A Retrospective Analysis of Early 20^th Century Asylum Records of Patients with Dementia Praecox

Abstract

Mental illness definitions and classifications are to a certain extent intrinsically tied to social factors. To empirically examine the impact of sociodemographic factors on patients institutionalized with dementia praecox in the early 20^th century, we examined records from Dorothea Dix Hospital (DDH), an asylum in Southeastern United States. Data was extracted from digitally archived handwritten admission ledgers and general casebooks. Of those institutionalized at DDH between 1896-1917, 190 patients were diagnosed with dementia praecox. Clinical characteristics of patients are described using descriptive text analysis. We used regression models to examine the influence of sociodemographic factors on length of stay and release condition from the asylum. Race was not recorded for any patient and presumed White since DDH was not racially integrated until 1960s. Women had a significantly increased odds (OR = 3.8, p = 0.016) of dying in the facility than getting discharged; being single significantly increased the odds of dying in the facility (OR = 6.8, p = 0.002). Marital status predicted length of stay—being single increased the length of stay (b = 5.97, t (159) = 2.43, p = 0.016) adjusting for the effects of gender, age, and education. We report the impact of gender and marital status on patient release condition and length of stay in an asylum in the early 20^th century. Results from the historical data we empirically examined are relevant today as women continue to experience disparities in mental health care. Family support was crucial to better outcomes then, as it is today.

Acknowledgements

We would like to thank Professor Robert Allen and the Community Histories Workshop team at UNC Chapel Hill for graciously sharing the Dorothea Dix hospital records and data that was used for this study.

Disclosure statement

The authors report no conflicts of interest.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.

Notes on contributors

Rose Mary Xavier

RMX was responsible for conceptualization, methodology and data analysis including visualization, project administration and supervision, resources, writing, review and editing of the manuscript.

Allison M Britt

AMB contributed to data curation, investigation and writing of the manuscript.

Brandy Reardon

BR contributed to data curation, investigation and writing of the manuscript.

Wales T. George

WTG contributed to the investigation, writing, review and editing of the manuscript.