough analysis of literature reveals differences in the theoretical approaches in the East and West. Kisker, who was a representative of the West German social psychiatric movement, had a phenomenological-anthropological background. By contrast, Weise and Thom even though following the same subject orientation, established a socialist social psychiatry clearly integrating Marxist views into their concept. This contrastive also elaborates common viewpoints in understanding the social dimensions of mental health conditions in the two concepts.

Pharmacological Studies in Eating Disorders: A Historical Review

Eating disorders (EDs) are serious mental health conditions characterised by impaired eating behaviours and nutrition as well as disturbed body image, entailing considerable mortality and morbidity. Psychopharmacological medication is an important component in the treatment of EDs. In this review, we performed a historic analysis of pharmacotherapeutic research in EDs based on the scientific studies included in the recently published World Federation of Societies for Biological Psychiatry (WFSBP) guidelines for ED treatment. This analysis focuses on early approaches and trends in the methods of clinical pharmacological research in EDs, for example, the sample sizes of randomised controlled trials (RCTs). We found the development of psychopharmacological treatments for EDs followed advancements in psychiatric pharmacotherapy. However, the application of RCTs to the study of pharmacotherapy for EDs may be an impediment as limited participant numbers and inadequate research funding impede generalisability and statistical power. Moreover, current medication usage often deviates from guideline recommendations. In conclusion, the RCT model may not effectively capture the complexities of ED treatment, and funding limitations hinder research activity. Novel genetically/biologically based treatments are warranted. A more comprehensive understanding of EDs and individualised approaches should guide research and drug development for improved treatment outcomes.

[Psychiatric Rehabilitation in the GDR against the Background of Soviet Influences]

The study describes developments and local models of psychiatric rehabilitation in the GDR and the USSR. After the Second World War patient care was focused on hospitals. The Rodewisch Theses and the Brandenburg Theses as well as the "Conception to improve the patient care for mentally ill people after 1980" were important suggestions. The GDR primary literature review shows that soviet concepts were often received. The principles of stages, continuity and sectorization set the stage for success here and there. Transition units such as psychoneurological dispensaries, the occupational/protected workshops and assisted residences, therapeutic clubs, day and night hospitals were created. The occupational therapy was intended to facilitate the transition into the normal working. As a consequence, during the 1970s and 1980s in the GDR a high level of employment of mentally ill people in the economy could be achieved.

[The Therapy of Anxiety Disorders Around 1900. Hermann Oppenheim (1858-1919) and his Early Innovations]

As a teacher and textbook author in psychiatry, Oppenheim initially received high national as well as international scientific recognition. In 1892, with his monograph on traumatic neurosis, which he regarded as the result of organic or molecular changes, his views became increasingly controversial and were met with rejection from the specialists of his time. mainly from German colleagues, probably not least because of his Jewish origin. Less historical attention, however, has been paid to Oppenheim's examination of the phenomenon of anxiety, which at his time was still a poorly elaborated pathological disorder. In his work, Oppenheim considered anxiety disorders to be an etiologically multifactorial disease and a syndrome in their own right. Oppenheim not only oriented himself towards common treatment methods such as dietetics or psychoanalysis but also considered the patient with his multi-dimensional problems as an individual deserving respect. What was more, he also applied self-developed psychotherapeutic treatment methods that show similarities with cognitive behavioral therapy that is predominantly used for anxiety disorders today. Oppenheim's work on anxiety disorders can be considered as highly innovative for his time.

[Using electricity to combat headache : Electrotherapy and tDCS in the 1870s/1880s and today]

Headache can be a widespread symptom as well as a disorder in itself. Headache syndromes such as migraine cause a lot of distress, disability and overall socioeconomic costs. Pharmacological treatments are often limited in their efficacy as well as due to side effects. The therapeutic application of electricity for this medical indication was a relevant field of research in the 19th century and-in the form of transcranial direct current stimulation (tDCS)-is still widely studied today. This paper provides an overview of publications from the late 19th century (as the era of discovery and success of electrotherapy) as well as contemporary studies investigating the usage of weak currents for the treatment or prophylaxis of headache. Our results show a large number of highly favorable reports of treatment successes. However, the number of cases analysed is often rather small and the forms of electric stimulation applied were often highly heterogeneous. In summary, electric stimulation appears to be a promising field of research and a possible therapeutic agent for the treatment of headaches; however, further research is necessary, especially into the details of the stimulation techniques applied and the various indications in which it may be of use.

[The "Hilfsverein für Geisteskranke" in the Kingdom of Saxony, a Philantropic Organisation for the Mentally Ill]

This article provides an overwiew of the history of the "Hilfsverein für Geisteskranke" in the Kingdom of Saxony (later Free State of Saxony) from its foundation in 1898 until its probable dissolution during World War II. The "Hilfsverein" was a philantropic organization that aimed to provide support for the mentally ill and their relatives through financial aid and education. It relied on a network of representatives spanning all of Saxony´s regions. Its work continued during the Weimar Republic after World War I, though by then it had lost influence due to economic loss and other structures of public welfare being established. In the context of the rise in eugenic and social darwinist tendencies during the 1920s, the implications of "racial hygiene" and hereditability came to be discussed among its members. After the takeover of the National Socialist Party in 1933, the "Hilfsverein" was forcibly assimilated into the Nazi welfare system and used to propagate racial ideology.

