The neglected disorders in psychiatry

Psychiatry is a relatively recent medical discipline, which aims to describe, study, treat, and prevent mental and behavioural disorders (Bhugra et al., 2015a). As the political and social developments change, societies, human behaviours, and social determinants of health (and of mental health) also rapidly change (Fiorillo & Maj, 2018). Also, the presentation and clinical characterization of many mental disorders is heavily influenced by cultural factors (Bhugra et al., 2015b; Bhugra et al., 2018). Therefore, in the last few decades a number of new conditions have emerged and a number have either disappeared and/or not being diagnosed as frequently. Some new forms of psychiatric disturbances and psychopathological features have arisen as a consequence of modernization and social crises (Fiorillo et al., 2013; Ventriglio et al., 2020), which have taken over and replaced many classical psychiatric disorders.

Since the publication of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders in the 1990s (DSM-IV; APA, 1994), a remarkable amount of progresses has occurred in social and human sciences as well as in neurosciences which have contributed to the introduction of new diagnostic categories in the DSM-5 (APA, 2013).

Descriptive psychopathology is still the core of modern psychiatry and an essential and critical part of psychiatrists’ daily clinical practice (Jaspers, 1913; Kendler, 2018; Von Engelhardt & Gerigk, 2009). Therefore, it needs to be re-discovered by the young generations of psychiatrists and mental health professionals. Recently, a need for a detailed characterization of the individual cases, beyond any psychiatric diagnosis, has been suggested in order to promote a tailored case-management plan and a reliable prognosis according to the ‘precision medicine’ principle (Jablensky, 2018; Krueger et al., 2018; Maj, 2020; Zachar, 2018).

This themed issue of International Review of Psychiatry is entirely dedicated to the rediscovery of some old-fashioned psychiatric descriptions, which over the years have become neglected or redefined in the modern conceptualization and classification of mental disorders. All contributions in this issue are focussed on a set of historically described psychiatric clinical conditions (e.g. Hysteria, Catatonia, Eponymous Syndromes, Neurasthenia, etc.), which are no longer included in the modern diagnostic systems, and some have changed into other categories. However, these have guided the categorical approach to mental disorders and have inspired generations of scholars and researchers. The authors of our papers have approached these disorders through historical and psychopathological perspectives. They guide the reader from ancient times through the modern era of DSM-5, taking into account discoveries in neurosciences. In particular, this applies to anxiety–depressive syndrome, dysthymia, hysteria, catatonia, or melancholia. Several eponymous syndromes, such as De Clèrambault syndrome, Capgras syndrome, Cotard syndrome, or Ekbom syndrome, have been described since they are almost unknown to the younger generations of psychiatrists.

We believe that these ‘neglected’ disorders still have a place in a modern psychiatric practice and education, and it is likely that these reviews may inspire future generations of psychiatrists, medical students, and other healthcare professionals. It is important that the historical background of psychiatry is readily available in order to promote a ‘psychopathological’ approach to mental illness and an awareness among the younger generations of psychiatrists. We hope that this issue will contribute to increasing the knowledge of new generations of psychiatrists for a better understanding of human behaviour and brain functioning.

Acknowledgements

We are profoundly grateful to Professor Bhugra and all the authors, who gave us the opportunity to work together on this project and make it available to the international readership.