Mental diseases: a public health problemMay, James Vance
Science
Mental diseases: a public health problem
May, James Vance
Mental health services; Psychology, Pathological
A brief reference to some of the discrepancies shown in a consideration
of the various psychoses will serve to illustrate the need of more
accurate information on many of these subjects. In discussing the
predisposing causes of mental diseases, for instance, White[123] made
the following statement, which is perfectly correct: "An inherited
predisposition to mental disorder is found in from 30 to 90 per cent
of cases according to different authorities, while the average for all
conditions has been estimated at from 60 to 70 per cent." Information
on this subject is certainly far from being complete or satisfactory.
The Thirty-first annual report of the State Hospital Commission shows
that of 4,492 first admissions to the New York hospitals during the
year ending June 30, 1919, 2,003, or 44.6 per cent, were reported as
having a family history of insanity, nervous diseases, alcoholism or
other neuropathic taint. As far as could be determined 55.4 per cent
showed no evidence of heredity in their family history. The necessity
of further information on this important subject would appear to be
obvious. The question as to the relation between syphilis and general
paresis may be said to have been definitely settled for all time. The
origin of this disease has, however, been the subject of controversy
since 1857. Paton[124] in a review of this discussion in 1905 states
that Gudden found a history of syphilis in 35.7 per cent of his cases,
Hirsch, in fifty-six per cent, Jolly, in sixty-nine, Mendel, in
seventy-five, and Alzheimer, in ninety per cent. In the light of our
present knowledge this difference of opinion and experience is quite
interesting and illuminating.
The most extravagant and misleading statements made about etiological
factors, perhaps, are those which relate to the alcoholic psychoses.
This was due largely to the statements of enthusiastic propagandists
who were advocating prohibitory legislation. The facts of the matter
are that when the use of liquor was unrestricted, the admission rate of
alcoholic psychoses, as shown by the New York state hospital reports,
had averaged ten per cent for a number of years (1908 to 1913).
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