[The 'Tabes Syphilis Controversy' : A Dispute About the Cause of Tabes Dorsalis and Progressive Paralysis at the End of the 19th Century]

For some years now, the incidence of syphilis and neuroluetic clinical pictures has been increasing. As a result, tabes dorsalis and progressive paralysis are once again gaining relevance in neurology. In the last two decades of the 19th century, there was a heated debate in German neurology about the understanding of the aetiology of these conditions, the so-called 'tabes syphilis controversy'. In 1879, Wilhelm Erb had called on the German neurological community in a much-noticed lecture to finally tackle the problem to unequivocally identify the cause of tabes dorsalis. Mainly on the basis of disease statistics he himself postulated a previous syphilitic infection as of key importance. Answering this question was urgent, because the proportion of patients in psychiatric institutions suffering from progressive paralysis, to which tabes was seen in close parallel, was rapidly increasing. The Berlin neurologists Carl Westphal, Ernst Julius Remak, Martin Bernhardt and Ernst Victor von Leyden regarded Erb's thesis as a gauntlet. They saw the causes of tabes and progressive paralysis in social impoverishment such as damp and cold living conditions, in physically one-sided work overloads or in the hardships of soldiers in the army. They assumed that traumatic tabes was caused by concussions or bruises. The Leipzig neurologist Paul Julius Möbius was the first to state between 1890 and 1897 that the only cause of tabes and progressive paralysis was a previous syphilitic infection. He consistently ruled out all other aetiological theories. Above all, bacteriological and microbiological research in the following years proved Möbius right. Thus 40 years after Erb's lecture, in addition to diagnostic, specific therapeutic approaches could be developed and applied.

["Impulsive insanity" according to Emil Kraepelin : A clinical framework for female criminals at the beginning of the twentieth century]

BACKGROUND

In his comprehensive classification of the beginning of the twentieth century, Emil Kraepelin provided a detailed description of an entity he called "impulsive insanity", which had not been elaborated before him. The forms depicted by him largely corresponded to the offences, which were referred to as typically female in their nature in the late nineteenth and early twentieth centuries.

QUESTION

How did Kraepelin classify "impulsive insanity" and what forms did he describe? Did Kraepelin also see these disorders predominantly prevailing in women, did he establish a connection with women's criminality and how did this fit into the discourses of the time on femininity, criminal legislation and degeneration?

MATERIAL AND METHODS

This study focused on the clinical picture "impulsive insanity" as described by Emil Kraepelin in his main work, the 8th edition of his Textbook of Psychiatry published between 1909 and 1915. His description was analyzed in detail and embedded in a historical context on the basis of secondary literature.

RESULTS

In rudiments Kraepelin's clinical classification is still comprehensible today, although there are major differences to how literature in later years treated this issue. Kraepelin clearly sees "impulsive insanity" as a driving disorder predominantly prevailing in women.

DISCUSSION

Elaborating his concept of "impulsive insanity", Kraepelin positioned himself in relation to important scientific discourses of the early twentieth century, such as the debate on criminal legislation and the theory of degeneration. On the basis of the individual forms of "impulsive insanity" described by Kraepelin, various concepts of constructing and pathologizing femininity can be identified. Apparently, it also aims to explain common female crimes within the patriarchal hegemony.

[Therapy of Food Refusal and Anorexia Nervosa in German-Language Psychiatry Textbooks of the Past 200 Years]

The aim of this study was to describe how the therapy of anorexia nervosa (AN) and food refusal have been discussed in leading textbooks used in German-speaking academic psychiatry over the past 200 years. For this purpose, 18 textbooks of important school psychiatrists were selected. These were analyzed in a structured way to determine the content of the subject taught at universities in German-speaking countries at a given period. We found that AN was not taught as a distinct disorder until the end of the 20th century, although great attention had been paid to food refusal as a symptom and manifold therapeutic concepts had been developed much earlier. Whereas at the beginning of the 19th century forced feeding using feeding tubes was established, in the following years pharmacotherapies and special diets were developed. It is noteworthy that since the beginnings of academic psychiatry, some early forms of psychotherapy have been developed; for instance, special kinds of behavior were recommended when dealing with the patient, as the therapist was supposed to serve as a role model to encourage patients to eat. Treatment of food refusal by means of structured psychotherapeutic approaches were not established before AN was generally accepted as a distinct disease entity. The understanding of etiological factors that might lead to AN as well as potential psychotherapeutic interventions have changed fundamentally over the past decades.

[Forensic Psychiatry in the GDR: An overview]

In the discussion of medical history of psychiatry in the GDR, little attention has been paid to the subfield of forensic psychiatry. In the following literature-based overview, essential aspects of this specific topic are therefore presented. The content-related discussion in this field took place in particular in the area of forensic psychiatric expertise in criminal law, to which, among others, the most well-known forensic psychiatrist of the GDR, Hans Szewczyk, made important contributions. After the introduction of the Criminal Code in 1968 and the accompanying legal changes regarding reduced or abolished criminal responsibility of delinquents, a discourse took place until the beginning of the 1980s on various questions on the improvement of the quality of expert opinions and further development of their work. The focus was on the assessment of criminal responsibility rather than on the assessment of prognosis, which probably resulted from the abolition of the "Maßregelvollzug" in 1968. Only a few sources refer to the placement and treatment of forensic psychiatric patients. Mentally ill offenders were hardly ever accommodated in specific departments, which were apparently established in a few clinics from the mid-1970s onwards. There was also a lack of specially developed structural treatment concepts specifically for forensic psychiatric patients. Especially for mentally ill lawbreakers with a high level of delinquency, inpatient placement was apparently hardly possible due to a new legislation after 1968. In the area of civil law, only a few sources indicate that the topics of incapacitation and guardianship were addressed.

