The myth of reserpine-induced depression: role in the historical development of the monoamine hypothesis

For five decades it has been generally accepted that reserpine, an antihypertensive and antipsychotic drug, causes depression. The discovery that reserpine depletes brain monoamines was an important factor in the development of the monoamine hypothesis of depression, and it continues to be widely cited in support of this hypothesis. The present paper argues that, contrary to prevailing belief, reserpine is not depressogenic. The reason for perpetuation of this myth is reluctance to discard the monoamine hypothesis. This hypothesis ushered the modern biochemical paradigm into psychiatry and is still of great importance. It serves as a heuristic to guide research, it enhances psychiatry's prestige, and it helps to validate and promote drug therapy for depression and other mental disorders.     

The serotonin hypothesis of schizophrenia: a historical case study on the heuristic value of theory in clinical neuroscience

Clinical examination of the reliability and coherence of the evidence concerning modern neurochemical theories of mental disorders has led some scholars to conclude that support for many of these theories is weak. Nevertheless, these theories continue to be widely promoted. One explanation that has been offered for continued adherence to questionable theory is that it stimulates and gives direction to research. The heuristic value of theory is examined in the present paper by tracing the discoveries that followed from an old theory of schizophrenia, which is--by current consensus--false. It is shown that the original serotonin hypothesis of schizophrenia did, in fact, lead to significant advances in neuropharmacology, neurology and psychiatry.     

Monoamine theories of depression: historical impact on biomedical research

Monoamine theories associate depression with reduced brain monoamine levels. These theories achieved broad popularity in the mid-1960s. The present article reviews the historical development of monoamine theories and their subsequent impact on biomedical research. Alleged divisions between West European and US researchers over competing versions of the theories are investigated using bibliometrics. Subsequently, the application of monoamine theories in the NIMH Collaborative Program on the Psychobiology of Depression is covered. The article argues that the impact of monoamine theories is best explained by the ability of researchers, governmental agencies, and pharmaceutical companies to invoke theories that advance various projects and agendas.     

Performing a cure for schizophrenia: insulin coma therapy on the wards

Most historians of psychiatry regard insulin coma therapy (ICT) either as an embarrassing stumble on the path to modern biological psychiatry or as one member of a long line of somatic therapies used to treat mental illness in the mid-twentieth century. This article explores the ICT era, roughly 1933-60, as a key moment in the development of American psychiatry. Developed only ten years after insulin had been embraced as a "miracle drug" for the treatment of diabetes, ICT was perceived by psychiatrists as a means of bringing their field closer to mainstream medicine, particularly to neurology. In addition, the story of ICT reveals how a treatment never quite proven on paper was unquestionably efficacious in the local world in which it was performed. An institutionally-based treatment, ICT was administered in a specific area of the mental hospital deemed the insulin unit, a room with its own staff, practices, and attitudes toward mental illness. There, psychiatrists often experienced wondrous recoveries of individual, formerly intractable patients. These intense personal experiences allowed psychiatrists to feel truly efficacious, enabling them to reinvent themselves as medical doctors rather than behavioral and disciplinary supervisors. The confidence they derived from this capacity, along with the operating room-like setting of the insulin unit, the unit's specialized staffing and group bond, and the availability of both risk-assessment tests and a medley of treatments that countered side effects and complications, allowed ICT to be understood as an efficacious treatment for schizophrenia within the local world in which it was administered.     

Historical Development of the Dopamine Hypothesis of Schizophrenia

This review examines the history of discoveries that contributed to development of the dopamine hypothesis of schizophrenia. The origin of the hypothesis is traced to the recognition that neuroleptic drugs interfere with brain dopamine function. This insight was derived from two distinct lines of research. The first line originated from the discovery in 1956 that reserpine depletes brain serotonin. This finding resulted in a sequence of studies that led to the discovery that brain dopamine is involved in neuroleptic-induced extrapyramidal motor disturbances. The second line of research was aimed at determining the mechanism of action of psychomotor stimulants. This research produced evidence that stimulants directly or indirectly activate brain dopamine receptors. Because nonreserpine neuroleptics such as chlorpromazine block stimulant-induced movement, these findings suggested that neuroleptics were dopamine antagonists. Most previous accounts of the development of the dopamine hypothesis of schizophrenia emphasize the first line of research and ignore the second.     

