The legacy of Italian psychiatry

The General Assembly of the World Psychiatric Association had approved, in the Action Plan of the WPA 2014–2017 (Bhugra, 2017), that, in order to foster communication, papers from other languages should also be translated into English. We were delighted at the invitation to put together a volume of papers originally written in Italian. However, we were concerned that, due to the enormous contribution Italian psychiatrists have made over decades to the development and flourishing of psychiatry worldwide, it would have been impossible to provide a complete picture of the state of Italian psychiatry. Moreover, the task was made even more difficult by the fact that several historical Italian papers have already been translated and published in English language by the WPA in 2002 within the ‘Anthology of Italian Psychiatric Texts’ (Maj & Ferro, 2002).

We have decided to sub-divide the contribution of Italian psychiatry into five main themes. From the perspective of social psychiatry, we cannot ignore the contributions of Cesare Lombroso (1835–1909) (Carrà & Barale, 2004), who, in spite of all the criticisms, is considered the father of criminology, and who contributed significantly to the scientific study of madness, and of Franco Basaglia. The experience by Basaglia and his collaborators at the asylums in Gorizia and Trieste led to the closing down of all asylums in the country (Basaglia & Ongaro, 2004), and to the promulgation in 1978 of the 180 law, which is now well-known almost everywhere in the world. More recently, the work of Michele Tansella (Thornicroft, 2017) and his coworkers at the University of Verona has highlighted the importance of the assessment of psychiatric treatments and outcomes, and has proposed an alternative model of mental healthcare (Amaddeo & Tansella, 2011).

A second theme is that of psychotherapy. In particular, Silvano Arieti, Carlo Perris, and Vittorio Guidano gained international recognition of their work on psychoanalysis (the former) and cognitive-behavioural therapy (the other two). Their books have been translated into several languages and represent the basis of many psychotherapeutic approaches being used globally for managing severe mental disorders (Arieti, 1974; Guidano, 1987; Perris, 1989).

The third theme is that of the contribution of Italian psychiatry to our understanding of the clinical characterization of many mental disorders, in particular bipolar disorder (e.g. Koukopoulos and Maj) (Koukopoulos, Minnai, & Müller-Oerlinghausen, 1985; Maj, Arena, Lovero, Pirozzi, & Kemali, 1985) and major depression (e.g. Cassano) (Cassano et al., 1988). Italian psychiatrists recently have proposed the need to improve psychiatric diagnoses. In particular, Maj (2013) has recently discussed the importance of the ‘clinical judgement’ for the diagnosis of depressive disorders in the presence of bereavement.

The fourth theme is that of phenomenological psychopathology in clinical practice, which has been highlighted by several authors, such as Arnaldo Ballerini, Bruno Callieri, Romolo Rossi and, more recently, Giovanni Stanghellini (Ballerini, 1982; Callieri & Castellani, 1971; Rossi, 2005; Stanghellini & Rosfort, 2013). These authors have made available texts of classical and phenomenological psychopathology, and they have provided a ‘koinè’, which is a common language for psychiatrists. In particular, all of them have stressed the importance of psychopathology in clinical practice and for clinical psychiatrists.

The fifth theme is that of contributions of various Italian psychiatrists to biological psychiatry. The electroconvulsive therapy was discovered in Italy by an Italian neurologist (Bini) and an Italian physiologist (Cerletti). They used ECT for the first time in Rome in 1938 on a patient with delusions, hallucinations, and depressive symptoms (Cerletti & Bini, 1938). Since then, the contribution of Italian psychiatrists to various other aspects of the biological approaches, such as genetics, neurophysiology, neuropathology, neurochemistry, and psychopharmacology, has been well-recognized.

In this special issue, we acknowledge the major impact of the two most influential Italian psychiatrists worldwide: Carlo Lorenzo Cazzullo, who has been the President of the Italian Psychiatric Association for 18 years and who was the first university professor of psychiatry in Italy in 1958, and Mario Maj, who was the first Italian President of the European Psychiatric Association (2003–2004) and of the World Psychiatric Association (2008–2011). To both of them, global psychiatry, but especially Italian psychiatrists, are profoundly indebted.

In this special themed issue, we attempt to illustrate the history of Italian psychiatry and its contribution to the development of the discipline worldwide. The selection is not a reflection of the merits of contributors, but it is rather a selected sample of significant papers originally published in Italian.

We decided to include in this issue two manuscripts by Franco Basaglia and Mariano Bassi from the theme of social psychiatry. For psychopathology, we have selected two papers from Callieri and Stanghellini; and the original paper by Bini and Cerletti about the effects of ECT on the theme of biological psychiatry. The role of psychiatry is described by Rossi and especially in the opening lecture by Cazzullo at the Italian Congress of Psychiatry of 1980. The introduction to the Italian edition of the DSM-5, written by Mario Maj, highlights the current clinical challenges and perspectives for psychiatrists worldwide. The last contribution of this issue is a reflection on the role of psychiatry in modern medicine (Fiorillo et al., 2013) and society from one of the editors with Professor Maj.

Psychotherapeutic and clinical papers are not included in this issue because the most influential papers were originally written in English, and are already available to the international readership.

We are profoundly grateful to the Past-President of the WPA, Professor Dinesh Bhugra, who gave us the opportunity to publish all these papers, and to make them available to an international readership. We would like to also thank Dr Christopher, who has translated all the manuscripts from Italian to English, and Lundbeck Italia, whose unrestricted educational grant made this issue possible.

Disclosure statement

No potential conflict of interest was reported by the authors.