[The Practice of Medicinal Alcohol Withdrawal in the Psychiatry of the GDR - The Methods of Aversion and Disulfiram Treatment]

OBJECTIVE

The aversion and disulfiram treatment used for alcohol withdrawal in the GDR are described in their mode of action, application and in their therapeutic outcome.

METHOD

In this literature study primarily works published in the GDR itself were identified, analysed and contextualised.

RESULTS

While aversion therapy caused aversion to alcohol through the development of a conditioned reflex, disulfiram has an alcohol-sensitising effect. In therapeutic practice, the aversion therapy was largely replaced by disulfiram during the 1970 s, although there was no general guideline for its use. Disulfiram therapy could prove itself as a drug adjuvant, but was successively marginalised by psycho- and socio-therapeutic approaches.

CONCLUSION

Both aversion and disulfiram therapy were the central drug procedures for the treatment of people with alcohol problems in the GDR psychiatric system, were applied inconsistently, and complemented a complex therapeutic regime.

Electric neurostimulation in sleep disorders - yesterday and today. A comparative analysis of historical and contemporary case reports and clinical studies

BACKGROUND

Insomnia is a widespread symptom of many psychiatric and neurological disorders, but can also be a clinically relevant disorder of its own. The application of low-dose electricity as a treatment for both has had a long history, dating back to the 19th century, but has seen somewhat of a renaissance in therapies such as tDCS.

OBJECTIVE

The aim of this publication was to identify and present original works from the second half of the 19th century as well as contemporary studies that investigated the therapeutic value of electricity in treating sleep disorders.

METHODS

While the nine historical sources identified mostly presented impressive successes in treatment, the nine modern publications had much more heterogeneous and moderate results.

RESULTS

The discussion of these differences refers to the scientific discourse of the late 19th century about the placebo-effect and the role of suggestibility in the therapeutic process and outcome.

CONCLUSION

In conclusion profound parallels can be seen between treatment innovations and methodological discussions in the 1880-1890s and nowadays.

[The Psychotherapist and Neurologist Ernst Jolowicz (1882-1958): An International Career in the Shadow of Anti-semitism and Emigration]

The study focuses on the life and work of the German-Jewish neurologist Dr. Ernst Jolowicz who was born in 1882. Originally from Poznan in present-day Poland, Jolowicz had gained his initial professional experience in the German Empire before serving as a neurologist at the Western Front during the First World War. After the war, he opened a private psychotherapeutic practice in Leipzig, published numerous scientific papers and was involved in the General Medical Society for Psychotherapy. In his writings, Jolowicz appeared as an undogmatic adherent of suggestive techniques and came up with his own methods for a patient-centered, psychagogic psychotherapy. In addition, he wrote numerous cultural and social scientific essays showing a wide range of interest. Shortly after the seizure of power by the National Socialists, he emigrated to Paris and supported the anti-fascist resistance in a Strasbourg radio station. After the occupation of France, Jolowicz fled to the United States in 1941 and gained a foothold there once more before he died of a heart disease in New York City in 1958.

[What Seems in Need of Psychiatric Care Does not Always Have to be. Hearing Loss as the Cause of a Suspected Psychopathological Diagnosis]

In the history of psychiatry and otology, there is evidence that mental and hearing disorders can be interdependent. For example, Emil Kraepelin in 1915 and a Leipzig serial study published in 1962 indicated that hearing-impaired people become psychologically conspicuous or mentally till more often than people whose hearing is not impaired.We outline the case of a patient who showed psychopathological abnormalities before and after giving birth to her daughter, especially in attention, cognitive conversion ability and social competence. After being diagnosed a bilateral moderate sensorineural hearing loss and being provided with hearing aids, no psychopathology was detectable. The case may be a pointer to the fact that hearing-impaired patients still fall through professional boundaries and are not provided with adequate care due to their lack of or limited ability to communicate.

The Work of Oskar Herzberg-Did Psychosis or the Residence in a Psychiatric Institution Serve as a Catalyst for Creativity?: A Thought-Provoking Impulse to Reconsider the Interrelationship Between Mental Illness and Art

ABSTRACT

In the 1920s, the Heidelberg psychiatrist and art historian Hans Prinzhorn collected pictorial works by "mentally ill people"-today's Prinzhorn Collection.His colleague Paul Schilder sent him works by Oskar Herzberg thereto, which Prinzhorn included as "Case 355" in his famous work Bildnerei der Geisteskranken.Using Herzberg as an example, we approached the general issue of the relationship between mental illness, creativity, and art from a historical psychiatric perspective.It was not before his admission to the Leipzig clinic due to his schizophrenic illness that Herzberg began to paint. Prinzhorn and his doctor Ernst Jolowicz considered this late start of artistic activities to be the expression of an immanent creative urge caused by exceptional psychotic experiences. Our study intends to view such artworks outside a rather pathological context. Therefore, we discuss being secluded in psychiatry, supplied painting utensils, and released from his daily constrains as other possible triggering factors for Herzberg's artistic development.