Historical development of the dopamine hypothesis of schizophrenia

This review examines the history of discoveries that contributed to development of the dopamine hypothesis of schizophrenia. The origin of the hypothesis is traced to the recognition that neuroleptic drugs interfere with brain dopamine function. This insight was derived from two distinct lines of research. The first line originated from the discovery in 1956 that reserpine depletes brain serotonin. This finding resulted in a sequence of studies that led to the discovery that brain dopamine is involved in neuroleptic-induced extrapyramidal motor disturbances. The second line of research was aimed at determining the mechanism of action of psychomotor stimulants. This research produced evidence that stimulants directly or indirectly activate brain dopamine receptors. Because nonreserpine neuroleptics such as chlorpromazine block stimulant-induced movement, these findings suggested that neuroleptics were dopamine antagonists. Most previous accounts of the development of the dopamine hypothesis of schizophrenia emphasize the first line of research and ignore the second.     

Beyond the metaphor of the pendulum: electroconvulsive therapy, psychoanalysis, and the styles of American psychiatry

It is common to represent the history of American psychiatry by comparing it to a pendulum. In this metaphorical rendering, psychiatry has swung back and forth between extremes of emphasis on psyche (life events and inner conflict ruling etiological thinking, talk therapy dominating treatment) and soma (biochemical sources dominating etiological thinking, somatic treatments dominating treatment). This article argues that, while this metaphor is suited to capturing certain aspects of American psychiatric history, it distorts others by, for example, exaggerating the extent of dogmatism on either side and obscuring continuities in psychiatry's history. The article looks specifically at the reception by psychoanalysts to the introduction of electroconvulsive therapy. It shows that psychoanalytic views of ECT were diverse and more receptive to ECT than the pendulum metaphor might lead us to believe.     

‘Mother's Little Helper’: The Crisis of Psychoanalysis and the Miltown Resolution

This paper examines the discourse surrounding the release in 1955 of Miltown, America's first psychotropic wonder drug. According to many histories of psychiatry, Miltown heralded the arrival of a new paradigm in treating psychiatric patients – as a drug that operated on a neurochemical level, it was argued to replace a psychoanalytic approach with its focus on the mother‐child relation. Between 1955 and 1960, articles about pharmaceutical miracle cures for mental illnesses filled mass‐circulation news magazines and top fashion magazines. Through analysis of these representations, this article shows how the newly discovered pills came to be associated with existing concerns about conditions problematically referred to as ‘maternal conditions,’ ranging from a woman's frigidity, to a bride's uncertainty, to a wife's infidelity. Using these representations, the paper demonstrates how in American popular culture, psychoanalytic notions of motherhood prevalent in the 1950s shaped early understandings and uses of psychotropic drugs.     

Continuity and Discontinuity in the Historical Development of Modern Psychopharmacology

In the middle of the twentieth century psychiatry underwent a transition that is often referred to as the “psychopharmacology revolution.” Implicit in the term revolution is the idea that a paradigm shift occurred. Specifically, it has been argued that psychiatry abandoned the psychoanalytic paradigm in favor of a qualitatively distinct conceptual system based on brain chemistry. The validity of this view requires that psychoanalysis had the status of a paradigm. This paper presents evidence that psychoanalysis did not constitute a paradigm and that the advent of psychopharmacology was not, technically, a scientific revolution. Instead, the rise of modern psychopharmacology was the culmination of a linear growth of biological knowledge that began to develop in the nineteenth century.     

Continuity and discontinuity in the historical development of modern psychopharmacology

In the middle of the twentieth century psychiatry underwent a transition that is often referred to as the "psychopharmacology revolution." Implicit in the term revolution is the idea that a paradigm shift occurred. Specifically, it has been argued that psychiatry abandoned the psychoanalytic paradigm in favor of a qualitatively distinct conceptual system based on brain chemistry. The validity of this view requires that psychoanalysis had the status of a paradigm. This paper presents evidence that psychoanalysis did not constitute a paradigm and that the advent of psychopharmacology was not, technically, a scientific revolution. Instead, the rise of modern psychopharmacology was the culmination of a linear growth of biological knowledge that began to develop in the nineteenth century.     

The Maudsley Hospital and the Rockefeller Foundation: the impact of philanthropy on research and training

Opened in February 1923 to raise the status of academic psychiatry in the UK, the Maudsley Hospital struggled to secure grant income. Without a track record of published research and lacking internationally recognized clinicians, it failed to impress the British Medical Research Council. To challenge leading U.S. and German departments of neuropsychiatry, Edward Mapother, the medical superintendent, looked overseas for investment in an "institute of psychiatry." Intense lobbying and a modified strategy for research and training designed to meet the Rockefeller Foundation's prioritization of psychiatry and medical specialization ultimately led to a significant endowment. Alan Gregg and Daniel O'Brien at the Foundation played a pivotal role in re-defining the Maudsley's programs of research and teaching. Pressure on Mapother to attract funding was matched by that on administrators required to show that their philanthropy had yielded tangible gains in public health. While wealthy charities, like the Rockefeller, often had a vision of the direction that they wished to pull medical science, and they provided much needed income, the impact of their policy agenda was not without drawbacks. Institutions unwilling to embrace a charity's philosophy were unlikely to secure grants, while those that did might find themselves drawn into less optimal areas.     

