History of psychiatry and its institutions

Engström, Eric J.

doi:10.1097/yco.0b013e3283590474

Cited by 15 publications

(7 citation statements)

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“…The true changes that revolutionised psychiatry and shaped current practise date back to the period after the Second World War, with the introduction of standardised diagnoses and the approval of treatments based on evidence. The pharmacological revolution of the 1950s, deinstitutionalisation of psychiatric care for outpatient treatment, behavioural and cognitive approaches in the 1960s ( 2 ), development of the DSM-III diagnostic approach, and third-generation cognitive-behavioural approaches ( 3 , 4 ) have all contributed to the emergence of modern psychiatry. Significant progress has been made in the characterisation of diagnostic entities and their evolution, prevention, and treatment, which now include various forms of psychotherapy, medication, psychosocial intervention, and biological treatment.…”

Section: Introductionmentioning

confidence: 99%

Reading, Conducting, and Developing Systematic Review and Individual Patient Data Meta-Analyses in Psychiatry for Treatment Issues

2021

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Introduction: Individual participant data meta-analyses (IPD-MAs) include the raw data from relevant randomised clinical trials (RCTs) and involve secondary analyses of the data. Performed since the late 1990s, ~50 such meta-analyses have been carried out in psychiatry, mostly in the field of treatment. IPD-MAs are particularly relevant for three objectives: (1) evaluation of the average effect of an intervention by combining effects from all included trials, (2) evaluation of the heterogeneity of an intervention effect and sub-group analyses to approach personalised psychiatry, (3) mediation analysis or surrogacy evaluation to replace a clinical (final) endpoint for the evaluation of new treatments with intermediate or surrogate endpoints. The objective is to describe the interest and the steps of an IPD-MA method applied to the field of psychiatric therapeutic research.Method: The method is described in three steps. First, the identification of the relevant trials with an explicit description of the inclusion/exclusion criteria for the RCT to be incorporated in the IPD-MA and a definition of the intervention, the population, the context and the relevant points (outcomes or moderators). Second, the data management with the standardisation of collected variables and the evaluation and the assessment of the risk-of-bias for each included trial and of the global risk. Third, the statistical analyses and their interpretations, depending on the objective of the meta-analysis. All steps are illustrated with examples in psychiatry for treatment issues, excluding study protocols.Conclusion: The meta-analysis of individual patient data is challenging. Only strong collaborations between all stakeholders can make such a process efficient. An “ecosystem” that includes all stakeholders (questions of interest prioritised by the community, funders, trialists, journal editors, institutions, …) is required. International medical societies can play a central role in favouring the emergence of such communities.

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Section: Introductionmentioning

confidence: 99%

Reading, Conducting, and Developing Systematic Review and Individual Patient Data Meta-Analyses in Psychiatry for Treatment Issues

2021

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“…In a general historiographical sense, it would seem as if it is too soon to abandon interest in the institutional settings of mental health care after World War II—to consign institutional histories “to the methodological dustbin,” as Engstrom (2012, p. 486) called it. The early history of Stikland Hospital largely fits into the well-established account of what happened to psychiatric hospitals in the second half of the previous century.…”

Section: Discussionmentioning

confidence: 99%

Building a mental hospital in apartheid South Africa.

Louw¹

2019

History of Psychology

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a new mental hospital was inaugurated in Belville, a town near Cape Town, South Africa. Stikland Mental Hospital was planned as mental health care was changing with the introduction of psychotropic drugs and renewed debates about deinstitutionalization-and as the South African legislature formalized the system known as "apartheid." This article focuses on this hospital, which embodied many global ideas about treatment and management of the mentally ill but which also incorporated the local politics of strict racial segregation. It had been planned in response to overcrowded mental hospitals in the 1950s, but by the time it opened, new forms of treatment had produced a surplus of beds for White patients. Architecturally, the hospital was conceived with the general principles of the villa plan in mind, although utilitarian aspects, such as patient and staff numbers, gardens, and budgets, dominated the design of the buildings. The public relations exercises undertaken highlight the negotiations involved in building a mental hospital in 1960s South Africa, but the example of Stikland also showcases new plans for research and training in mental health professions in the 1960s and 1970s. Disciplines such as clinical psychology benefited from the professional training opportunities provided. Overall, Stikland Mental Hospital therefore provides an important perspective on deinstitutionalization outside its familiar settings and historical accounts.

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“…Toutes ces réflexions scientifiques autant que juridiques auraient pu mener à l'application d'un traitement médical systématique efficace, mais la diversité et l'incertitude des différentes opinions n'aident pas à construire une politique de soins adaptée, d'autant moins dans le contexte colonial. Si des essais sont faits 200 , les asiles restent donc, jusque tard dans le XIX e siècle, davantage des lieux de confinement des individus pouvant troubler l'ordre public que des lieux de soins 201 . Ces expérimentations prennent des formes très diverses, telles que les « shock therapy » ou encore des inoculations de substances variées, comme des injections de lait en Indochine 202 !…”

Section: If In Any Licensed Asylum No Provision For Curative Treatmen...unclassified

La réglementation des asiles dans les colonies françaises et britanniques des années 1850 aux années 1920

Ledolley¹

2022

cliothemis

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We're all mad here. I'm mad. You're mad.-How do you know I'm mad ? said Alice. -You must be, said the Cat, or you wouldn't have come here. 1 1 Seul un fou tenterait l'aventure au pays des merveilles, ou peut-être le pays des merveilles n'apparaît-il qu'aux fous. Dans les deux cas, l'endroit et l'individu sont liés et Lewis Caroll décrit un pays dans lequel les fous pullulent et trouvent finalement leur place. Mais l'idée d'un endroit dédié aux fous est antérieure à la fiction. Michel Foucault dans Histoire de la folie à l'âge classique parle de ce phénomène de « grand renfermement » qui touche plusieurs catégories de la population européenne à partir du XVI e siècle 2 . Au Moyen Âge, il existe des institutions de confinement des fous 3 , mais ce sont surtout les lépreux qui sont enfermés. C'est principalement à partir de l'époque moderne que les pauvres et les vagabonds, auxquels sont associés les fous, vont subir cette entreprise d'internement. En vertu du maintien de l'ordre public des structures telles que l'Hôpital général en 1656 vont être créées. 2 La réglementation des asiles dans les colonies françaises et britanniques des... Clio@Themis, 23 | 2022 La réglementation des asiles dans les colonies françaises et britanniques des...

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History of psychiatry and its institutions

Abstract: As carceral narratives have begun to lose their paradigmatic status within psychiatric historiography, a much more nuanced picture of asylum culture is becoming visible. The history of psychiatric institutions remains an integral and productive part of psychiatric historiography.

Cited by 15 publications

References 52 publications

Reading, Conducting, and Developing Systematic Review and Individual Patient Data Meta-Analyses in Psychiatry for Treatment Issues

Reading, Conducting, and Developing Systematic Review and Individual Patient Data Meta-Analyses in Psychiatry for Treatment Issues

Building a mental hospital in apartheid South Africa.

La réglementation des asiles dans les colonies françaises et britanniques des années 1850 aux années 1920

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