[The medical history of Elsa Asenijeff in the context of the Saxon psychiatric institution and care system from the 1920s to 1941]

AIM

This article aims to describe and discuss in detail the psychiatric medical history of the writer Elsa Asenijeff (1867-1941) in different mental institutions in the German state of Saxony.

RESEARCH QUESTIONS

What can be discovered in preserved archive documents about the placement of Elsa Asenijeff in different mental institutions between 1923 and 1941? What is the historical context in which this individual medical history took place?

MATERIAL AND METHODS

Through systematic research in different archives a part of Elsa Asenijeffs medical records and relevant administrative files of the institutions could be found.

RESULTS

The preserved documents provide an insight into the statements of the physicians and the conditions of Elsa Asenijeffs placement in the institutions of that time.

CONCLUSION

The findings of our research suggest that, at least since 1927, Elsa Asenijeff was kept in mental institutions primarly for being an unmarried, destitute and more or less isolated woman. In other words, her stay was justified with social and not psychiatric-medical arguments.

[Concepts of nymphomania in the German academic psychiatry: Changes over the last two centuries]

BACKGROUND

This chronology aims to provide an overview of the views on nymphomania in the history of German academic psychiatry over the past 200 years.

AIM

The aim of this study was to answer the following questions: What are the continuities over that period with regard to the etiology, diagnosis, classification or therapeutic recommendations? What changes can be observed? Was the increase in sexual desire in women seen as a disease or rather as a symptom? What significance did psychiatry attribute to female sexuality at a certain point in time? What reasons can be identified for the perceptions made and conclusions drawn at a certain time?

METHODS

A cursory review of the most influential German-language psychiatric textbooks of the respective period was conducted in chronological continuity. Relevant passages were identified, analyzed in detail and compared with each other, taking the historical context into account.

RESULTS

At the turn of the 19th and 20th century, a clear break in the understanding of nymphomania as a disease could be observed. In the 19th century, it was seen as a severe mental illness, which was assumed to have been caused at least in part by a peripheral disease of the female reproductive organs and the nervous system associated with them, which could lead to irreversible terminal mental states. In the 20th and 21st centuries, nymphomania was perceived as either a sexual neurosis or a functional sexual disorder, limited to the symptom complex of hypersexuality. The reasons for this were, on the one hand, the overall change in diagnosis resulting from a comprehensive reclassification of mental disorders, which assigned nymphomaniac symptoms of the 19th century to both manic and schizophrenic disorders, and, on the other hand, changes in the perception of female sexuality in the social discourse in general. The fact that nymphomania as a diagnosis was eliminated with the 11th edition of the International Classification of Diseases is a clear expression of this change.

CONCLUSION

The concept of nymphomania has undergone considerable changes over time. At the beginning of the 20th century, the understanding of the disease changed significantly, so that it is even possible to distinguish between an early and a late phase. The diagnosis has meanwhile become obsolete.

Descriptions of Disordered Eating in German Psychiatric Textbooks, 1803-2017

The most common eating disorders (EDs) according to DSM-5 are anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorder (BED). These disorders have received increasing attention in psychiatry due to rising prevalence and high morbidity and mortality. The diagnostic category "anorexia nervosa," introduced by Ernest-Charles Lasègue and William Gull in 1873, first appears a century later in a German textbook of psychiatry, authored by Gerd Huber in 1974. However, disordered eating behavior has been described and discussed in German psychiatric textbooks throughout the past 200 years. We reviewed content regarding eating disorder diagnoses but also descriptions of disordered eating behavior in general. As material, we carefully selected eighteen German-language textbooks of psychiatry across the period 1803-2017. Previously, in German psychiatry, disordered eating behaviors were seen as symptoms of depressive disorders, bipolar disorder or schizophrenia, or as manifestations of historical diagnoses no longer used by the majority of psychiatrists such as neurasthenia, hypochondria and hysteria. Interestingly, 19th and early 20th century psychiatrists like Kraepelin, Bumke, Hoff, Bleuler, and Jaspers reported symptom clusters such as food refusal and vomiting under these outdated diagnostic categories, whereas nowadays they are listed as core criteria for specific eating disorder subtypes. A wide range of medical conditions such as endocrinopathies, intestinal or brain lesions were also cited as causes of abnormal food intake and body weight. An additional consideration in the delayed adoption of eating disorder diagnoses in German psychiatry is that people with EDs are commonly treated in the specialty discipline of psychosomatic medicine, introduced in Germany after World War II, rather than in psychiatry. Viewed from today's perspective, the classification of disorders associated with disordered eating is continuously evolving. Major depressive disorder, schizophrenia and physical diseases have been enduringly associated with abnormal eating behavior and are listed as important differential diagnoses of EDs in DSM-5. Moreover, there are overlaps regarding the neurobiological basis and psychological and psychopharmacological therapies applied to all of these disorders.