Magic Bullets for Mental Disorders: The Emergence of the Concept of an “Antipsychotic” Drug

When “antipsychotic” drugs were introduced into psychiatry in the 1950s, they were thought to work by inducing a state of neurological suppression, which reduced behavioral disturbance as well as psychotic symptoms. This view was reflected in the name “neuroleptic.” Within a few years, however, the idea that the drugs were a disease-specific treatment for schizophrenia or psychosis, and that they worked by modifying the underlying pathology of the condition, replaced this earlier view, and they became known as “antipsychotics.” This transformation of views about the drugs' mode of action occurred with little debate or empirical evaluation in the psychiatric literature and obscured earlier evidence about the nature of these drugs. Drug advertisements in the British Journal of Psychiatry reflect the same changes, although the nondisease-specific view persisted for longer. It is suggested that professional interests rather than scientific merit facilitated the rise of the disease-specific view of drug action. The increasing popularity of atypical antipsychotics makes it important to examine the origins of the assumptions on which modern drug treatment is based.     

REVIEW ESSAY Beyond Social Construction: Toward New Histories of Psychiatry

Focusing on symptom classification and on the outcome of somatic interventions, Berrios and Shorter challenge the social constructionist and anti-psychiatry tendencies that have framed the writing of the history of psychiatry for the past quarter-century. Contextualizing clinical interventions, these studies point out the value of examining the proposition that practitioners were motivated as much about curing distress as they were about eliminating nonconformity. Such examinations require an understanding of the strengths and limits of medical science that often have been trivialized or ignored by some social constructionists. Together the studies under review open the possibility that recent biological interventions may have transformed psychiatry in such fundamental ways that they call into question the assumptions that have underlay in an almost two-century-old classification system. Ironically, adherence to the scientific method (falsification) reveals that the biological revolution in psychiatry fits post-modern claims about the tentative nature of knowledge claims, while it simultaneously undercuts the particular historical interpretations of post-modern scholarship.     

Beyond social construction: toward new histories of psychiatry (review essay)

Focusing on symptom classification and on the outcome of somatic interventions, Berrios and Shorter challenge the social constructionist and anti-psychiatry tendencies that have framed the writing of the history of psychiatry for the past quarter-century. Contextualizing clinical interventions, these studies point out the value of examining the proposition that practitioners were motivated as much about curing distress as they were about eliminating nonconformity. Such examinations require an understanding of the strengths and limits of medical science that often have been trivialized or ignored by some social constructionists. Together the studies under review open the possibility that recent biological interventions may have transformed psychiatry in such fundamental ways that they call into question the assumptions that have underlay in an almost two-century-old classification system. Ironically, adherence to the scientific method (falsification) reveals that the biological revolution in psychiatry fits post-modern claims about the tentative nature of knowledge claims, while it simultaneously undercuts the particular historical interpretations of post-modern scholarship.     

Où va la philosophie de la psychiatrie ?Where is going philosophy of psychiatry ?Wohin Geht Die Philosophie Der Psychiatrie ?

This contribution provides a critical outline of the current trends in the field of “philosophy of psychiatry” by following their developments in the last decade. The first part of the paper focuses on the evolution of this field from a strictly conceptual approach to a perspective more attentive to the social, practical, and clinical dimension of psychiatry. The second part of the paper points out that the need of a mutual commitment of philosophy and psychiatry is perceived according to different ways by the countries involved in this research area. The paper deals especially with the case of France, where the enthusiasm for the “new philosophy of psychiatry” has not had the same impact on the philosophical scene as in the English speaking countries. In conclusion, the paper shows that the field of philosophy of psychiatry stands as a fertile ground for new forms of interaction between the analytic, and the continental philosophical traditions. This interaction takes place, more particularly, as regards such topics as normativity, language, and interpretation.     

