Psy News

November 17, 2010

A History of Mental Illness: Part 1 - The Gods Were At Work

Filed under: Psychology Articles — admin @ 4:47 pm

We’ve all heard the famous line “Those whom the Gods destroy, they first make mad”. The author of this line is often debated. Some maintain it was written by Euripides, a Greek playwright who wrote famous tragedies (plays that explore human suffering).The version used here and often quoted, appears in Daniel Anderson Scott’s ‘Daniel: A Model for Young Men‘ on page 248.Whatever its origin, throughout the centuries man has believed that mental illness was the result of the work of Gods and demons in some form or another. Porter (2002, p. 10) states that in early religious texts, madness was often a curse or punishment. For example, in Deuteronomy (6:5) there is the line ”The Lord will smite thee with madness”. As well as this, Porter (2002, p. 10) goes further stating throughout the Old Testament are various accounts of possession by devils. Burton (1621) states that when the French stole an image of St. John, they became frantic. Additionally, Burton (1621) states that when Lord Radnor came home late from hunting, he placed his dogs inside the church, only to find in the morning they had turned mad, and he suddenly became blind. Outside of Western culture,  Grahi, a Hindu demon was said to cause convulsions. Additionally, Retief and Cilliers (1997) state that the Mesopotamians also believed mental illness was cast down from gods as punishment for sins, and that treatment focused upon their appeasement. However, Stone (1937) argues that some individuals of the day actually had a reasonably good understanding of mental illnesses. For example, Stone argues that Aretaeus of Cappadocia (200 A.D.) was the first to ”identify the manic-depressive psychosis in its various phases”. Additionally, Galen (129 – 199/217 A.D.) (cited in Burton, 1621) stated “It is vain to speak of cures, or think of remedies, until such time as we have considered of the causes” - a notion that we use today.Given the religious oppression that filled the vacuum of power in Europe and Britain following the collapse of the Roman Empire, one can be fooled into thinking that such notions of superstitious thought continued unchecked. Indeed, it is true that throughout the dark ages and middle ages there was much superstitious thought at dominated almost every aspect of life, from the changing of seasons to rituals. Superstitious thought also lead to many conflicts. For example in Tudor Britain there raged the Catholic/Protestant too-and-fro-ing of dominance following the death of Henry VIII. However, Stone (1937) argues that the some works of the Greeks which had been preserved still informed how individuals at the time sought to understand mental illness. Specifically, Stone (1937) maintains that  Galen’s work on insanity formed the basis of psychiatric thought throughout the middle ages. However, it was mainly only monks who were medical practitioners, and the work of the classical philosophers and physicians was distorted with medieval influences of demonic possession, superstition and church theology. For example, writing in Burton (1621) writes:”Ruland gives an instance of one David Helde, a young man, who by eating cakes which a witch gave him, began to dote on a sudden, and was instantly mad”and”FHD Hildesheim, consulted about a melancholy man, thought the disease was partly magical, and partly natural because he vomited pieces of iron and lead, and spake such languages as he had never been taught”It would not be until the 16th Century, in which more time was spent on recording and gathering data and that psychiatric knowledge would begin to flourish. Scholars of the past were aware of mental illness, although at times they were wrong about the causes. However, reading the texts of the past especially Burton’s ‘Anatomy of Melancholy’ provides the reader with a rich source of understanding of previous approaches to an illness that afflicts so many individuals. Perhaps by looking back, students of psychology can gain a better appreciation for the technological and theoretical advances of today. What would the Greek Scholars make of the medication we use, or the DSM-IV-TR? Although there is fierce debate regarding some aspects of diagnosing and treating mental illnesses, we all owe a debt of gratitude to those in the past who worked to uncover the truth of mental illness and end centuries of superstitious thought.In Part 2 I will discuss important individuals throughout history who suffered from mental illnesses. Any names are welcome.References:Porter, R. (2002). Gods and demons Madness: A Brief History, 10-33 Other: 0-19-280267-4Retief FP, & Cilliers L (2007). Mesopotamian medicine. South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde, 97 (1), 27-30 PMID: 17378276Stone, S. (1937). Psychiatry through the ages. The Journal of Abnormal and Social Psychology, 32 (2), 131-160 DOI: 10.1037/h0058883 …

Porter, R. (2002) Gods and demons. Madness: A Brief History, 10-33. info:other/0-19-280267-4

Retief FP, & Cilliers L. (2007) Mesopotamian medicine. South African medical journal , 97(1), 27-30. PMID: 17378276   Mesopotamian medicine.

