[Psychiatry in the GDR as a "niche" - Between adaptation and autonomy]. / Psychiatrie in der DDR als "Nische" ­ Zwischen Anpassung und Freiraum.

BACKGROUND: With the help of statements from contemporary witnesses, it shall be deduced, if and to what extent Psychiatry was experienced as a shelter for employees and patients in the state controlled society of the GDR and which effort of adaptation to the authoritarian regime was needed to organize protected and protective spaces, here called "niches". METHOD: 74 guide-based interviews from subjects including former patients and different staff groups of the East german Psychiatry were analyzed qualitatively. RESULTS: Many quotations show, that Psychiatry in the GDR was experienced as a "niche" for dissenting people and could offer a certain amount of protection for patients. On the other hand, the autonomy of the psychiatric care was often violated by political intrusions regarding individual treatments. Moreover, treatment autonomy was restricted by harsh shortages in supplies. CONCLUSION: Psychiatrists in the GDR could protect their patients through their actings and so Psychiatry could establish a "niche" for patients and employees. However, establishing such protected spaces required efforts in adaptation. In reverse, Psychiatry has also been politically instrumentalised - either directly through unjustified admissions and exit restrictions or indirectly by a stigmatization of dissenters and removing them from society.

[An Essential Therapeutic: Occupational Therapy in GDR Psychiatric Institutions as Seen by Contemporary Witnesses]. / "Ein wesentliches Therapeutikum" ­ Arbeitstherapie in psychiatrischen Einrichtungen der DDR aus Sicht von Zeitzeugen.

OBJECTIVE: The aim of this survey of professionals working in the GDR and former patients was to help determine the role and function of occupational therapy in psychiatric institutions. METHODOLOGY: 74 contemporary witnesses were interviewed who had worked professionally in psychiatric institutions in the GDR or had been treated there in adulthood. The interviews were evaluated qualitatively. RESULTS: The eyewitnesses interviewed described the organisation and goals of occupational therapy as well as changes that took place over time. Occupational therapy was rated highly, as it represented an important additional therapy offering. Uniform activities and the misuse of patients' labor while neglecting their therapeutic requirements were subjected to critical assessment. CONCLUSION: In future, the interviews with contemporary witnesses should be included to a greater extent in investigations into the history of psychiatry. The view of the development of occupational therapy can provide valuable insights for further historical reappraisal, and contribute to our current understanding of these forms of therapy.

[The Journal "Deine Gesundheit" - A Reflection of Social Psychiatry in the GDR?] / "Deine Gesundheit" ­ Spiegelbild der Sozialpsychiatrie in der DDR?

BACKGROUND: Articles on psychiatric care in the GDR published in the journal "Deine Gesundheit" are identified. This involved examining how psychiatry was presented to the public and the intentions of addressing a lay audience. METHODOLOGY: All booklets published between 1955 and 1989 were systematically reviewed, the role of the publishers examined, and an assessment made in the context of social psychiatry and sociopolitical conditions. RESULTS: There was a lively publication activity of psychiatric topics by mainly professional actors. The temporal accumulation in the context of psychiatric reform efforts is striking. CONCLUSIONS: Reform-oriented psychiatrists in particular used the popular science medium to reach a broad public and thus greater social acceptance of community psychiatric care concepts.

[On the way to democracy-The transformation process 1990/1991 and the role of the Association for Psychiatry and Neurology in the GDR]. / Auf dem Weg zur Demokratie ­ der Transformationsprozess 1990/91 und die Rolle der Gesellschaft für Psychiatrie und Nervenheilkunde in der DDR.

OBJECTIVE: The transition from socialist dictatorship to liberal democracy in the GDR was associated with political and social upheaval. The transformation accompanying the democratic sociopolitical process is examined using the example of the Association for Neurology and Psychiatry of the GDR, which led to its unification with the German Association for Psychiatry and Neurology (DGPN). METHOD: For the historical investigation material from the archives of the DGPPN as well as the personal belongings of the protagonists of the time were used and eyewitness interviews were conducted. RESULTS: The transformation process can also be seen for the Association for Neurology and Psychiatry of the GDR. As at the political level, there was also a loss of legitimacy at the board level of the Association for Psychiatry and Neurology in 1990. The new understanding of democracy required the participation of all members. The Spokesman Council and the DGPN (East) were responsible for establishing and consolidating democratic structures. CONCLUSION: Beyond the transformation process, little is known about the merger. The phase of reorientation at the beginning of the 1990s should be examined for the DGPN as well as the question of how to deal with the suspected political abuse of psychiatry in the GDR.

