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Philippe Pinel and the foundations of modern psychiatric nosology

Published online by Cambridge University Press:  20 November 2020

Kenneth S. Kendler Open the ORCID record for Kenneth S. Kendler [Opens in a new window]
Kenneth S. Kendler*
Affiliation:
Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA Department of Psychiatry, Medical College of Virginia/Virginia Commonwealth University, Richmond, VA, USA
*
Author for correspondence: Kenneth S. Kendler, MD, E-mail: kenneth.kendler@vcuhealth.org
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Abstract

Philippe Pinel (1745–1826) played a major role in the foundation of modern psychiatric nosology. Much of his contribution, historically contextualized within the enlightenment generally and post-Revolutionary France more specifically, can be summarized through five themes in his background, education and writings. First, he applied an inductive, enlightenment-informed natural science approach to classification adapted from the biological sciences, which he had studied, and applied this to large samples of mentally ill individuals in Parisian asylums, frequently referring to ‘varieties’ and ‘species’ of insanity. Second, Pinel's classificatory approach rejected metaphysical and highly speculative etiologic theories in favor of a Baconian inductive approach utilizing observational data. Third, Pinel advocated repeated assessments of patients over time, feasible given long in-patient stays. Fourth, trained in philosophy, Pinel relied on philosophically informed models of the mind and of insanity. Fifth, Pinel extensively utilized faculty psychology to understand and classify mental illness. He anticipated further developments of nineteenth-century psychiatric nosology by challenging the then-dominant intellectualist models of insanity, adopting a humanistic-informed emphasis on the importance of symptoms alongside signs, arguing that passions could be the primary cause of mental illness, and trying to infer causal inter-relationships in psychiatric patients between disturbances in affect and understanding.

Type
Review Article
Information
Psychological Medicine , Volume 50 , Issue 16 , December 2020 , pp. 2667 - 2672
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Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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