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Trends in the development of intra mural psychiatry from 1867 to 1931


, : Trends in the development of intra mural psychiatry from 1867 to 1931. Archiv fuer Psychiatrie und Nervenkrankheiten 223(4): 271-286

A total of 4000 case histories from the State Mental Hospital, Goettingen were evaluated. Age at admission, family status, duration of illness before admission, duration of hospitalization, results on discharge and diagnosis and social class were studied. The 60 yr period showed a consistent development toward shorter duration of hospitalization, more frequent readmission, better results on discharge, decreased death rate (particularly in the middle-aged) and a reduced length of illness before admission (only the 1867-1871 group showed different results in various points). An increase of patients in the following diagnostic categories was found: psychopathy/neuroses, alcoholism and diseases of the aged. The last was related to a higher average age and to the shifting of fatality toward the elderly, acute admissions. Mortality and duration of illness before admission were unrelated to social class; patients from the lowest social class were more frequently transferred and discharged less frequently and later. A similar unfavorable situation was found in unmarried compared with married patients. These findings, showing an improved therapeutic efficiency in intramural psychiatry, occurred at a time when adequate medical treatment, with the exception of some social psychiatric activity, was practically lacking. Possible factors for this development, in particular a lowering of the barrier between the population and mental hospitals, were discussed.


Accession: 006839510

PMID: 332112

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