Stone, S. (1937) Psychiatry through the ages. The Journal of Abnormal and Social Psychology, 32(2), 131-160. DOI: 10.1037/h0058883  Psychiatry through the ages.

Effects of anxiety on memory in young children

Effects of anxiety on memory storage and updating in young children From International Journal of Behavioral Development This paper presents the findings of studies that tested the visual and verbal short term memory of young children. The test on visual memory did not reveal anxiety levels had any significant influence, however the results for verbal [...]...




Visu-Petra, L., Cheie, L., Benga, O., & Packiam Alloway, T. (2010) Effects of anxiety on memory storage and updating in young children. International Journal of Behavioral Development. DOI: 10.1177/0165025410368945  Effects of anxiety on memory storage and updating in young children



Gratitude among married couples

When did you lastly thank your spouse? Gratitude is an excellent booster for your relationship, it improves the other well being both psychologically as well as physically. It gives him or her more satisfaction, and activates pro-social behavior. So go and do it.

An individual who expresses gratitude is not only providing a positive expression to [...]

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Gordon, C., Arnette, R., & Smith, R. (2010) Have you thanked your spouse today?: Felt and expressed gratitude among married couples. Personality and Individual Differences. DOI: 10.1016/j.paid.2010.10.012  Have you thanked your spouse today?: Felt and expressed gratitude among married couples



A Brush with Madness

I'm giving myself ten minutes to do this. To write whatever storms into my mind then hit post.

I think the archaic revival might run into some barriers. Like starvation, no communication, and other electrical difficulties if it embraces the Abbey-esque Luddite philosophy entirely.

As much as I want to get onto that other boat I think I will just slip between the hulls and end up swimming by myself among the sea-monsters, bullets whizzing past my head with bubbles trailing behind in dark water.

What will this same attempt look like when I'm able to just think the text into existence without the trouble of commanding my fingers. We're almost there.

Have I done this before?

What were some of the ideas I was having earlier today? I was going to write a post entitled "a brush with madness" and I even logged into research blogging several times with the intention of creating an HTML tag for the citations I found via pubmed search about psychotic manifestations in patients with the blood related disease - porphyria.

You see, I had a most jarring experience a few days before Halloween this year. It's ironic I went to the "Rally to Restore Sanity" the weekend after this experience.  I speak of a secondary encounter with real madness at a free public lecture fellow graduate student Nick Clark and I presented at the Park Hill library in Denver on October 26th, 2010. Our talk took place downstairs in the community room at the library. It felt like the community room at Saint Peter and Paul Church in Jamestown New York; the one where my parents met in choir - threadbare carpet and the dank smell of stale coffee. It was in the basement and it felt like a basement. We were presenting our lecture "The Biochemistry of Halloween" as a fun science-out-reach type event. After a successful presentation last year we were asked for an encore lecture by the CSU alumni association. Nick and I showed up about an hour and a half early to make sure we had a functional projector and helped set up seats. When we finished setting up a young woman with curly black hair entered the otherwise empty room and excitedly asked us

"Are you the guys talking about VAMPIRES?"

"Indeed we are, but the talk does not start for another 45 minutes." I replied

"Oh that's OK I'll just wait here." She said and sat giddily waiting it the front row.

We had decent turn out for an event in the basement of a public library held at 5:30 on a weekday. About 35 people showed up to hear about the "Biochemistry of Halloween" and there was really positive audience participation and several intelligent questions. All ages were represented.

(We recorded some of it here)

At the end of the lecture the excited patron was the first to run up to Nick and I . She quickly asked for all our references linking dementia and porphyria. We took her e-mail address and said no problem. The woman then went on to explain that she was particularly interested in the topic as her ex-boyfriend was afflicted with porhyria. She knew the specific form - coproporphyria. Nick and I both immediately felt bad and responded by saying that we did not want to offend anyone by implying that patients with porphyria were actually vampires. Her reaction to this was most shocking. She said she was fascinated by the idea that historical cases of porphyria might explain the origin of vampire myths because her ex-boyfriend was in fact presently in jail because he went "nuts" and tried to cut her head off with a knife!

