- French Chronic Delusional States
- (from 1909)In France, there had been a long tradition of regarding delusions as the essence of psychosis, as witnessed in the work of Valentin Magnan. Yet around the time of the First World War, Magnan’s distinction between degenerative and nondegenerative illnesses started to be played down. This compelled a whole reworking of the delusional diagnoses. As well, French psychiatrists were at pains to distance themselves from such German concepts as schizophrenia, which emphasized flattening of affect and other kinds of affective pathology. Delusional states became therefore catalogued on the basis of presumed mechanism (whether hallucinations or delusions were paramount). Pierre Pichot provides a useful explanation of these French diagnostic divergences in an article in Psychological Medicine (1982).Chronic nonhallucinatory delusional states: delusional thinking (Le délire d’interprétation) (1909). Paris psychiatrists Sérieux and Capgras in their book Intelligent Insanity: Delusional Thinking (Les folies raisonnantes: le délire d’interprétation), hived these off from the larger block of delusions on the grounds that the absence of hallucinations and the failure to progress to dementia were important diagnostic features. (For details, see PARANOIA.)Chronic imaginative psychosis (1910). This second member in the triad of French nondeteriorating delusional disorders, a classification that has survived to the present, was published by Ferdinand-Pierre-Louis-Ernest Dupré (1862–1921), then a staff psychiatrist at the Hôtel-Dieu hospital in Paris, and his student Benjamin Logre, in L’Encéphale under the title "Les délires d’imagination," meaning roughly elaborate confabulations. At a congress in 1910, they suggested "imagination," in the sense of fabrication, as a mechanism alongside hallucinations and interpretative delusions: "The imaginative patient is just as indifferent [as the delusional patient] to sensory impressions and logical demonstrations. . . . Creating fully formed his associations of ideas, the patient transposes upon the exterior world his subjective creations, giving them the character of objectivity. . . . The point of departure of his error is not the notion of an external fact, true or false . . . but a fiction of endogenous origin, a subjective creation. The delusional patient proceeds like a scholar, the imaginative patient like a poet" (L’Encéphale, 1911, p. 211). Many years later, and in apparent ignorance of Dupré’s work, the American Psychiatric Association considered making "pathological lying" an official diagnosis.Chronic hallucinatory psychosis (la psychose hallucinatoire chronique) (1911). Psychiatrist Gilbert-Louis-Siméon Ballet (1853–1916), who ran the service for "diffi-cult psychopaths" at the Hôtel-Dieu hospital in Paris, proposed in 1911 in the journal L’Encéphale chronic hallucinatory psychosis combined with delusions as a distinct disease entity caused by heredity. The term was already familiar but, Ballet said, when properly circumscribed (as a singular noun) it represented a nosologically distinct disease. As with the Sérieux and Capgras formulation, Ballet’s disease did not run downhill either, and other mental functions remained intact. The diagnosis was much debated in France, little adopted abroad, yet remains today a familiar construct.Mental automatism and the passional psychoses (les psychoses passionnelles) of Gatian de Clérambault (1920). In 1920, Gaétan-Henri Gatian de Clérambault (1872–1934), often referred to as Clérambault rather than by his full last name, long-standing psychiatrist of the psychiatric emergency ward for the city of Paris (L’Infirmerie spéciale of the Prefecture of Police), published two important articles on delusional psychosis: the first, appearing in April in the Bulletin of the Psychiatric Society (Bulletin de la Socíeté Clinique de Médecine Mentale), proposed a possible mechanism for all of the delusional psychoses. Clérambault called it mental automatism and believed it similar to the underlying mechanism driving neurosyphilis, a profoundly organic cause of psychosis that literally took over the brain, producing "automatically" delusions and hallucinations.A second article by Clérambault in December 1920 in the same journal introduced a new class of delusional disorders alongside the above-mentioned triad. Clérambault called them "the passional psychoses," meaning those with deep emotional conviction at their core; the psychosis springs fully formed into life, he said. Clérambault included among them erotomania, often called thereafter "Clérambault’s syndrome," often confused with mental automatism as another "Clérambault’s syndrome." (See Erotomania.) Clérambault believed the whole range of these chronic systematized, or well-defined, psychoses to be driven by mental automatism. Both concepts—mental automatism and the passional psychoses—had a large impact on French psychiatry, although Clérambault’s doctrine of mental automatism has not survived, and the passional psychoses are no longer seen as independent entities.
Edward Shorter. 2014.
Look at other dictionaries:
Delusion, Delusional Disorder — See French Chronic Delusional States (from 1909); Paranoia; Paraphrenia; Psychosis: Emergence; Schizophrenia: Emergence … Historical dictionary of Psychiatry
Paranoia — (See also Erotomania; Folie à Deux; French Chronic Delusional States; Psychosis: Emergence.) Paranoia means a fixed false belief formed via logical reasoning (making it distinct from schizophrenia); aside from his delusional system, the… … Historical dictionary of Psychiatry
Moral insanity — (insanity without hallucinations or delusions). See Prichard, James Cowles (1835). Distinction between momentary symptom picture and underlying disease process in psychiatry (1844). To some extent, physicians have always been aware that the … Historical dictionary of Psychiatry
Erotomania — Erotomania is the delusional belief that one’s love for someone else is reciprocated. In the non French world today, it is considered to be part of paranoia or schizophrenia, but in France, Clérambault’s syndrome retains the status of an… … Historical dictionary of Psychiatry
Ste.-Anne Mental Hospital — (1867), Paris. Given that at mid nineteenth century, the Seine department (Paris) disposed of only two mental hospitals, Bicêtre and the Salpêtrière, in 1860 Baron Georges Haussmann (1809–1891), the prefect of the Seine, ordered a… … Historical dictionary of Psychiatry
Psychosis: Emergence of Concepts — (See also Folie à Deux; French Chronic Delusional States [from 1909]; Paranoia; Paraphrenia; Positive vs. Negative Symptoms; Schizophrenia: Emergence; Unitary Psychosis.) In medicine, psychosis can mean (1) loss of contact with reality, in… … Historical dictionary of Psychiatry
Clérambault’s Syndrome — See Erotomania; French Chronic Delusional States: mental automatism (1920) … Historical dictionary of Psychiatry
Gatian de Clérambault, Gaetan-Henri — See Erotomania; French Chronic Delusional States: mental automatism (1920) … Historical dictionary of Psychiatry
Hallucination — See French Chronic Delusional States; Psychosis: Emergence; Schizophrenia: Emergence; Schizophrenia: Recent Concepts … Historical dictionary of Psychiatry
Lacan, Jacques-Marie-Emile — (1901–1981) The founder of an independent school of thought within psychoanalysis, Lacan was born in Paris into an upper middle class family. As an intern at the psychiatric hospitals of the Seine department (Paris), in 1928 he spent a year … Historical dictionary of Psychiatry