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Culture, Medicine, and Psychiatry

, Volume 43, Issue 4, pp 548–573 | Cite as

Schizophrenia Infrastructures: Local and Global Dynamics of Transformation in Psychiatric Diagnosis-Making in the Twentieth and Twenty-First Centuries

  • Nicolas HenckesEmail author
Original Paper

Abstract

This article uses the concept of “diagnosis infrastructures” to propose a framework for narrating the history of schizophrenia as a global category in the twentieth century. Diagnosis infrastructures include the material and architectural arrangements, legal requirements, and professional models that enable both the ways in which patients come to clinics and navigate the world of schizophrenia as well as the means through which clinicians organize their diagnostic work. These infrastructures constitute a framework for how schizophrenia has been identified as a disorder. This article explores three moments in the history of schizophrenia infrastructures in the twentieth century. The first is the German psychiatrist Kurt Schneider’s discussion of first- and second-rank symptoms in the interwar period. The second is the research on criteria for defining schizophrenia within the framework of the WHO International Pilot Study of Schizophrenia at the turn of the 1970s. The third corresponds to the changing infrastructures of mental health care in the context of both global mental health and the changing landscape of schizophrenia research over the last decades.

Keywords

Schizophrenia Infrastructures Psychiatric Diagnosis History of Psychiatry 

Notes

Acknowledgements

A very preliminary version of this paper was presented at the European Research Council (ERC)-funded conference, “Historical and Ethnographic Perspectives on the Emergence of Global Mental Health,” organized in Florence, Italy, in June 2017 by Anne M. Lovell, Claudia Lang, and Ursula Read. I thank the organizers for inviting me both to participate in the workshop and to contribute to this special issue, for their comments on subsequent versions of this article, as well as for their patience with my unabashed tendency to stretch deadlines. I also thank two anonymous reviewers for their close reading as well as generous and inspiring comments.

Funding

The research on which this paper is based was funded by the Agence Nationale de la Recherche; the Programme Emergence(s) of the City of Paris; and the Deutsche Forschungsgemeinschaft.

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Authors and Affiliations

  1. 1.CNRS - Centre de Recherche Médecine, Sciences, Santé, Santé mentale et Société (CERMES3)ParisFrance

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