Well, that just hit me like a ton of bricks! Here we are trying to be super politically correct by not offending anyone connected with any of these diseases we were talking about and here was a real world case where a patient with porphyria was acting deranged. This rose a significant ethical dilemma in my mind. Current treatment of porphyria is diet control and injections of properly formed heme - analogous to diabetes patients receiving insulin as treatment - replacing the body's missing thing. But in the case of porphyria it is not just replacement of the problem chemical that needs to be addressed. The mal-formed chemicals stay in the blood stream and cause problems in the brain of the patient; hallucinations, dementia, and severe anxiety to name a few. To entirely alleviate the affects of the disease those "bad" molecules need to be removed as well. This is probably not an option as it would require the patient to be on constant dialysis.

The question then arises. If a patient experiences mental disturbances including psychopathic behavior because of a disease is that patient responsible for his/her actions? Can a patient plead insanity in this instance? What extent should the public help this individual manage their psychological problems to protect its members? I had heard of this type of scenario in ethical thought experiments before but this was the first time a case like this was staring me in the face. She said that she thought her ex was crazy and hoped he rotted in prison. But how much of his bad behavior was of his own free will and how much was due to biochemistry? Could his attempted murder have been prevented if medicine was able to safely remove the detrimental chemicals from his blood? This is much different that a badly behaving drug addict - in that case an individual is choosing to put the delusion -inducing chemicals in their blood while in the case of porphyria the patient has no choice. What if the patient was simultaneously abusing drugs?  To what degree is that self-medication attributed to the disease? Are patients in this situation doomed to the fate of this guy? How does society deal with this situation?

In looking for answers to some of the clinical aspects of these questions I stumbled on a surprising medical speculation.  Some scholars have attributed the bouts of madness experienced by the great impressionist painter Vincent Van Gogh to acute intermittent porphyria! 

His self mutilation, delirium, agitation, paranoia and sporatic timing of his attacks may all be explained by him having this disease. Exacerbated by poor diet and subsnace abuse - especially absinthe - may have pushed him over the edge.  Though he had produced some of the world's most stimulating paintings on July 29th, 1890 in a northwestern suburb of Paris Vincent took his own life by shooting himself in the chest. 

This medical scenario begs the question.  If Van Gogh were to be born today with the advent of contemporary medicine and diagnosis would his paintings scream with such beauty?...




Sedel F, Baumann N, Turpin JC, Lyon-Caen O, Saudubray JM, & Cohen D. (2007) Psychiatric manifestations revealing inborn errors of metabolism in adolescents and adults. Journal of inherited metabolic disease, 30(5), 631-41. PMID: 17694356   Psychiatric manifestations revealing inborn errors of metabolism in adolescents and adults.




Rose FC. (2006) Van Gogh's madness. International review of neurobiology, 253-69. PMID: 16730519   Van Gogh's madness.




Altintoprak AE, Ersel M, & Bayrakci A. (2009) An unusual suicide attempt: a case with psychosis during an acute porphyric attack. European journal of emergency medicine : official journal of the European Society for Emergency Medicine, 16(2), 106-8. PMID: 19262206   An unusual suicide attempt: a case with psychosis during an acute porphyric attack.




Mandoki MW, & Sumner GS. (1994) Psychiatric manifestations of hereditary coproporphyria in a child. The Journal of nervous and mental disease, 182(2), 117-8. PMID: 8308532   Psychiatric manifestations of hereditary coproporphyria in a child.



The Ancient Egyptian mummy as a drug

I’ve just found an amazing 1927 article from the Proceedings of the Royal Society of Medicine about the long history of using Egyptian mummies as drugs. The fact that powdered embalmed corpse from Ancient Egypt has never been shown to have any curative or mind altering properties hasn’t prevented an enthusiasm for the substance which [...]

