‘A more perfect arrangement of plants’: the botanical model in psychiatric nosology, 1676 to the present day

Psychiatric classification remains a complex endeavour; since the Enlightenment, nosologists have made use of various models and metaphors to describe their systems. Here we present the most common model, botanical taxonomy, and trace its history from the nosologies of Sydenham, Sauvages and Linnaeus; to evolutionary models; to the later contributions of Hughlings-Jackson, Kraepelin and Jaspers. Over time, there has been a shift from explicit attempts to pattern disease classification on botanical systems, to a more metaphorical use. We find that changes in the understanding of plants and plant relationships parallel changes in the conceptualization of mental illness. Not only have scientific discoveries influenced the use of metaphor, but the language of metaphor has also both illuminated and constrained psychiatric nosology.

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Phillipe Pinel and the foundations of modern psychiatric nosology

Psychological Medicine ◽

10.1017/s0033291720004183 ◽

2020 ◽

pp. 1-6

Author(s):

Kenneth S. Kendler

Keyword(s):

Biological Sciences ◽

Mental Illness ◽

Mentally Ill ◽

Psychiatric Patients ◽

Psychiatric Nosology ◽

Faculty Psychology ◽

Large Samples ◽

The Enlightenment ◽

The Mind ◽

Over Time

Abstract Phillipe Pinel (1745–1826) played a major role in the foundation of modern psychiatric nosology. Much of his contribution, historically contextualized within the enlightenment generally and post-Revolutionary France more specifically, can be summarized through five themes in his background, education and writings. First, he applied an inductive, enlightenment-informed natural science approach to classification adapted from the biological sciences, which he had studied, and applied this to large samples of mentally ill individuals in Parisian asylums, frequently referring to ‘varieties’ and ‘species’ of insanity. Second, Pinel's classificatory approach rejected metaphysical and highly speculative etiologic theories in favor of a Baconian inductive approach utilizing observational data. Third, Pinel advocated repeated assessments of patients over time, feasible given long in-patient stays. Fourth, trained in philosophy, Pinel relied on philosophically informed models of the mind and of insanity. Fifth, Pinel extensively utilized faculty psychology to understand and classify mental illness. He anticipated further developments of nineteenth-century psychiatric nosology by challenging the then-dominant intellectualist models of insanity, adopting a humanistic-informed emphasis on the importance of symptoms alongside signs, arguing that passions could be the primary cause of mental illness, and trying to infer causal inter-relationships in psychiatric patients between disturbances in affect and understanding.

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Enabling Occupation: The Importance of an Affirming Environment

Canadian Journal of Occupational Therapy ◽

10.1177/000841740106800204 ◽

2001 ◽

Vol 68 (2) ◽

pp. 80-89 ◽

Cited By ~ 53

Author(s):

Karen L. Rebeiro

Keyword(s):

Mental Illness ◽

Qualitative Study ◽

Social Environment ◽

Occupational Therapists ◽

Therapeutic Interventions ◽

Occupational Engagement ◽

Occupational Performance ◽

The Social ◽

The Individual ◽

Over Time

Occupational therapists have become increasingly concerned with factors beyond the individual which impact occupational performance. Several recent models propose that the environment is a significant influence on occupational performance and upon its meaningfulness. An in-depth, qualitative study was conducted which explored the meaning of occupational engagement for eight women with mental illness (Rebeiro & Cook, 1999). This study yielded several important insights about the environment, which have recently been replicated by Legault and Rebeiro (2001) and Rebeiro, Day, Semeniuk, O'Brien, and Wilson (In Press). Participants suggested that environments that provide opportunity, and not prescription are more conducive to fostering occupational performance. Participants further suggested that an environment that provides Affirmation of the individual as a person of worth, a place to belong, and a place to be supported, enables occupational performance over time. A series of research studies indicated that the social environment is an important consideration in planning therapeutic interventions which aim to enable occupation. Implications for occupational therapy practice, education and research are offered

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Cross-Sectional Trend Analysis of the NCHA II Survey Data on Canadian Post-Secondary Student Mental Health and Wellbeing from 2013 to 2019

10.31219/osf.io/gv4ex ◽

2021 ◽

Cited By ~ 1

Author(s):

Brooke Linden ◽

Randall Boyes ◽

Heather Stuart

Keyword(s):

