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Mental disorders in the 20th century

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Wikipedia entry on mental disorders in the 20th century. Public health. Newspaper headlines from around the world about polio vaccine tests (13 April 1955)

Public health

Mental health. Profession. A profession is a vocation founded upon specialized educational training, the purpose of which is to supply objective counsel and service to others, for a direct and definite compensation, wholly apart from expectation of other business gain.[1] The term is in essence a rather vaguer version of the term "liberal profession", an anglicisation of the French term "profession libérale".

Profession

Originally borrowed by English users in the nineteenth century, it has been re-borrowed by international users from the late twentieth, though the (upper-middle) class overtones of the term do not seem to survive retranslation: “liberal professions” are, according to the Directive on Recognition of Professional Qualifications (2005/36/EC) “those practised on the basis of relevant professional qualifications in a personal, responsible and professionally independent capacity by those providing intellectual and conceptual services in the interest of the client and the public”.[2] History[edit] Regulation[edit]

Clinical psychology. Clinical psychology is an integration of science, theory and clinical knowledge for the purpose of understanding, preventing, and relieving psychologically-based distress or dysfunction and to promote subjective well-being and personal development.[1][2] Central to its practice are psychological assessment and psychotherapy, although clinical psychologists also engage in research, teaching, consultation, forensic testimony, and program development and administration.[3] In many countries, clinical psychology is regulated as a health care profession.

Clinical psychology

The field is often considered to have begun in 1896 with the opening of the first psychological clinic at the University of Pennsylvania by Lightner Witmer. In the first half of the 20th century, clinical psychology was focused on psychological assessment, with little attention given to treatment. This changed after the 1940s when World War II resulted in the need for a large increase in the number of trained clinicians.

History[edit] Social work. Social work is a professional and academic discipline that seeks to improve the quality of life and subjective well-being of individuals, groups, and communities through research, policy, community organizing, direct practice, crisis intervention, and teaching for the benefit of those affected by social disadvantages such as poverty, mental and physical illness or disability, and social injustice, including violations of their civil liberties and human rights.

Social work

A person who practices social work is called a social worker. Psychoanalysis. Psychoanalysis is a set of psychological and psychotherapeutic theories and associated techniques, originally popularized by Austrian physician Sigmund Freud and stemming partly from the clinical work of Josef Breuer and others.

Psychoanalysis

Since then, psychoanalysis has expanded and been revised, reformed and developed in different directions. This was initially by Freud's colleagues and students, such as Alfred Adler and Carl Gustav Jung who went on to develop their own ideas independently from Freud. Later neo-Freudians included Erich Fromm, Karen Horney, Harry Stack Sullivan and Jacques Lacan. The basic tenets of psychoanalysis include the following: Under the broad umbrella of psychoanalysis there are at least 22 theoretical orientations regarding human mental development.

World War II. World War II (WWII or WW2), also known as the Second World War, was a global war that lasted from 1939 to 1945, though related conflicts began earlier.

World War II

It involved the vast majority of the world's nations—including all of the great powers—eventually forming two opposing military alliances: the Allies and the Axis. It was the most widespread war in history, and directly involved more than 100 million people from over 30 countries. In a state of "total war", the major participants threw their entire economic, industrial and scientific capabilities behind the war effort, erasing the distinction between civilian and military resources.

World War II altered the political alignment and social structure of the world. The United Nations (UN) was established to foster international co-operation and prevent future conflicts. Chronology Others follow the British historian A. The exact date of the war's end is also not universally agreed upon. Background. Diagnostic and Statistical Manual of Mental Disorders. The Holocaust. The Holocaust (from the Greek ὁλόκαυστος holókaustos: hólos, "whole" and kaustós, "burnt")[2] also known as Shoah (Hebrew: השואה, HaShoah, "the catastrophe"; Yiddish: חורבן, Churben or Hurban, from the Hebrew for "destruction"), was the mass murder or genocide of approximately six million Jews during World War II, a programme of systematic state-sponsored murder by Nazi Germany, led by Adolf Hitler and the Nazi Party, throughout the German Reich and German-occupied territories.[3] Of the nine million Jews who had resided in Europe before the Holocaust, approximately two-thirds were killed.[4] Over one million Jewish children were killed in the Holocaust, as were approximately two million Jewish women and three million Jewish men.[5] A network of over 40,000 facilities in Germany and German-occupied territory were used to concentrate, hold, and kill Jews and other victims.[6] The persecution and genocide were carried out in stages.

