Die Geschichte der Zwangserkrankung: Ihre Stellung im Wandel der psychiatrischen Formenlehre bis Anfang des 20. Jahrhunderts

Abstract

Influenced by French psychiatry, the first German works on obsessive-compulsive phenomena were published in the second half of the 19th century. First they were seen as one form of the unitary psychosis, later they became involved in the dispute about the concept of paranoia. The first German definition, proposed by Carl Westphal in 1877 and of crucial importance in the conceptual history of obsessive disorders as an illness (OCD) ever since, stood in this tradition. Still the adequate nosological classification of obsessive phenomena was still heavily disputed. As more and more varied forms of obsessive disorders were described, the highly unspecific concept of neurasthenia gained importance. Then degeneration theory was a widespread aetiological concept to integrate the large number of obsessive phenomena. Towards the end of the 19th century, when psychoanalysis emerged, psychological aspects started to interest psychiatrists and psychoanalytical suggestions like Sigmund Freud's concept of obsessional neurosis were discussed. However, none of these different nosological suggestions, nor any of the proposed definitions, found general approval. Above all the question to what extent affects were involved and whether certain phenomena were compulsive in nature or not remained the subject of (ongoing) controversy. This led to a variety of highly inconsistent aetiopathogenetic concepts being proposed.