American Madness: The Rise and Fall of Dementia Praecox

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In 1895 there was not a single case of dementia praecox reported in the United States. By 1912 there were tens of thousands of people with this diagnosis locked up in asylums, hospitals, and jails. By 1927 it was fading away . How could such a terrible disease be discovered, affect so many lives, and then turn out to be something else?

In vivid detail, Richard Noll describes how the discovery of this mysterious disorder gave hope to the overworked asylum doctors that they could at last explain� �though they could not cure � the miserable patients surrounding them. The story of dementia praecox, and its eventual replacement by the new concept of schizophrenia, also reveals how asylum physicians fought for their own respectability. If what they were observing was a disease, then this biological reality was amenable to scientific research. In the early twentieth century, dementia praecox was psychiatry ��s key into an increasingly science-focused medical profession.

But for the moment, nothing could be done to help the sufferers. When the concept of schizophrenia offered a fresh understanding of this disorder, and hope for a cure, psychiatry abandoned the old disease for the new. In this dramatic story of a vanished diagnosis, Noll shows the co-dependency between a disease and the scientific status of the profession that treats it. The ghost of dementia praecox haunts today’s debates about the latest generation of psychiatric disorders.

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American Madness: The Rise and Fall of Dementia Praecox Review

"American Madness: The Rise and Fall of Dementia Praecox" by Richard Noll, Ph.D., is a meticulously researched and referenced book not only about the history of dementia praecox, but also about the history of psychiatry and psychiatric research in the U.S. in the early 1900s. Relying heavily upon primary source material, Dr. Noll presents a thoughtful analysis of the influence in the U.S. of the German neuropsychiatrist Emil Kraepelin and his European colleagues regarding the diagnosis and elusive causes of dementia praecox and other mental disorders; and the attempts to cure these disorders with mostly ineffective treatments of the time.

There are a number of "pearls" in this book that are difficult--or impossible--to find elsewhere: the contributions to the founding of the Phipps Psychiatric Clinic of Johns Hopkins Hospital by friends of Harry K. Thaw--found not-guilty-by-reason-of-insanity for the 1906 sensational slaying of New York architect Stanford White; the radical intestinal surgeries performed by Dr. Bayard Holmes of Chicago, which led to the death of his son and others, after years of painstaking research by him to eradicate focal infections believed to cause dementia praecox; the rise of psychoanalysis in America and its effect on classifications and causes of psychiatric disorders for years to come; and the relationship between dementia praecox and later, related concepts of schizophrenia.

In "American Madness" there is hard-to-find biographical information on a great number of "alienists," to use the term of the time, both well-known and obscure. Among the well-known, there are detailed biographies of Kraepelin, famous for refining and promoting the concept of dementia praecox; and of Adolf Meyer, the leading figure in American psychiatry in the first half of the 20th century, who devised a classification system that persists today and initiated modern patient-charting practices that allowed scientific research of mental disorders.

This book will be greatly appreciated and enjoyed by anyone interested in the history of mental illness and the roots of modern biological and psychosocial therapies. I would guess it will be the definitive book for years to come on the historical concepts of dementia praecox and related disorders in the U.S.

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