Mental diseases: a public health problemMay, James Vance
Science
Mental diseases: a public health problem
May, James Vance
Mental health services; Psychology, Pathological
Heredity varies with the psychoses, having its greatest influence in
the transmission of manic-depressive attacks, epileptic and hysterical
conditions, nervousness, compulsive and impulsive insanity, sexual
perversions and morbid personalities (Kraepelin). As the result of a
study of two thousand cases, Pilcz[69] (1907) found that in alcoholism
heredity was most likely to manifest itself in the form of alcoholism,
epilepsy and imbecility or manic-depressive psychoses. In the
progenitors of epileptics he found epilepsy and migraine. Apoplectics
showed a family history of paralysis, arteriosclerosis, senile dementia
or melancholia. Senile dementia preceded paralysis, arteriosclerosis,
feeblemindedness and dementia praecox. Tabes and paralysis apparently
frequently precede paralysis and dementia praecox. The various forms of
alcoholic psychoses furthermore show a tendency to repeat themselves
in the offspring of alcoholics. Similar heredity is said to be the
general rule in manic-depressive psychoses, epilepsy and alcoholism,
and to a less extent in arteriosclerosis. Heredity, in so far as it
is related to mental diseases, may be said to be largely a question
of the transmission of a neuropathic or psychopathic constitution or
predisposition. Various psychoses are now held to be the direct result
of constitutional causes or hereditary influences. This is probably
true of manic-depressive insanity, Huntington's chorea, involution
melancholia, dementia praecox, paranoia and paranoid conditions,
epileptic psychoses, the psychoneuroses and neuroses, psychopathic
personality and mental deficiency. It is true that some of these
conditions develop as the immediate results of certain predisposing
factors and that in frequent instances no evidences of heredity can
be found. It is also true that various authorities maintain that
a predisposition to the development of certain psychoses may be
acquired. If, however, we assume that the above mentioned psychoses are
constitutional in their nature and due primarily to heredity, it may
be definitely stated that, based on recent statistical studies,
hereditary influences account for from fifty-five to sixty per cent of
the mental cases admitted to our institutions. It may be pointed out,
as an objection to this suggestion, that although manic-depressive
psychoses often develop in an emotionally unstable or cyclothymic
personality and dementia praecox is associated with certain
peculiarities of makeup, not all of these cases show clear evidences
of constitutional origins. This is unquestionably true. It is equally
true, on the other hand, that heredity is also probably very often a
factor in the production of the senile and arteriosclerotic conditions,
various nervous diseases, alcoholism and drug habits.
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