Diagnoses of personality disorders between 1879 and 1929 in the largest croatian psychiatric hospital

Scientific paper - Original scientific paper

• Author: Zvonimir Paštar
• Author: Božo Petrov
• Author: Aida Križaj
• Author: Ante Bagarić
• Author: Vlado Jukić
• Author's institution: University of Zagreb; School of Medicine
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences

Abstract (english)

AIM: To study demographic characteristics, comorbidities, and diagnoses of patients admitted for personality disorders to Psychiatric Hospital Vrapče between 1879 and 1929. ----- METHODS: Data were collected from the archives of Vrapče Psychiatric Hospital for a 50-year period from November 1879 to December 1929. The ratio between the number of patients with personality disorder and the number of all admitted patients was determined. We used 3 systems of definitions of personality disorder: for cases before 1923, we used Prichard’s concept of moral insanity and unpublished definitions of one of the hospital managers at that time; for cases after 1923, we used Schneider’s classification of psychopathic personalities and unpublished definitions of one of the hospital managers at that time. ----- RESULTS: The total number of admissions during the study period was 18 960, 141 (0.74%) of which were for a personality disorder. Of the admitted patients, 85.8% were men and 59.7% were single. The average age was 29.7 } 9.5 years. Most of them (61.7%) were sent to the hospital by courts or police, and the median length of stay was 92 days (interquartile range, 92.0 - 127.5 days). The first patient with a personality disorder was admitted in 1889 with a diagnosis of moral insanity. Until 1920, only 3 terms were used for personality disorder: moral insanity, psychopathic inferiority, and psychopathy. The term was subdivided only after that year. Of the 141 patients admitted for personality disorder, 34 (24.1%) were discharged with comorbid disorders, mainly substance abuse. The most common single comorbid diagnosis was Ganser syndrome (prison psychosis). ----- CONCLUSION: Archives of the Vrapče Psychiatric Hospital contain reliable data about the earliest nomenclature of personality disorders, the increase in the prevalence of personality disorders, and further subdivision of the term personality disorder. Nomenclature for these disorders used at the Vrapče Psychiatric Hospital was consistent with that used in clinical practice in other parts of the world at the time.

Abstract (croatian)

Dijagnoze poremećaja ličnosti između 1879. i 1929. u najvećoj hrvatskoj psihijatrijskoj bolnici ----- Cilj Odrediti demografska obilježja, komorbidne poremećaje, i dijagnoze bolesnika primljenih u psihijatrijsku bolnicu Vrapče zbog poremećaja ličnosti između 1879. i 1929. ----- Postupci Podatke smo prikupili iz arhiva Psihijatrijske bolnice Vrapče za razdoblje od 50 godina, od studenog 1879. do prosinca 1929. Odredili smo omjer između broja bolesnika s poremećajem ličnosti i broja svih primljenih bolesnika. Za definiciju poremećaja ličnosti rabili smo 3 sustava definicija: za slučajeve prije 1923., rabili smo Prichardov koncept moralnog ludila (engl., moral insanity) i neobjavljene definicije jednog od bolničkih ravnatelja iz toga vremena; za slučajeve nakon 1923., rabili smo Schneiderovu klasifikaciju psihopatskih osobnosti i neobjavljene definicije jednog od bolničkih ravnatelja iz tog vremena. ----- Rezultati Ukupan broj primljenih bolesnika za vrijeme istraživanog razdoblja bio je 18,960, od kojih je 141 (0,74%) primljeno zbog poremećaja ličnosti. Od primljenih bolesnika, 85,8% su bili muškarci i 59,7% su bili samci. Prosječna dob bila je 70±9,52 godina. Većinu bolesnika (61,7%) su u bolnicu poslali sudovi ili policija, a medijan duljine boravka bio je 92 dana (interkvartilni raspon, 92,00±127,50 dana). Prvi bolesnik s poremećajem ličnosti primljen je 1889., s dijagnozom moralnog ludila. Do 1920, samo 3 naziva su korištena za poremećaj ličnosti: moralno ludilo, psihopatska inferiornost i psihopatija. Tek poslije je došlo do daljnje podjele naziva. Od 141 bolesnika koji su primljeni zbog poremećaja ličnosti, 34 (24,1%) su puštena iz bolnice s komorbidnim poremećajima, uglavnom zloporabom opojnih sredstava. Najčešća komorbidna dijagnoza bio je Ganserov sindrom (zatvorska psihoza). ----- Zaključak Arhivi psihijatrijske bolnice Vrapče sadrže pouzdane podatke o najranijoj nomenklaturi poremećaja ličnosti, povećanju prevalencije poremećaja ličnosti, i daljoj podjeli naziva za poremećaj ličnosti. Nomenklatura tih poremećaja u bolnici Vrapče bila je u skladu s kliničkom praksom u drugim bolnicama u svijetu.

• Keywords (english): Adult; Croatia / epidemiology; Cross-Sectional Studies; Female; History, 19th Century; History, 20th Century; Hospitals, Psychiatric; Humans; Male; Patient Admission / trends; Personality Disorders / diagnosis; Personality Disorders / epidemiology; Personality Disorders / history; Retrospective Studies; Young Adult
• Language: english
• Publication type: Scientific paper - Original scientific paper
• Publication status: Published
• Peer review: Peer review
• Publication version: Published version
• Journal title: Croatian Medical Journal
• Numbering: vol. 51, no. 5, pp. 461-7
• p-ISSN: 0353-9504
• DOI: https://doi.org/10.3325/cmj.2010.51.461
• URN:NBN: urn:nbn:hr:105:965224
• Publication: 2010-10-15
• Document URL: http://www.cmj.hr/2010/51/5/20960596.htm
• Type of resource: Text
• Access conditions: Open access
• Created on: 2024-03-28 11:56:57