Goethe: A bipolar personality? Periodicity of affective states in Johann Wolfgang von Goethe as reflected by Paul Julius Möbius

This paper aims to investigate the character and etiological basis of German poet Johann Wolfgang von Goethe's mental disorder. From 1898, German neuropsychiatrist Paul Julius Möbius developed the hypothesis that Goethe's work provided several hints for the notion that the German poet suffered from a distinct bipolar disorder. The paper investigates Möbius's psychopathographic study on Goethe and his hypothesis of a mood periodicity in Goethe against the mirror of modern concepts. Möbius came to the conclusion that Goethe's illness was bipolar in character and became visible at intervals of seven years and lasted for about two years. The majority of Möbius's contemporary psychiatric colleagues (Emil Kraepelin, Max Isserlin, Ernst Kretschmer, Josef Breuer) supported this view which has still not been convincingly challenged. In present-day terms, Möbius's hypothesis can be best mirrored as a subclinical foundation of mood disorder. Furthermore, with his extensive study, Möbius disproved the common notion that Goethe had suffered from an illness as the result of a syphilitic infection.

[Paranoia Querulans in the First Half of the 20th Century: The Case of Elsa Asenijeff (1867-1941) and the German Psychiatric Literature of that Time]

OBJECTIVE

The writer Elsa Asenijeff was placed under guardianship based on the diagnosis paranoia querulans in 1921. The aim of this study was to commemorate her case and to question how this clinical picture was understood at the time in order to contribute to the history of this little researched disorder.

METHODS

We illustrate the essence of Asenijeffs forensic examinations and of the descriptions of paranoia querulans in selected German psychiatric literature of the beginning of the 20^th century.

RESULTS

The literature describes paranoia querulans as a delusional disorder provoked by judicial conflict. The selected authors offer different theories of its genesis and classification.

CONCLUSIONS

The symptoms described in the forensic examinations are in accordance with the doctrine of academic psychiatry of the time. The chosen literature also illustrates the difficulties of a clear distinction between mental health and illness.

[Pain asymbolia-discovered around 1930 by Paul F. Schilder, almost forgotten today?]

Paul Ferdinand Schilder was born in Vienna in 1886 and died in New York in 1940. Today he is remembered particularly as a psychoanalyst and a psychotherapist. His research in neuroscience, however, was also both comprehensive and innovative. For example, he is considered to be the first to describe Schilder's disease, which was named after him. This article focuses on pain asymbolia, which was also first described by Schilder, and is currently little known and considered to be rarely encountered. Pain asymbolia is a central impairment of pain experience with no negative affective-emotional component. The basis of Schilder's discovery and the differential diagnosis of pain asymbolia was the detailed examination of eleven medical cases between 1928 and 1930. His publications on the condition are characterized by meticulousness, progressive thinking and critical reflection. He nosologically assigned pain asymbolia to the group of agnosias and integrated it into the concept of body image, which was a central issue in his entire scientific work. This article additionally addresses the question of whether Schilder's assumptions are still valid today and what consequences might arise from this.

[Work Participation for People with Severe Mental Illnesses: A Challenge Yesterday and Today]

Throughout its history, German psychiatry has been aware of the challenge it imposes to capacitate persons with severe mental disorders to participate in the job market. In the past, it was above all work therapy that was seen as an instrument to overcome this problem. The reform efforts of the Rodewisch Propositions can serve as an example. In Germany, social law legislation favored the classic rehabilitation sector to provide labor market participation benefits. Aiming at reintegrating patients in labor was not regarded a primary task of acute psychiatry. This approach should be altered to maintain the employability of mentally ill people and to prevent early retirement because of mental illnesses.

Mastering your Fellowship

The series, “Mastering your Fellowship”, provides examples of the question format encountered in the FCFP(SA) examination. The series aims to help family medicine registrars and their supervisors prepare for this examination. Model answers are available online.

Vladimir Bechterev – ein Protagonist der Hypnoseforschung?

Vladimir Michajlovič Bechterev (1857–1927) gilt als der bekannteste und berühmteste russische Neurologe und Psychiater. Wenngleich sein Name im deutschsprachigen Raum vor allem mit der nach ihm benannten orthopädischen Erkrankung, dem Morbus Bechterew, verbunden ist, lag sein Forschungsschwerpunkt vor allem auf neuroanatomischem, physiologischem und psychiatrischem Gebiet. Letzteres spielt in der Wahrnehmung der Leistungen Bechterevs bislang eine untergeordnete Rolle. Er selbst sah sich in einer späten autobiografischen Schrift als Protagonist der russischen Hypnoseforschung und -therapie. Deshalb stellt dieser Artikel wichtige Arbeiten zur Hypnose vor und legt dar, wie seine diesbezüglichen Überlegungen in sein Spätwerk – die Reflexologie – einflossen.

