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Schizophrenia—A Hundred Years Ago and Today

The Bethlem Royal Hospital and The Maudsley Hospital

ABSTRACT

In order to answer the question "Have there been changes in the clinical picture of schizophrenic illness over the past hundred years ?" a selected group of schizophrenics of both sexes from the I850s and l950s is compared. Methods of proper selection of comparable material from past and present are described. Data are presented in two tables.

Comparing the two groups revealed:

1. The average age was essentially the same in the nineteenth and twentieth century groups.
   
2. The proportions of married and single patients was almost the same in both groups.
   
3. Both groups were comparable with respect to religion. Differences were related to factors unconnected with schizophrenic illness.
   
4. Remarkably similar familial incidence of mental illness in the nineteenth and twentieth century groups was found.
   
5. Six times as many male and nine times as many female schizophrenics were acutely disturbed in the nineteenth, as compared with the twentieth century group. This discrepancy was discussed. It was thought probable that psychomotor agitation was more prevalent in the nineteenth century schizophrenics.
   
6. Length of hospitalization was twice as great in the nineteenth as in the twentieth century schizophrenic group. Reasons for this were discussed.
   
7. The cured percentages of the nineteenth century male and female schizophrenic groups were exactly the same. What "cured" meant in the mid nineteenth century was discussed. Three times as many patients of both sexes had religious preoccupations in the nineteenth century as compared with the twentieth century group. This was the most striking finding of the study, and its importance for contemporary phenomenological research in schizophrenia was emphasized.
   
8. Summarizing the position of religion in mid-nineteenth century England, it was shown that religious preoccupations were largely culturally determined. It was suggested that the contemporary sexual preoccupation of schizophrenics might also be culturally determined. Delving deeply into the meaning of symptoms that might be culturally determined was not thought helpful in searching for the cause of schizophrenic illness.
   
9. Approximately twice as many patients of both sexes had sexual pre occupations in the twentieth century group as compared with the nineteenth century group. Reasons for this difference were discussed.
   
10. Approximately three times as many patients of both sexes had both sexual and religious preoccupations in the nineteenth century as in the twentieth century group.
    
11. Data was presented on the postulated causation and on thetreatment of schizophrenic illness during the mid-nineteenth century.