The Holocaust

Etymology and use of the term Distinctive features. Euthanasia. Euthanasia (from Greek: εὐθανασία; "good death": εὖ, eu; "well" or "good" – θάνατος, thanatos; "death") refers to the practice of intentionally ending a life in order to relieve pain and suffering.

Euthanasia

Euthanasia is categorized in different ways, which include voluntary, non-voluntary, or involuntary. Voluntary euthanasia is legal in some countries and U.S. states. Non-voluntary euthanasia is illegal in all countries. Psychiatrist. A psychiatrist is a physician who specializes in psychiatry.

Psychiatrist

A psychiatrist specializes in the diagnosis and treatment of mental disorders. Psychiatrists are medical doctors who must evaluate patients to determine whether or not their symptoms are the result of a physical illness, a combination of physical and mental, or a strictly psychiatric one. In order to do this, they may employ the psychiatric examination itself, a physical exam, brain imaging (computerized tomography or CT/CAT scan), magnetic resonance imaging (MRI), and positron emission tomography (PET) scanning), and blood laboratories.

Psychiatrists prescribe medicine, and may also use psychotherapy, although the vast majority do medical management and refer to a psychologist or another specialized therapist for weekly to bi-monthly psychotherapy. International Statistical Classification of Diseases and Related Health Problems. The International Statistical Classification of Diseases (ICD) is the international "standard diagnostic tool for epidemiology, health management and clinical purposes".[1] The ICD is maintained by the World Health Organization, the directing and coordinating authority for health within the United Nations System.[2] The ICD is designed as a health care classification system, providing a system of diagnostic codes for classifying diseases, including nuanced classifications of a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or disease.

International Statistical Classification of Diseases and Related Health Problems

This system is designed to map health conditions to corresponding generic categories together with specific variations, assigning for these a designated code, up to six characters long. Thus, major categories are designed to include a set of similar diseases. The ICD is revised periodically and is currently in its tenth revision. Historical synopsis[edit] Endocrinology. Endocrinology is concerned with study of the biosynthesis, storage, chemistry, biochemical and physiological function of hormones and with the cells of the endocrine glands and tissues that secrete them. Various specializations exist, including behavioral endocrinology[1][2][3] and comparative endocrinology. The endocrine system consists of several glands, all in different parts of the body, that secrete hormones directly into the blood rather than into a duct system.

Hormones have many different functions and modes of action; one hormone may have several effects on different target organs, and, conversely, one target organ may be affected by more than one hormone. Stress (biology) Walter Cannon used it in 1926 to refer to external factors that disrupted what he called homeostasis.[2] But "...stress as an explanation of lived experience is absent from both lay and expert life narratives before the 1930s".[3] Physiological stress represents a wide range of physical responses that occur as a direct effect of a stressor causing an upset in the homeostasis of the body.

Upon immediate disruption of either psychological or physical equilibrium the body responds by stimulating the nervous, endocrine, and immune systems. The reaction of these systems causes a number of physical changes that have both short and long term effects on the body. Homeostasis is a concept central to the idea of stress. In biology, most biochemical processes strive to maintain equilibrium (homeostasis), a steady state that exists more as an ideal and less as an achievable condition.

The ambiguity in defining this phenomenon was first recognized by Hans Selye (1907-1982) in 1926. Outpatient commitment. Outpatient commitment refers to mental health law that allows the involuntary treatment of individuals diagnosed with mental disorders who are resident in the community rather than detained in hospital. The individual may be subject to rapid recall to hospital, including for forced treatment, if the conditions of the plan/order are broken.