[The slack observation of a public enemy: East and West German psychiatrist and psychotherapist Dietfried Müller-Hegemann in files of the East German state security (Stasi)]

This paper is the first to present and assess material gathered on a psychiatrist and psychotherapist by East German Intelligence Service Stasi, officially referred to as Ministry of National Security (Ministerium für Staatssicherheit, MfS), over the course of several decades.We have analysed all files on professor of psychiatry Dietfried Müller-Hegemann (1910-1989) preserved in the authority now responsible for preserving, studying and making all files of the former East German Secret Service accessible (BStU). The material gained from different authorities within the MfS and on a variety of topics showed significant differences in relevance, in terms of both their quality and their amount.In the 1950 s, Müller-Hegemann's career was willingly promoted by political leaders, while in the 1960 s these same authorities started to try to hinder it, until finally Müller-Hegemann emigrated to West Germany. Even though the material presented here substantiates how such influence was exerted in a single case only, it might also help to better understand procedures commonly applied by the MfS and political hierarchies. The files show that from the end of the 1950 s on leading health ministry staff and political hierarchies started categorising Müller-Hegemann as politically unreliable and as a 'public enemy' and trying to hinder his career. By contrast, it was not before after his 'defection' (emigration) in 1971 that he was first officially dealt with by the MfS.What the study of the material gained made clear is that despite a great power, this power of the Secret Service was indeed restricted. On the one hand, the MfS needed to rely on very subjective opinions of both colleagues and neighbours on the 'target'. On the other hand, in the case of Müller-Hegemann the MfS did not succeed in stopping all contact to his family left behind.Another result of our analysis is that intelligence operations on Müller-Hegemann were sporadic and relaxed and by no means systematic. Even though this is the result of a single cases study only, it might still cast some shade of doubt on findings in contemporary research saying that psychiatrists and psychotherapists stood in the special focus of the Secret Service's work.

The views of Wilhelm Griesinger (1817-68) on suicidality or 'self-murder'

To date, little attention has been paid to the fact that a whole section in Wilhelm Griesinger's textbook is devoted to suicidality. Griesinger perceived suicide as a distinct entity. In his opinion, only one-third of all suicides were committed by people suffering from mental disorders; heredity and brain anomalies could also be involved. Therapeutically, Griesinger recommended removing all potential means for suicide and admitting people at risk to a psychiatric hospital. Since his textbook was a standard work, his views reveal what young doctors could have learned about suicidality in German psychiatry of the second half of the nineteenth century.

Crystallographic orientation errors in mechanical exfoliation

We evaluate the effect of mechanical exfoliation of van der Waals materials on crystallographic orientations of the resulting flakes. Flakes originating from a single crystal of graphite, whose orientation is confirmed using STM, are studied using facet orientations and electron back-scatter diffraction (EBSD). While facets exhibit a wide distribution of angles after a single round of exfoliation ([Formula: see text]), EBSD shows that the true crystallographic orientations are more narrowly distributed ([Formula: see text]), and facets have an approximately [Formula: see text] error from the true orientation. Furthermore, we find that the majority of graphite fractures are along armchair lines, and that the cleavage process results in an increase of the zigzag lines portion. Our results place values on the rotation caused by a single round of the exfoliation process, and suggest that when a 1-2 degree precision is necessary, the orientation of a flake can be gauged by the orientation of the macroscopic single crystal from which it was exfoliated.

Some comparative psychiatric studies in the 19th century

This article analyses 19th-century publications which dealt with the social and cultural aspects of psychiatric disorders in different parts of the world. Systematic reviews were conducted of three German medical journals, one Russian medical journal, and a relevant monograph. All these archives were published in the 19th century. Our work highlights the fact that long before Kraepelin, several, mostly forgotten, publications had already discussed cultural aspects, social conditions, the influence of religion, the influence of climate, and also "race" as a trigger or amplifier of psychiatric diseases. These publications also reflect racist notions of the colonial period.

[The Contributions of the East-German Sports Medicine Specialist and Neurologist Bernhard Schwarz (1918-1991) in the Field of Boxing]

This study is the first to provide research on the East-German (GDR) sports physician and neurologist Bernhard Schwarz. It summarises Schwarz's publications from 1953 to 1966 regarding the impact of boxing on health, particularly craniocerebral injury. Also, the study analyses his work in the context of current discussions. It shows that Schwarz, who was a tenured professor and director of the Department of Psychiatry at the University Hospital of Leipzig and the physician of the GDR national boxing team, conducted systematic clinical surveys and pointed to the health impacts of boxing at an early point in time. He believed that risk exposure for athletes could be minimised through intensive and trained supervision by the coach and the physician as well as through changes to the conditions of boxing matches. Schwarz opposed a ban on boxing. Instead, he picked up suggestions concerning the prevention of adverse health impacts and added his own recommendations, which are remarkably similar to current practices aimed at minimising risk. For instance, he advised that ring-side physicians be trained to recognise dangerous conditions. Today, physicians must obtain a license to be allowed to care for a boxer. In addition, Schwarz pursued the concept of integral medicine. He called for a diversified training of boxers and argued that injured athletes should be treated holistically. Being a neurologist, he emphasised the important role of psychotherapy in this context. He identified the key role of rehabilitation, and suggested that rehabilitation is complete only with the patient's successful social and professional reintegration.

Spectroscopy of bulk and few-layer superconducting NbSe2 with van der Waals tunnel junctions

Tunnel junctions, an established platform for high resolution spectroscopy of superconductors, require defect-free insulating barriers; however, oxides, the most common barrier, can only grow on a limited selection of materials. We show that van der Waals tunnel barriers, fabricated by exfoliation and transfer of layered semiconductors, sustain stable currents with strong suppression of sub-gap tunneling. This allows us to measure the spectra of bulk (20 nm) and ultrathin (3- and 4-layer) NbSe2 devices at 70 mK. These exhibit two distinct superconducting gaps, the larger of which decreases monotonically with thickness and critical temperature. The spectra are analyzed using a two-band model incorporating depairing. In the bulk, the smaller gap exhibits strong depairing in in-plane magnetic fields, consistent with high out-of-plane Fermi velocity. In the few-layer devices, the large gap exhibits negligible depairing, consistent with out-of-plane spin locking due to Ising spin-orbit coupling. In the 3-layer device, the large gap persists beyond the Pauli limit.