[History of neurology in the GDR: a systematic review]. / Neurologie in der DDR: eine systematische Literaturübersicht zur historischen Aufarbeitung.

BACKGROUND: Neurology as a discipline developed differently in the two German states after 1945 and little is known about neurology in the GDR. OBJECTIVE: This article examines the present state of historical research on neurology in the GDR. MATERIALS AND METHODS: We systematically screened the existing literature from the period 1991-2021 and assigned the studies to different categories. RESULTS: We found significant regional differences in the way specific topics are addressed. We also identified a lack of a general overview on the subject and a lack of studies dealing with neurology within the specific socio-political context of the GDR. Comparative studies between the GDR and the BRD and between the GDR and other countries are also scarce. CONCLUSION: Further systematic research (in the form of a separate research project) into the history of neurology in the GDR and its role within the socialist healthcare system of the GDR is needed, taking comparative aspects into account.

[On "Alienated Consumption" - How a Large Company in the GDR Dealt With Alcohol Abuse]. / Vom "wesensfremden Konsum" ­ Zum Umgang mit der Alkoholproblematik in einem DDR-Großbetrieb.

The paper investigates the treatment of alcohol abuse in the GDR, and specifically in Rostock, and was written using insights from the documentary film Abhängig [Addicted], which was filmed in 1983. This is not a film analysis. Rather, the paper functions as an impetus to examine from a micro-historical perspective the various dimensions of the way in which alcoholism was dealt with in a large GDR enterprise. From a historical perspective, the documentary is interesting in several respects and is ideally suited as both a source and an analytical tool for the study of the history of psychiatry in former East Germany. By intertwining perspectives from the history of ideas and social history, the film makes it possible to experience the tension between social ostracism, on the one hand, and acceptance of alcoholism as a disease, on the other. Moreover, it also shows attempts to establish therapies in multiprofessional teams and thus, ways out of addiction. Extensive archival material, viewed here for the first time, as well as interviews with contemporary witnesses are used as sources to supplement the film. The insight which the combined sources provide into the social space of a large, "volkseigener" [nationally owned] enterprise (the Neptune shipyard with polyclinic) permits a more nuanced insight into real socialist society and - in the broadest sense - into its specific approach towards deviant and depending on interpretation, marginal-asocial or pathological excessive alcohol consumption. In addition to highlighting different perspectives on alcoholism in the GDR, in the course of whose existence/history an expansion of the scope of medical definitions took place, the paper aims to provide impetus for comparative research and to point out where shifts in perspective may be necessary. In the long-term, the goal of such research would be to make generally valid statements about the role of psychiatry in the context of the healthcare system of the GDR.

[Comparison of Inpatients in Child Psychiatry in Rostock Between 1960 and 2015]. / Vergleich der stationären Kinderpsychiatrie 1960 und 2015 in Rostock.

Comparison of Inpatients in Child Psychiatry in Rostock Between 1960 and 2015 Since its beginnings, child psychiatry has been subject to permanent change due to social changes and thus different expectations of the field, developments in diagnostics, therapy and the respective classification systems. After 1949 Child and Adolescent Psychiatry in the German Democratic Republic (GDR) underwent an independent and somatically oriented development. Although assumed that there was systematic injustice in inpatient facilities of child psychiatry in the GDR, no study from this period has been published to our knowledge up to now. The work presented here begins to close this gap by comparing data from 1960 with current data (2015) of the Child and Adolescent Psychiatry Department at the Rostock Medical Center. Significant differences between results from 1960 and 2015 indicate a currently higher number of admissions, only half the length of stay, an alignment in the gender ratio, a trend towards adolescent patients, a shift away from the 1960 dominant intelligence impairment towards behavioural and emotional disorders, a higher proportion of children and adolescents treated with drugs, and more specialist follow-up treatments after the inpatient stay in 2015. We found no evidence of forced medication in 1960. The discussion also addresses the danger of a solitary development of child psychiatry away from a medical to a more social psychiatric, educational and therapeutic subject.

[Poison in the filter: implementing detoxification procedures in schizophrenia]. / Gift im Filter: der Einsatz von "Detoxikationsverfahren" bei Schizophrenien.