This generally means taking psychiatric medication as directed and may also include attending appointments with a mental health professional, and sometimes even not to take non-prescribed illict drugs and not associate with certain people or in certain places deemed to have been linked to a deterioration in mental health in that individual. In the United States the term "assisted outpatient treatment" or "AOT" is often used and refers to a process whereby a judge orders a qualifying person with symptoms of severe untreated mental illness to adhere to a mental health treatment plan while living in the community. Implementation[edit] United States[edit] Lobotomy. Lobotomy (Greek: λοβός – lobos: "lobe (of brain)"; τομή – tomē: "cut/slice") is a neurosurgical procedure, a form of psychosurgery, also known as a leukotomy or leucotomy (from the Greek λευκός – leukos: "clear/white" and tome).

It consists of cutting or scraping away most of the connections to and from the prefrontal cortex, the anterior part of the frontal lobes of the brain. While the procedure, initially termed a leucotomy, has been controversial since its inception in 1935, it was a mainstream procedure for more than two decades, prescribed for psychiatric (and occasionally other) conditions – this despite general recognition of frequent and serious side-effects. Context[edit] Insulin shock therapy. Insulin shock therapy or insulin coma therapy (ICT) was a form of psychiatric treatment in which patients were repeatedly injected with large doses of insulin in order to produce daily comas over several weeks.[1] It was introduced in 1927 by Austrian-American psychiatrist Manfred Sakel and used extensively in the 1940s and 1950s, mainly for schizophrenia, before falling out of favour and being replaced by neuroleptic drugs in the 1960s.[2]

Electroconvulsive therapy. Electroconvulsive therapy (ECT), formerly known as electroshock, is a standard psychiatric treatment in which seizures are electrically induced in patients to provide relief from psychiatric illnesses.[1] ECT is usually used as a last line of intervention for major depressive disorder, schizophrenia, mania and catatonia.[2] A usual course of ECT involves multiple administrations, typically given two or three times per week until the patient is no longer depressed. Anti-psychiatry. Anti-psychiatry is the view that psychiatric treatments are ultimately more damaging than helpful to patients. Psychiatry is seen by proponents of anti-psychiatry as a coercive instrument of oppression. According to anti-psychiatry, psychiatry involves an unequal power relationship between doctor and patient, and a highly subjective diagnostic process, leaving too much room for opinions and interpretations.[1][2][3] Anti-psychiatry originates in an objection to what some view as dangerous treatments.[2] Examples include electroconvulsive therapy, insulin shock therapy, brain lobotomy,[2] and the over-prescription of potentially dangerous pharmaceutical drugs.

An immediate concern lies in the significant increase in prescribing psychiatric drugs for children.[1][2] Every society, including liberal Western society, permits involuntary treatment or involuntary commitment of mental patients.[1] Psychiatric survivors movement. The psychiatric survivors movement (more broadly consumer/survivor/ex-patient movement[1]) is a diverse association of individuals who either currently access mental health services (known as consumers or service users), or who consider themselves survivors of interventions by psychiatry, or who identify themselves as ex-patients of mental health services.[2] History[edit] Deinstitutionalisation. Deinstitutionalisation (or deinstitutionalization) is the process of replacing long-stay psychiatric hospitals with less isolated community mental health services for those diagnosed with a mental disorder or developmental disability.

Community mental health service. Homelessness. Although The Bowery once was synonymous with homelessness, it has since become an avenue of high-priced luxury condominiums that jockey for space with its past. Chinese Classification of Mental Disorders. Cognitive behavioral therapy. CBT has been demonstrated to be effective for the treatment of a variety of conditions, including mood, anxiety, personality, eating, substance abuse, tic, and psychotic disorders. Many CBT treatment programs for specific disorders have been evaluated for efficacy; the health-care trend of evidence-based treatment, where specific treatments for symptom-based diagnoses are recommended, has favored CBT over other approaches such as psychodynamic treatments.[3] However, other researchers have questioned the validity of such claims to superiority over other treatments.[4][5] History[edit] Philosophical roots[edit]

Psychiatric medication. Antidepressant. Benzodiazepine. Lithium (medication) Antipsychotic. Chlorpromazine. Eugenics. Compulsory sterilization. World War I. Shell shock.