Beginn der akademischen Psychiatrie des Abendlandes

Die Universitätspsychiatrie der westlichen Welt feiert in diesem Jahr die 200. Wiederkehr ihrer Begründung: Am 21. Oktober 1811 wurde in Leipzig die außerordentliche Professur für “Psychische Therapie” für Johann Christian August Heinroth eingerichtet. Dieses Jubiläum blieb eher unbekannt. Die vorliegende Quellenstudie legt durch Aktenschriftstücke gesicherte Aussagen zur akademischen Karriere Heinroths und Entstehungsgeschichte seines Lehrstuhls vor. Zugleich verfolgt sie das Ziel, dieses Jubiläum bekannt zu machen. Der psychiatriehistorisch bedeutsame Vorgang wurde wohl erst möglich durch Heinroths eigenes seelenheilkundliches Interesse. Erleichtert wurde er durch eine allgemeine Universitätsreform sowie die Entstehung des sächsischen Irrenversorgungssystems, welche das Bedürfnis nach irrenärztlicher Ausbildung offenbarte. Letzteres erkannte die Ministerialbürokratie. Diese Umstände werden neu in die Forschung eingebracht. Weiterhin wird auf bleibende Verdienste Heinroths für die Konzeptgeschichte der Psychiatrie hingewiesen, die angesichts seiner theologisch verbrämten und rein reflektorischen ätiologischen Überlegungen lange nicht wahrgenommen oder negiert wurden.

Zum 200. Jahrestag der Schöpfung des Begriffes „Psychosomatisch“ in der medizinischen Weltliteratur durch Johann Christian August Heinroth

Johann Christian August Heinroth (1873–1843) blieb bis heute v. a. bekannt als erster Inhaber eines seelenheilkundlichen Lehrstuhls in der Welt. Diesen Lehrstuhl für „Psychische Therapie“ besetzte er an der Universität Leipzig von 1811 bis zu seinem Tode 1843 1 2.

Die Dorpater Zeit von Emil Kraepelin – Hinterließ dieser Aufenthalt Spuren in der russischen und sowjetischen Psychiatrie?

Emil Kraepelin (1856–1926) gilt auch in Russland als bedeutender Psychiater. Hinzukommt, dass Kraepelin selbst im Russischen Reich tätig war – und zwar in den Jahren 1886 bis 1891 in Dorpat, dem heutigen Tartu in Estland. Wir gingen der Frage nach, ob die Popularität auf genau dieser Dorpater Zeit beruht. Es konnte gezeigt werden, dass – obwohl jene Jahre für das Schaffen Kraepelins von Bedeutung waren – sie nicht wesentlich zu seiner Popularität in Russland beitrugen. Übersetzungen von Kraepelins Schriften ins Russische liegen erst aus dem Zeitraum vor, in dem Kraepelin die Lehrstühle in Heidelberg bzw. in München innehatte. Zudem war es keinem seiner Dorpater Studenten und Doktoranden vergönnt, eine Position zu erreichen, die es ihm ermöglicht hätte, zu einem einflussreichen Protagonisten Kraepelinscher Lehren zu werden.

Die Kraepelin-Rezeption war im Russischen Reich und in der Sowjetunion höchst uneinheitlich. Zeitweise wurden rückblickend seine Dorpater experimentalpsychologischen Arbeiten gewürdigt – vor allem im Zusammenhang mit dem Aufstieg der Reflexologie in der russischen und vor allem frühen sowjetischen Psychiatrie, später wurden vor allem Kraepelins Verdienste um die Klassifikation psychiatrischer Erkrankungen herausgestellt.

Kraepelin's views on obsessive neurosis: a comparison with DSM-5 criteria for obsessive-compulsive disorder

Emil Kraepelin (1856-1926) is considered one of the founders of modern psychiatric nosology. However, his conceptualization of obsessive-compulsive phenomena is relatively understudied. In this article, we compare and contrast excerpts from the eighth edition (1909-1915) of Kraepelin’s Textbook of Clinical Psychiatry focusing on what Kraepelin called “obsessive neurosis” and related “original pathological conditions” with the current DSM-5 criteria for obsessive-compulsive disorder (OCD). Consistently with DSM-5 OCD, Kraepelin described obsessive neurosis as characterized by obsessive ideas, compulsive acts, or both together. His detailed descriptions of these symptoms are broadly coherent with their characterization in DSM-5, which is also true for the differential diagnoses he provided. He also mentioned cases illustrating decreased insight into symptoms and association with tic disorders. In conclusion, Kraepelin’s experience, which reflects decades of consistent clinical work, may help validate current ideas and explain how the current conceptualization has emerged and developed. Even though one can hardly say that the classification laid out in DSM-5 goes back to Kraepelin’s views directly, it still is true that Kraepelin played an outstanding role in systematizing psychiatric diagnostic criteria in general, and provided a major contribution to the conceptual history of OCD.

