The Development of Psychiatric Nosology in Minnesota State Hospitals 1885-1910
Current categories used to identify and treat mental disorders have developed out of the diagnostic classificatory systems (called nosologies) that arose in the state hospitals and asylums of the late 19th and early 20th centuries. While contemporary scientific work acts to refine and provide a physiological basis for some of these categories, a vast part of the current system remains a direct product of the developments that took place during this historical period. However, these developments have not been carefully explored.
This project examined documents from Minnesota's state hospitals during this time period. The general purpose was to investigate the types of categories for diagnosing and treating mental health at work in Minnesota's state hospitals. There were at that time, as there are today, competing theories regarding the causes and processes of mental disorders.
The research addressed which, if any, underlying theory of mental disorders these diagnostic categories suggest, with intent to provide a better understanding of the historical development of current psychiatric nosology from the perspective of Minnesota’s state hospitals and to compare Minnesota’s history with that of other areas. Questions are continually raised concerning the validity of diagnostic concepts as well as the degree to which such concepts reflect nothing more than the values of the current society. Accordingly, care was taken to note any social, moral, or religious norms that may be influencing all such developments.
The larger project, of which this was a part, addressed the question of how psychiatric concepts are formed and change over time, whether any of these changes reflect a move toward a more objective, less-value-laden nosology, and how concepts reflect particular metaphysical frameworks.
The research results were to be described in two papers, one submitted for presentation at the American Psychiatric Association meeting in May, 2002, and another sent to the journal, Philosophy of Science; and presentations of the research made to both the Minnesota Bioethics Center and the Minnesota Independent Scholars Forum. Some months later, the author publiched a chapter on “the larger project” (above): “Values and Objectivity in Psychiatric Nosology” (2002). In Sadler, John Z. (Ed.), Descriptions and Prescriptions: Values, Mental Disorders, and the DSMs. Baltimore, MD: John Hopkins UP.