In the history of psychiatry a variety of "blood detoxification" procedures have repeatedly been used to treat schizophrenic disorders under the assumption of autointoxication. In the 1970s this led to the use of dialysis. In addition to the historical classification of this therapeutic approach, particularly the protagonists active in the German Democratic Republic (GDR) as well as the dimension of research and science policy are highlighted. Despite the relatively low success rate of the treatment overall, the question of which patients actually had a positive response to the treatment arises. This seemed to primarily be the case for young patients in whom acute catatonic symptoms occurred. From today's perspective there are striking indications that the patients who were successfully treated at that time could belong to the group of autoimmune encephalitis, as they are known today. Autoimmune encephalitis and specifically anti-N-methyl-D-aspartate receptor encephalitis (NMDA-R) demonstrate a characteristic clinical progression with the frequent occurrence of psychiatric symptoms, which also include catatonic symptoms. These can occur in a variety of mental and neurological disorders but are often associated with schizophrenia. To primarily reduce the risk of diagnostic errors, they should initially be considered as non-specific from a diagnostic perspective. In the future, correlating immunological and psychopathological changes may help to delineate groups for whom specific therapies are particularly suitable.

[Psychiatry in East Germany (GDR) Between Awakening and Stagnation: The Brandenburg Proposition to the "Therapeutic Community" (1974/76)]. / Psychiatrie in der DDR zwischen Aufbruch und Stagnation: Die Brandenburger Thesen zur "Therapeutischen Gemeinschaft" (1974/76).

Inspired by the concept of the English psychiatrist Maxwell Jones, the Brandenburg proposition or thesis towards the "Therapeutic Community" was formulated in 1974. Its objective was to transform the therapeutic environment in psychiatric hospitals of the German Democratic Republic (GDR). Based on sources from the Federal Archive in Berlin and for the first time from the Historical Archive of the Asklepios Hospital in Brandenburg, the motivation, implementation and effect of the so-called Brandenburg proposition will be analysed within its socio-political context. Although it was not able to exert a broader influence on the provision of psychiatric care, important impulses for the development of social psychiatry and psychotherapy in the GDR were nonetheless given. The discussions on the concept of "therapeutic community" illustrated that this concept was supposed to coincide with the socio-political objectives of the Socialist Unity Party of Germany (SED) and their principles of collective education.

The Development of Sayk's Cell Sedimentation Chamber: A Historical View on Clinical Cerebrospinal Fluid Diagnostics.

OBJECTIVE: The history of Sayk's cell sedimentation chamber is examined and reviewed in the context of clinically utilizable cerebrospinal fluid (CSF) cytology. METHODS: A review of the literature was undertaken in PubMed and Google Scholar to search for primary and secondary sources on the history of CSF diagnosis. Moreover, documents in the archives of the Universities of Rostock and Jena, the Brain Research Institute of Cécile and Oskar Vogt in Düsseldorf and the Centre for Neurology at Rostock University were used. RESULTS: The cell sedimentation chamber, developed by Johannes Sayk (1923-2005) at the beginning of the 1950s, enabled, for the first time, CSF cells to be presented with a quality comparable to the blood profile, with a low technological expenditure and using all staining methods suitable for haematological cells. The procedure could be performed quickly and cost efficiently, and therefore, it was easy to integrate it into clinical routine and it quickly became a widely used procedure. In Europe, it was considered the standard method for cytodiagnosis of CSF until the 1990s. CONCLUSIONS: The procedure revolutionised CSF diagnostics and paved the way for modern qualitative CSF cytology. In course of time, the cell sedimentation chamber was superseded by the cytocentrifuge.

[In process.] / Helmut Rennert - Protagonist der Psychiatrie in der DDR?

Internationally, Helmut RENNERT (1920-1994) was one of the most renowned representatives of psychiatry in the GDR. From 1958 until 1984 he was the chair of the department of psychiatry and neurology at the Martin Luther University in Halle-Wittenberg. He was also the chairman of the Association for Neurology and Psychiatry of the GDR for many years. The textbook on neurology and psychiatry which he prepared together with Rudolf LEMKE (1906-1957) turned into the standard textbook for training and education in the GDR. RENNERT became well known primarily with his model of the universal genesis of endogenous psychoses in which he propagated the idea of unitary psychosis. In 1965 he became a member of the German National Academy of Sciences Leopoldina and as vice- president he represented the medical section. RENNERT belonged to the so-called second generation of professors which established itself at the end of the 1950s at university clinics in the GDR. As the leading experts and academic lecturers they influenced the field with respect to education and research for the entire time the GDR existed. This generation of professors maintained a strong bond with their academic teachers and continued their tradition in the sense of a "school" for the most part independent of political circumstances and restrictions.

Oxytocin promotes facial emotion recognition and amygdala reactivity in adults with asperger syndrome.