Brain MRI White Matter Intensities: Clinical Significance

T2 White Matter Hyperintensity (Mild left, Extensive right)Novel imaging findings emerge with the advancement of imaging techniques.  Commonly, the meaning of new imaging findings is unknown until further clinical research provides answers.  This situation describes the finding of white matter intensities on brain magnetic resonance imaging.  White matter intensities are relatively common in the aging brain as well as with a variety of clinical disorders.  Two manuscripts provide new insight into the clinical significance of this MRI finding.Debette and Markus performed a metanalysis of the existing literature through November 2009 in a BMJ article published in early 2010.  Their study examined 46 longitudinal studies.  Often, when first discovered, white matter intensities occur in the context of relatively normal brain function.  But these lesions are not normal as they indicate an increased risk for the following outcomes (estimated as relative risk increases)Increased risk of stroke 3.5 (350% increase)Increased risk of dementia 1.9 (90% increase)Increased risk of death 2.0 (100% increase)The Debette and Markus review noted that there was some support for white matter hyperintensities to be linked to neuropsychological deficits like global cognitive decline, impaired executive function and decreased processing speed.The neuropsychological effects of white matter intensities is the subject of a manuscript by Murry and colleagues from the Mayo Clinic.  This study examined a total of 148 elderly (73-91 years of age) subjects with white matter intensities on MRI but without current dementia.  The subjects underwent a battery of neuropsychological tests.  Additionally, the specific brain region for the white matter hyperintensities was examined in relationship to cognitive performance.  The primary findings from this study were:Lower executive function was found with these lesions for all areas except for occipital white matter hyperintensities (executive function including planning and complex decision making skills)White matter hyperintensities (particularly parietal lobe) were correlated with Parkinson's disease scores for impaired gait, posture and postural stability)Higher white matter intensities in all regions except the occipital regions as well as subcortical and periventricular regions correlated with slowed visuomotor performance (Trail Making Test Part B) and reduce gait (walking) speedSo this study adds two important elements to understanding white matter intensities.  First location makes a difference and second, white matter intensities should not be just noted to be present or absent but an estimation of the burden (volume) of the lesions is informative.  This study also helps to quantitate the effect of white matter intensities on risk for Parkinsonian symptoms. Murray and colleagues conclude: "The selective nature of the functional deficits associated withWMHsuggests thatthe primary effect of WMH is to reduce the efficiency of neuronal signaling. This conclusion is strengthened by the fact that vastly different functional domains—cognition and gait—were affected, with the common theme being processing speed.White matter MRI images from the BMJ 2010:341:c3666 an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license.Debette, S., & Markus, H. (2010). The clinical importance of white matter hyperintensities on brain magnetic resonance imaging: systematic review and meta-analysis BMJ, 341 (jul26 1) DOI: 10.1136/bmj.c3666Murray, M., Senjem, M., Petersen, R., Hollman, J., Preboske, G., Weigand, S., Knopman, D., Ferman, T., Dickson, D., & Jack, C. (2010). Functional Impact of White Matter Hyperintensities in Cognitively Normal Elderly Subjects Archives of Neurology, 67 (11), 1379-1385 DOI: 10.1001/archneurol.2010.280...




Murray, M., Senjem, M., Petersen, R., Hollman, J., Preboske, G., Weigand, S., Knopman, D., Ferman, T., Dickson, D., & Jack, C. (2010) Functional Impact of White Matter Hyperintensities in Cognitively Normal Elderly Subjects. Archives of Neurology, 67(11), 1379-1385. DOI: 10.1001/archneurol.2010.280  Functional Impact of White Matter Hyperintensities in Cognitively Normal Elderly Subjects



September 22, 2010

Rare footage of physical treatments in psychiatry, 1957

I’ve just found a remarkable documentary on YouTube from a 1957 BBC series called ‘The Hurt Mind’. The programme attempts to de-stigmatise mental health for the public but also documents some of the most controversial treatments in the history of psychiatry. The programme was an edition of a then pioneering five-part BBC series on mental [...]

12 Vote(s)

Featured - I don't want to sound like a blogger, but…

Filed under: Psychology Articles — Tags: , , , , — admin @ 9:00 am
Since I accepted an invitation to write for LabSpaces I've been wondering how best to make my debut. For those not familiar with my blog (and I take that to be the exceeding majority) I approach a topic that arises in my everyday life, and find an explanation for it from the Psychological literature. To be completely honest, it's really a self-serving exercise - I'm usually trying to find ; (read

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Sci vs Spy

The Cold War espionage styles of the US and Soviet spy agencies are compared in a fantastic article for the history of science journal Isis that notes that while the Americans tended to invest in technology, the Russians were more focused on ‘human intelligence’. The article, by historian Kristie Macrakis, explores the technophilia of the [...]

8 Vote(s)

Sleep problems in chronic pain & what helps

Filed under: Psychology Articles — Tags: , , , , — admin @ 1:00 am
I have written about sleep problems in people with chronic pain several times. It is one of those aspects of dealing with pain that inevitably arise as I talk with people about energy, their activity through the day, and their mood. Many people blame the pain for their sleep problems, which is unsurprising really – … Read more... Tang, N. (2009) Cognitive-behavioral

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