The Evolution of Insanity

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William Duell, Vincent Schiavelli, Delos V. Smith Jr., Jack Nicholson, and Danny DeVito star in One Flew Over the Cuckoo's Nest.

The Psychopathology of Schizophrenia
Borut Skodlar, Mojca Dernovsek and Marga Kocmur, University of Ljubljana

The Gist:
Today's schizophrenic may believe that terrorists are beaming radio transmissions into his brain; 50 years ago, however, Communists were the culprits. And a century ago, before radio was invented, it might have been a simple case of "hearing voices." In a paper published last spring, three Slovenian psychiatrists examined the ways in which insanity has historically manifested itself, and whether "crazy" has always been the same. Borut Skodlar, Mojca Dernovsek and Marga Kocmur studied 120 records of schizophrenic patients admitted to the Ljubljana (Slovenia) psychiatric hospital between 1881 and 2000 to see if psychotic delusions are affected by contemporary culture. As it turns out, they are.

Highlights:
1. Religious and magical delusions were the least prevalent during 1941-1980, during which time Slovenia was part of Yugoslavia — a communist dictatorship. The Yugoslavian government suppressed religion, and the less people practiced or thought about it, the researchers theorize, the less frequently it appeared in schizophrenic delusions. From 1981 and 2000 — as communism crumbled and Slovenians were allowed to find God again — reports of people claiming to be possessed, haunted or tormented by spirits rose.

2. Paranoid delusions, feelings of persecution and the belief that someone is out to get you appear to be unique to the 20th century. "The trend is primarily ascribed to urbanization, industrialization and technical developments with much new information and communication transfer, exerting considerable 'cultural pressure' on an individual," the researchers write. An increasing sense of individualism might add to the problem — the 1970s weren't called "The Me Decade" for nothing. The repression of political dissidents by Yugoslavia's communist regime probably didn't help either.

3. After radio and television were invented, more and more patients reported delusions with technical themes, including radio waves, voices, sounds, images — anything beamed to them from somewhere else. These appeared to be symptoms no one had noticed or recorded before. After all, it's hard to believe you're being bombarded by television signals when the TV hasn't been invented yet.

The Lowdown:
The report, published in the International Journal of Social Psychiatry, uses relatively simple language easily digested by anyone with an amateur interest in psychology (or who ever completed a high school science report). Although Skodlar, Dernovsek and Kocmur shy away from pinpointing the exact causes behind their observations — admitting that their research was hindered by a small sample size, the need to rely on second-hand interpretations of patients' problems, and the fact that the medical community's knowledge of schizophrenia has changed over the past century — their observations are enough to give us pause. While the underlying causes of mental illness have remained the same, the delusions it produces are a distorted, funhouse mirror-type look into our own world. History is almost never viewed through the eyes of the insane, especially not the locked-up, straight-jacketed kind that Big Nurse just wants to subdue. But the mentally ill are products of society too; they are influenced by culture and they carry the same fears and fascinations as the sane minds that surround them. Craziness may be more normal than we think.

The Verdict: Read

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