Master of Arts (MA)
The growth of mental hospital populations during the 19th and 20th centuries along with the corresponding increase in the number of mental institutions is well documented. The cause of the growth is the subject of considerable debate. One hypothesis is that the growth in hospital population was due, in part, to an increase in the prevalence or incidence of schizophrenia. Another is that diagnostic criteria for schizophrenia changed with time in such a manner that increasing numbers of patients were given this diagnosis. The present study sought to address these issues in two ways: 1) by comparing the number and type of symptoms recorded in the files of patients who had a first diagnosis of schizophrenia in either 1930 or 1960; and 2) by retrospective diagnosis of these patients based on recorded symptoms using the DSM-IV-TR and ICD-10 diagnostic criteria. Subjects were two groups of 50 patients (N=100) randomly selected from a large state hospital in Louisiana. The results showed that recorded symptoms of patients diagnosed with schizophrenia changed dramatically between 1930 and 1960. In addition, patients from the 1930 cohort were significantly more likely to receive a retrospective diagnosis of schizophrenia than those from the 1960 cohort. Limitations of the study are discussed: 1) recorded symptoms are not necessarily veridical to actual symptoms; 2) the results may not be generalizable to other hospitals. The central finding of this study is that despite clear evidence of a change in the way schizophrenia was conceived – from a narrow Kraepelinian perspective to a broader psychoanalytic perspective – the percent of the hospital population diagnosed with schizophrenia did not change. This undermines the hypothesis that apparent changes in prevalence and incidence are due to a psychoanalytic redefinition of the boundaries of schizophrenia.
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Henderson, Kristopher Michael Lee, "A Comparison of Psychotic Symptoms Recorded in Patient Files of Persons with a First Diagnosis of Schizophrenia in 1930 and 1960 Cohorts Drawn from a Large State Hospital" (2015). LSU Master's Theses. 1062.