Three Great Phases Of 20thcentury American Psychiatry

Following the decline of German medical influence in 1914, the progression of 20th-century psychiatry emerged largely on the Anglo-American scene, at least until the most recent psychopharmacological era when new agents were discovered, around the world, to have more remarkable and specific effects on the psyche than anything discovered since morphine and cocaine. This history can be conveniently broken down into three phases of about three decades each, with the Kraepelinian approach to diagnostics and pathophysiology providing a sustained background theme for all. His systematics matured when effective medicines were discovered to treat most major disorders—with the advent of powerful medications for the treatment of schizophrenia, depression, mania, and anxiety in the 1950s. It remains controversial how much each phase advanced the field relative to the ones that preceded it. Nonetheless, each period was distinctive, reflecting, perhaps, an evolving progression of scientific understanding fraught with essential growing pains. Future progress will arise from a weaving of these strands into a whole cloth that does not yet exist.

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