[Hormone-based classification and therapy concepts in psychiatry]

Abstract

This study retells key aspects of the history of the idea of hormone-based classification and therapy concepts in psychiatry. Different contributions to the history are not only represented from a historical, but also from a current medico-scientific perspective. One of the oldest, yet ethically most problematic, indications concerning hormonal methods to modify undesirable behaviour and sexuality was castration, which was widely used in the 20th century to "cure" homosexuality. Felix Platter, whose concept was humoral-pathological in nature, documented the first postpartum psychosis in the German-speaking countries, the pathogenesis of which according to present-day expertise is brought about by changes in female hormones. The concept of an "endocrine psychiatry" was developed at the beginning of the 20th century. Some protagonists for neuroendocrinology are highlighted, such as Paul Julius Möbius around 1900 or, in the 1950s, Manfred Bleuler, the nestor of this new discipline. Only the discovery of the hormones as such and the development of technologies like radioimmunassay to measure and quantify these hormone changes in mental illnesses allowed investigating these conditions properly. Ever since hormone-based therapeutic and classification concepts have played an important role, above all, in sexual, affective and eating disorders as well as alcohol dependence.