[Müller-Hegemann's classification of depressions of 1964 as a proposal for a conceptualization of affective disorders: A critical review]

Against the background of current discussions on the classification of psychiatric disorders, this study analyses and discusses the East-German psychiatrist Dietfried Müller-Hegemann's concept of a clinical classification of depressions of 1964.In his paper, Müller-Hegemann differentiated between two main forms of depression, namely the "vitally tinged depression" (= melancholy), found mainly in the depressive phases of the manic-depressive disorder, and the "depressive disgruntlement" (= dysthymia) seen in "reactive and neurotic depression", "involutional depression", and in the depressive states in psychopathic personalities. Due to a lack of sufficient biological evidence, Müller-Hegemann refrained from a purely etiological differentiation.His proposal is significant in so far as it provided a classification that could easily be used in clinical practice, and at the same time, by pointing to the traditional concept of melancholy and by calling for a differentiated psychopathology, anticipated aspects of topical interest.

Characterization of Lymphocytes in Canine Gastrointestinal Lymphoma

Primary canine gastrointestinal lymphoma has been believed to be of B-cell origin based on the morphology and behavior of the neoplastic cells and the evidence from the human medical field. However, the neoplasms have not to date been characterized as to the origin of the cell population. Forty-four cases diagnosed as canine gastrointestinal lymphoma were retrieved from the records of the Veterinary Teaching Hospitals at the University of Minnesota and the University of Wisconsin-Madison. Four of the cases have been previously identified as epitheliotropic T-cell gastrointestinal lymphoma. Twenty-three of the dogs were female, with 11 intact and 12 neutered, and 21 of the dogs were male, with 12 intact and nine neutered. Sixteen breeds as well as individuals of mixed breeding were represented. The Boxer and the sharpei were the most commonly represented breeds with six individuals each. The age range of the dogs was 1.5–14.66 years, with two dogs identified as adult and two of unknown age. Archived tissue blocks of gastrointestinal samples were sectioned in duplicate and prepared for immunohistochemical staining with CD3 (T-cell marker) and CD20 (B-cell marker). In 75% of the cases examined under light microscopy, 50–95% of the neoplastic cells stained positively with CD3 and exhibited marked epitheliotropic behavior. In three of the cases, from 10% up to 50% of the neoplastic cells stained positively with CD20, with widely scattered CD3(+) cells. In the remainder of the cases, few to none of the neoplastic cells stained with either of the markers. This retrospective study shows that canine primary gastrointestinal lymphoma is more commonly of T-cell origin, rather than B-cell origin.

[25 years after re-unification of Germany: An overview on Eastern German psychiatry. Part 2: Pluralistic approaches and the collapse in the 1980s]

This is the second part of a 2-part study of the history of psychiatry in East Germany, i. e. the Soviet Occupied Zone and later German Democratic Republic. This part primarily covers the 1970 s and 1980 s. Starting from the 1970 s, pluralistic views on and approaches to mental illness and its treatment gained ground, which was especially visible in psychotherapy. The exacerbating economic crisis of the 1970 s and 1980 s led to a steadily worsening collapse of the building infrastructure of clinics and any reformation that would have led to significant financial investment became impossible. Despite attempts from party and state, psychiatric institutions successfully resisted being systematically misused against their patients.In the discussion part, the study supports the notion that East German psychiatry was neither totally isolated nor communist in nature. Even though communism had an influence, it did not have a decisively modifying impact on psychiatry, so that one can characterize psychiatry in East Germany as a medical discipline with a certain specific typology.

The Historical Development of Immunoendocrine Concepts of Psychiatric Disorders and Their Therapy

Relationships between the central nervous, immune and endocrine systems are a focus of psychiatric research, particularly in depression and schizophrenia. The field has long antecedents. Observed phenomena attributable to these relationships date back to the Neolithic era. Immunoendocrine theories in the broadest sense are recorded in antiquity. In the 19th century, Kraepelin and Wagner-Jauregg reported pioneering clinical observations in psychiatric patients. Von Basedow, Addison and Cushing described psychiatric symptoms in patients suffering from endocrine diseases. The 20th century opened with the identification of hormones, the first, adrenaline, chemically isolated independently by Aldrich und Takamine in 1901. Berson and Yalow developed the radioimmunoassay (RIA) technique in 1959 making it possible to measure levels of hormones and cytokines. These developments have enabled great strides in psychoimmunoendocrinology. Contemporary research is investigating diagnostic and therapeutic applications of these concepts, for example by identifying biomarkers within the endocrine and immune systems and by synthesizing and testing drugs that modulate these systems and show antidepressant or antipsychotic properties.

The creator of the term 'anancasm' was Hungarian: Guyla Donáth (1849-1944)

There is considerable confusion in the field of research on the history of psychiatry as to who created the term anancasm. This article seeks to clarify that the term was coined by the Hungarian psychiatrist Gyula Donáth, who was born in Baja, on the Danube, and worked mainly in Budapest. Donáth's publications reveal that his predominant sphere of interest and research was neurology and psychiatry. A number of his publications deal with epilepsy and obsessive-compulsive disorders. After a period of intensive research, during which he spent some time in Berlin at the clinic of neuroscientist Carl Westphal, Donáth proposed the term 'anancasm' in 1895 to describe compulsive mental processes.