Mental Health ◽

Mental Illness ◽

Secondary Students ◽

Help Seeking ◽

Female Students ◽

Male Students ◽

Post Secondary ◽

Health Related ◽

Over Time ◽

Post Secondary Students

BACKGROUND: Canadian post-secondary students are considered to be at risk for chronic stress and languishing mental health, but there has been no longitudinal analysis of the available population-level data. The purpose of this study was to examine trends in the overall and sex-specific prevalence of self-reported stress, distress, mental illness, and help seeking behaviours among Canadian post-secondary students over the past several years. METHODS: Using the 2013, 2016, and 2019 iterations of the National College Health Assessment II Canadian Reference data, we conducted a trend analysis for each variable of interest, stratified by sex. The significance and magnitude of the changes were modelled using cumulative linked ordinal regression models and log binomial regression models.RESULTS: With few exceptions, we observed significant increases over time in the proportion of students reporting symptoms of psychological distress, mental illness diagnoses, and help seeking for mental health related challenges. Female students reported a higher level of stress than male students, with a statistically significant increase in the stress level reported by female students observed over time. In all cases, larger proportions of female students were observed compared to male students, with the proportion of female students who self-reported mental illness diagnoses nearly doubling that of males. CONCLUSIONS: Our analysis indicated that the proportion of students self-reporting mental health related challenges, including stress, psychological distress, and diagnosed mental illnesses increased between the 2013, 2016 and 2019 iterations of the NCHA II conducted among Canadian post-secondary students.

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Autism, schizofrenie, ADHD. Perspective convergente

Revista Română de Terapia Tulburărilor de Limbaj şi Comunicare ◽

10.26744/rrttlc.2021.7.1.08 ◽

2021 ◽

Vol 7 (1) ◽

pp. 65-72

Author(s):

Bogdana MICLEA

Keyword(s):

Attention Deficit Hyperactivity Disorder ◽

Mental Illness ◽

Attention Deficit ◽

Hyperactivity Disorder ◽

The World ◽

Partial Overlap ◽

Over Time

Over time, continuous efforts have been made to clarify and circumscribe diagnoses of autism, schizophrenia, and attention deficit hyperactivity disorder (ADHD). The diagnostic split between the 3 disorders dominated psychiatry after the 80s, being still used and recognized as such by the diagnostic manuals. Recently a shift and flexibility of the psychiatric paradigm has been noticed. The categorical perspective on mental illness is gradually complemented by the dimensional one. In the last decade, research in the field of neuroscience and psychology has brought evidence in favor of a partial overlap between ADHD, autism and schizophrenia. The hypothesis of a partial overlap can also be supported by non-medical or psychological theorizations, related to common deficits of symbolic structuring of the psyche in achieving a coherent representation of the world and of one’s own person.

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Secular and Religious Citizenship

The Oxford Handbook of Citizenship ◽

10.1093/oxfordhb/9780198805854.013.21 ◽

2017 ◽

pp. 477-499

Author(s):

Bryan S. Turner

Keyword(s):

Political Theory ◽

Church And State ◽

Religious Community ◽

Educational Services ◽

National Context ◽

Ethical Practice ◽

Religious Development ◽

Liberal Politics ◽

The Enlightenment ◽

Over Time

Citizenship, having antecedents in the ancient world and in the Enlightenment, is often understood in political theory as a secular framework of rights and duties. This chapter argues that there is typically a parallel religious development in which members of churches have to pay taxes, follow the authoritative commands, abide by an orthodoxy and norms of religious and ethical practice, and in return they receive sacramental services and frequently welfare and educational services. Just as citizens can be incarcerated for misdemeanours, members of a religious community can also be expelled or denied ritual services. While there are two distinctive spheres of membership, their relationship has varied considerably over time and by national context. In the liberal politics of western societies, the two spheres are kept apart by the constitutional separation of church and state. However, the two spheres often overlap or conflict with each other.

