Julius Wagner von Jauregg, Otto Diem and research methods for assessing the contributions of hereditary burden to mental illness risk: 1902–1906

2021

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This article explores the nature of psychiatric genetics research conducted in asylums in Western Europe in the mid-19th century through an examination of four studies published 1841 to 1864 from Great Britain, France, and Germany. They all utilize asylum records to determine if patients had a hereditary predisposition (HP) to mental illness. A diverse range of topics were investigated, with most attention on whether men or women are more likely to transmit, or are more sensitive to the receipt of, an HP. When significant sex effects were seen, they consistently found women to be more likely to transmit and/or more sensitive to the receipt of an HP. Other questions explored included: (a) the relationship between an HP and recurrence rates; (b) the degree of homogeneity versus heterogeneity of transmission of specific mental illnesses in families; (c) the level of HP among different forms of mental illness; and (d) differences in the proportion of psychiatric patients with an HP as a function of their religion. While the method of assessment of familial/genetic risk was relatively crude, even at this early stage in the history of psychiatric genetics, investigators were asking thoughtful questions about the nature and clinical impact of that risk. K E Y W O R D S asylums, familial transmission, history, psychiatric genetics "[T]he study of madness can contribute, more than the study of any other malady, to the improvement of the general history of heredity and to the determination of the laws it follows. The consumptive, the scrofulous, the gouty are dispersed here and there, and only with a substantial amount of effort and time a singular observer would achieve to collect a sufficient number of observations. The lunatics, in contrast, are assembled by hundreds in the asylums …." (Baillarger, 1844)(as quoted by Gausemeier, 2015, p. 168) One approach to the history of psychiatric genetics is to focus on landmark papers that produced major conceptual or empirical advances in the field. This article takes a different approach. I attempt to characterize the more typical kinds of investigations of the heredity of insanity in mid-19th century Europe. In an effort to be representative (but not exhaustive), four relatively typical studies published from 1841 to 1864 from Great Britain, France, and Germany are investigated. Two are from general asylum reports and two are from published articles focusing on various aspects of the question of heredity.All use, as their primary source of information, records on the family background of hospitalized mentally ill patients' asylums which were the predominant research method at this time (Porter, 2018).Before proceeding with this review, some background is in order.The 18th and early 19th century in Europe saw a large increase of interest in human heredity particularly from a medical perspective (L opez-Beltrán, 1992;Ribot, 1875;Rushton, 2009). Of the many disorders that were examined for heritable influences by 19th-century physicians, insanity was one of the most prominent (...

Section: Discussionmentioning

confidence: 86%

The nature of hereditary influences on insanity from research on asylum records in Western Europe in the mid‐19th century

2021

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“…He proposed four major types of hereditary transmission: direct, crossed, indirect, and atavistic. Contrary to a number of investigators (Kendler, 2020a;Kendler & Klee, 2020a), Lucas regarded it of importance to study not only the direct ancestors of patients, but also their collateral relatives including siblings.…”

Section: Discussionmentioning

confidence: 98%

Prosper Lucas and his 1850 “Philosophical and Physiological Treatise on Natural Heredity”

2021

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Prosper Lucas (1808-1885) is a unique figure in the history of psychiatric genetics. A physician-alienist, he authored one of the most important books on human genetics in the mid-19th century cited frequently by Darwin: the 1,500 page treatise-Philosophical and Physiological Treatise on Natural Heredity (1847-1850). This book contained a novel theory of the nature of inheritance and a detailed review of the heredity of a range of human traits and disorders, including various forms of insanity. Lucas postulated four forms of heredity (direct, crossed, indirect, and atavistic), supported the importance of hereditary factors in insanity, accepted the inheritance of acquired characteristics, considered it important to examine both ancestors and collateral relatives, and recognized that heredity could influence both primary insanity and insanity secondary to other medical conditions. He reviewed the then available literature on most major forms of insanity including separate sections on hallucinations and suicidal monomania.The literature consisted of case reports of unusual families with high concentrations of illness. Lucas advocated for the homogeneity of transmission of forms of illness in families but recognized that-just as the form of illness could evolve within individuals over time-it could change forms when transmitted between relatives.

“…Put another way, these psychiatric genetic studies up until the 1890s never contained control probands whose rate of hereditary taint in relatives could be compared with that found for individuals with insanity. This point was made forcefully in an article published 3 years earlier, but almost surely not read by Pearson, by the eminent Austrian neuropsychiatrist Julius Wagner v. Jauregg (Jauregg, 1902; Kendler & Klee, 2021).…”

Section: Pearson 1905: On the Inheritance Of Insanitymentioning

confidence: 99%

“…But this research tradition had been broken by two young Swiss psychiatrists, Koller and Diem, who compared the rates of such hereditary taints not only in hospitalized insane patients but in controls, in papers published, respectively in 1895 (Kendler & Klee, 2020; Koller, 1895) and 1905 (Diem, 1905; Kendler & Klee, 2021). It was Diem's recently published paper, which has been reviewed (Kendler & Klee, 2021), that had come to Pearson's attention.…”

Section: Pearson 1905: On the Inheritance Of Insanitymentioning

confidence: 99%

The beginnings of biometrical psychiatric genetics: Studies of the insane diathesis 1905–1909

2022

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The year 1900 saw not only the rediscovery of Mendel's hybridization studies but also the publication by Karl Pearson of his newly developed tetrachoric correlation which he used to study the parent–offspring resemblance for the “insane diathesis” in 1905. This was followed by more detailed reports by two of his students/associates: Heron in 1907 and Goring in 1909. Both calculated the tetrachoric correlation for insanity in parent–offspring and Heron for sib–sib pairs. Estimates ranged from approximately +0.30 to +0.60. These papers were statistically sophisticated but demonstrated minimal interest in the phenotype being studied. They are of historical interest because they laid the groundwork for biometrical psychiatric genetics which emerged as a major research paradigm in latter third of the 20th century. In a biting critique of Heron's paper by a young Ernst Rüdin, we see the beginnings of a long‐running argument in psychiatric genetics about the relative value of detailed phenotyping versus novel statistical methods and of Mendelian versus Biometrical methods. While much interest has focused on the eugenic orientation of German psychiatric genetics in the early 20th century, these early British biometrical geneticists, like the majority of geneticists of that day, were also ardent advocates of the eugenic application of their research results.