The development of psychiatry in the German Democratic Republic (GDR) was initially marked by the establishment of large psychiatric hospitals and university psychiatry. While the large psychiatric hospitals influenced clinical care, the higher educational institutions defined the contours of theory and research. The consequence was that the two areas, theoretical thought and research and psychiatric practice, developed largely independently of one another. Nevertheless, they display certain common features and trends. In the university hospitals, a nosological orientation, taking its bearings from natural science, dominates, and is supported by clinical care. University hospitals usually have no territorial obligations with regard to admissions and generally admit groups of patients chosen according to clinical nosological criteria. Thus, the psychosocial dimension of the patient remains outside their purview, as is also the case with respect to remote large hospitals. This favors care centered on the illness and the institution and a desocializing and dehumanizing perspective in theory and practice. Various stages may be distinguished in the development of psychiatry in the GDR, although they are, of course, not totally discrete phases. Rather, different aspects of the complex subject that is psychiatry moved to the forefront and determined the general contours of psychiatry depending on the social situation, the development of the profession, and the possibilities and requirements of care. The profession's self-conception and assessments of the mentally ill and of psychiatry and the various ways society chooses to deal with the problem of mental illness are reflected in these developmental stages. The inner contradiction of psychiatry is thus revealed: i.e., its function in maintaining order and control, with a trend toward ostracizing and isolating, and, on the other hand, its therapeutic function, with its concern for social integration and acceptance of the patient. The various forms of psychiatric theory and practice, from increasing