Selective Transport of Animal Parts by Ancient Hunters: A New Statistical Method and an Application to the Emeryville Shellmound Fauna

When deciding which parts of a prey animal to transport home, hunters may be more or less selective. In our vocabulary, unselective hunters are those who usually bring home most of the carcass; selective hunters are those who usually abandon all but the choicest (and/or lightest) parts. This paper uses the abcml statistical method to develop a means of estimating transport selectivity from the frequencies of skeletal parts in a faunal assemblage. It then applies the method to artiodactyl data from the Emeryville Shellmound in order to test the local depression and distant patch use hypothesis. This hypothesis predicts that selectivity should decline during the early part of the Emeryville sequence and rise during the later part. The initial analysis did reveal such a pattern, but this pattern disappeared when samples were pooled in order to produce acceptably narrow confidence intervals. Although this result weakens the hypothesis, it does not firmly refute it, because the model fits the data imperfectly in the critical middle portion of the sequence. Abcml also provides estimates of the intensity of attrition, which indicate that attrition was most severe in early strata and least severe in later ones. Substantial attrition (50% of bones surviving) is indicated even from samples that show no indication of attrition using conventional methods. These conclusions are based on assumptions about the processes of transport and attrition that are more reliable in qualitative outline than in quantitative detail. Consequently, the paper's qualitative conclusions are more trustworthy than its quantitative estimates.     

Living in the tenth century. Mentalities and social orders

In his series of lectures, Le pouvoir psychiatrique, Michel Foucault employs concepts from the military field of knowledge in order to analyse the founding scenes of psychiatry. I focus on three issues connected to Foucault's use of these military terms. Firstly, I examine why Foucault was reluctant to use concepts from sociology and psychology in Le pouvoir psychiatrique and how this affects the notions that he had formulated in his earlier work, Histoire de la folie. Secondly, I show how he challenges traditional understandings of the founding scenes of psychiatry by using concepts from a different field of knowledge. In doing this, he creates metaphors, and this is something that he himself had previously been critical of doing. Thirdly, I reflect upon the fact that Foucault's creative use of concepts from different disciplines and examples from different historical times can be related to episodes in his own life; I argue why it is important to supplement a structural analysis with linguistic, phenomenological and hermeneutical ones.     

Prehistoric behavioral depression of cormorant (Phalacrocorax spp.) on the northern California coast

Resource depression is often assumed to result from the over-exploitation of a prey species leading to declines in its population, and therefore availability, to human hunters. However, two other forms of resource depression are noted in the ecological literature: behavioral and micro-habitat depression. Data presented in this paper demonstrate resource depression of cormorants (Phalacrocorax spp.), a coastally breeding and semi-pelagic bird genus, at a coastal site in northern California. Citing modern cormorant behavior and a lack of evidence for intensive rookery exploitation, it is argued that the observed resource depression resulted from changes in cormorant behavior that decreased encounter rates for human hunters. Such behavioral depression is cited as a buffer to the extirpation of prey in mainland settings.     

Turkish ultra–nationalists under review: a study of the Nationalist Action Party

This article aims to study the phenomenon of the Turkish National Party (MHP) by reference to the ongoing theoretical debates on the subject of extreme right–wing parties. This is instrumental in finding out whether the MHP displays similar characteristics to its counterparts in Europe, and whether it is an extreme right, a fascist or a centre–right party. The primary hypothesis of this article is that the MHP features many similarities with its European counterparts and hence, is a member of the European extreme right–wing family. In order to test this hypothesis, firstly the historical development of the MHP is clarified. Secondly, the contemporary debates in the study of the extreme right–wing family and different approaches to it are presented. Finally, based on the common characteristics of the extreme right–wing parties in general, the aforementioned hypothesis is tested and verified. The main contention of this article is that the MHP shows all the characteristics of a European extreme right–wing party.     

Queensland Aborigines,Multiple Realities and the Social Sources of Suffering: Psychiatry and Moral Regions of Being: Part 1

ABSTRACT This two part paper considers the experience of a range of magico‐religious experiences (such as visions and voices) and spirit beliefs in a rural Aboriginal town. The papers challenge the tendency of institutionalised psychiatry to medicalise the experiences and critiques the way in which its individualistic practice is intensified in the face of an incomprehensible Aboriginal ‘other’ to become part of the power imbalance that characterises the relationship between Indigenous and white domains. The work reveals the internal differentiation and politics of the Aboriginal domain, as the meanings of these experiences and actions are contested and negotiated by the residents and in so doing they decentre the concerns of the white domain and attempt to control their relationship with it. Thus the plausibility structure that sustains these multiple realities reflects both accommodation and resistance to the material and historical conditions imposed and enacted by mainstream society on the residents, and to current socio‐political realities. I conclude that the residents' narratives chart the grounds of moral adjudication as the experiences were rarely conceptualised by local people as signs of individual pathology but as reflections of social reality. Psychiatric drug therapy and the behaviourist assumptions underlying its practice posit atomised individuals as the appropriate site of intervention as against the multiple realities revealed by the phenomenology of the experiences. The papers thus call into question Australian mainstream ‘commonsense’ that circulates about Aboriginal and Torres Strait Islander people which justifies representations of them as sickly outcasts in Australian society.