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Balance Beams and Suicide-Risk Screening

Rethinking Suicide ◽

10.1093/med-psych/9780190050634.003.0004 ◽

2021 ◽

pp. 49-76

Author(s):

Craig J. Bryan

Keyword(s):

Mental Illness ◽

Suicide Risk ◽

Warning Signs ◽

Screening Tools ◽

Warning Sign ◽

Suicidal Behaviors ◽

Risk Screening ◽

Illness Model ◽

Over Time ◽

Suicide Risk Screening

This chapter examines how the mental illness model of suicide has led us to place more faith than may be warranted in concepts such as suicide “warning signs” and suicide-risk screening tools. These concepts are notoriously unreliable indicators of emerging suicidal behaviors because they do not sufficiently reflect the inherently dynamic and ever-changing nature of suicide risk. Any given warning sign for suicide will be wrong much, much more often than it will be right. Even when multiple warning signs are experienced or expressed by an individual, this problem persists. One factor limiting the accuracy of suicide-risk screening is that thoughts about death and suicide fluctuate over time. Thus, we should move away from assuming that we must know who will and who will not attempt suicide to prevent these behaviors from occurring.

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A brief history of suicidal behaviour

Suicide Prevention ◽

10.1093/med/9780198791607.003.0001 ◽

2019 ◽

pp. 1-8

Author(s):

Navneet Kapur ◽

Robert Goldney

Keyword(s):

Nineteenth Century ◽

Mental Illness ◽

Middle Ages ◽

Suicidal Behaviour ◽

Social Influences ◽

Historical Context ◽

Systematic Research ◽

History Of ◽

Over Time ◽

The Middle Ages

This chapter places suicide and suicidal behaviour in a European historical context. Although suicide has been documented throughout history, its meaning and functions have varied over time. In the Middle Ages, suicide was regarded as sinful but, subsequently, was conceptualized in terms of social influences or mental illness. Systematic research into suicidal behaviour has been undertaken for more than two centuries. The contributions of Morselli, using statistical and epidemiological techniques, were particularly notable. Many of the accepted social and psychiatric antecedents of suicide we talk about today were well described by the nineteenth century.

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Temporal and Clinical Course of Multiple Sclerosis

10.1093/med/9780199341016.003.0010 ◽

2016 ◽

Author(s):

Erica Grazioli ◽

Channa Kolb ◽

Bianca Weinstock-Guttman

Keyword(s):

Multiple Sclerosis ◽

Clinical Characteristics ◽

Progressive Disease ◽

Clinical Course ◽

Disease Classification ◽

Clinical Relapse ◽

Resonance Imaging ◽

Genetic Biomarkers ◽

Active Disease ◽

Over Time

The temporal and clinical course of multiple sclerosis is heterogeneous, varying among patients as well as over time in the same individual. Greater specificity in describing disease classification and course is important for conduct of clinical trials as well as prognosis for individual patients. This chapter reviews the results of recent consensus panels that have further defined the relapsing and progressive forms of multiple sclerosis through clarification of clinical relapse, subclinical relapse, active disease, and progressive disease. Clinical characteristics, conventional and nonconventional magnetic resonance imaging metrics, and immunologic and genetic biomarkers that can be used to predict disease severity and course are also discussed.

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Insight in psychosis: Standards, science, ethics and value judgment

International Journal of Social Psychiatry ◽

10.1177/0020764017693655 ◽

2017 ◽

Vol 63 (4) ◽

pp. 345-351 ◽

Cited By ~ 7

Author(s):

KS Jacob

Keyword(s):

Mental Illness ◽

Clinical Assessment ◽

Explanatory Models ◽

Value Judgments ◽

Value Judgment ◽

Discussion Article ◽

Complete Exclusion ◽

Over Time

Background: The clinical assessment of insight solely employs biomedical perspectives and criteria to the complete exclusion of context and culture and to the disregard of values and value judgments. Aim: The aim of this discussion article is to examine recent research from India on insight and explanatory models in psychosis and re-examine the framework of assessment, diagnosis and management of insight and explanatory models. Methods: Recent research from India on insight in psychosis and explanatory models is reviewed. Results: Recent research, which has used longitudinal data and adjusted for pretreatment variables, suggests that insight and explanatory models of illness at baseline do not predict course, outcome and treatment response in schizophrenia, which seem to be dependent on the severity and quality of the psychosis. It supports the view that people with psychosis simultaneously hold multiple and contradictory explanatory models of illness, which change over time and with the trajectory of the illness. It suggests that insight, like all explanatory models, is a narrative of the person’s reality and a coping strategy to handle with the varied impact of the illness. Conclusion: This article argues that the assessment of insight necessarily involves value entailments, commitments and consequences. It supports a need for a broad-based approach to assess awareness, attribution and action related to mental illness and to acknowledge the role of values and value judgment in the evaluation of insight in psychosis.

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