The neuropeptide oxytocin has recently been shown to enhance eye gaze and emotion recognition in healthy men. Here, we report a randomized double-blind, placebo-controlled trial that examined the neural and behavioral effects of a single dose of intranasal oxytocin on emotion recognition in individuals with Asperger syndrome (AS), a clinical condition characterized by impaired eye gaze and facial emotion recognition. Using functional magnetic resonance imaging, we examined whether oxytocin would enhance emotion recognition from facial sections of the eye vs the mouth region and modulate regional activity in brain areas associated with face perception in both adults with AS, and a neurotypical control group. Intranasal administration of the neuropeptide oxytocin improved performance in a facial emotion recognition task in individuals with AS. This was linked to increased left amygdala reactivity in response to facial stimuli and increased activity in the neural network involved in social cognition. Our data suggest that the amygdala, together with functionally associated cortical areas mediate the positive effect of oxytocin on social cognitive functioning in AS.

["No pleasant side can be discovered in this young boy"--aspects of "child euthanasia" in Silesia]. / "Irgend eine angenehme Seite ist bei dem Jungen nicht zu entdecken"--Aspekte der "Kindereuthanasie" in Schlesien.

Several thousand children also fell victim to the murder committed on physically or mentally handicapped persons under the term "euthanasia" during Nazi times. While at first they were included in the killings administered under "Action T4", beginning in 1941 the process of selection and murder was relocated to specialized "child departments" developed just for this purpose. Under the auspices of the Reich Committee for the Scientific Registering of Serious Hereditary and Congenital Illnesses (Reichsausschuss zur wissenschaftlichen Erfassung erb- und anlagebedingter schwerer Leiden) a network expanded with the objective of screening children and youth that did not seem fit and supportable for society and future generations. Care and educational institutions increasingly came into the center of attention. The primarily pedagogically motivated intent of removing children and youth from a harmful environment could very easily and quickly turn into organized murder. An example of this is Peter A. from Görlitz, who was ten years of age at the time of his murder. His path from his family to the corrective care that ultimately lead to his commitment into the specialized "child department" in Loben took less than half a year. His right to life was denied by Elisabeth Hecker, the director of the youth psychiatric clinic, as a result of labeling him as disruptive and useless.

[50 years Rodewisch theses--for the beginnings of social-psychiatric reforms in East Germany (GDR)]. / 50 Jahre Rodewischer Thesen - Zu den Anfängen sozialpsychiatrischer Reformen in der DDR.

The so-called Rodewisch Theses of 1963 demonstrate East German psychiatry's attempts to implement social-psychiatric reforms. To mark their 50th anniversary, this article analyses their emergence, drafting and implementation. It has been known that key requirements could only be fulfilled on a regional basis, the Leipzig University Department of Psychiatry being an outstanding example, although its staff worked rather autonomously of the Rodewisch Theses. The reasons for the different degree of success of these developments in individual areas are manifold, key reasons being the lack of stark political support and of opportunity to discuss shortcomings in mental health care, as in Western Germany, due to political circumstances in particular. There was no strong social basis and support as in Western democracies.

["Euthanasia" of children in Nazi Germany - the case of Günter Nevermannn. On the responsibility of childhood and adolescent psychiatry in the past, the present, and the future]. / Nationalsozialistische «Kindereuthanasie¼ - das Beispiel Günter Nevermann. Zur Verantwortung der Kinder- und Jugendpsychiatrie in Vergangenheit, Gegenwart und Zukunft.

«Euthanasia¼ was the cynical euphemism used by the Nazis to refer to the systematic murder of hundreds of thousands of mentally sick and handicapped people between 1939 and 1945, at least 6,000 of whom were children. Based on the example of Günter Nevermann, this paper provides insight into the complex acts of registering, selecting, and targeting children labelled as "inferior" and "unworthy to live." This case clearly shows that Nazi doctors were not necessarily enmeshed in some tragic conflict. Rather, apparently without any qualms, they sacrificed the sick children who had been entrusted to their care, for the ideal of obtaining a "racially healthy corpus," a term used without being questioned. Most of the perpetrators were never brought to justice, and not a few of them later held managerial positions in child and adolescent psychiatry in the two German states. Many of them were members or even honorary members of the "Deutsche Gesellschaft für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie e. V." in its present or previous form. We feel it is necessary to inform the public effectively about this state of affairs, to discover what really happened and to determine who was responsible.

Effects of intranasal oxytocin on the neural basis of face processing in autism spectrum disorder.

BACKGROUND: Autism spectrum disorder (ASD) is associated with altered face processing and decreased activity in brain regions involved in face processing. The neuropeptide oxytocin has been shown to promote face processing and modulate brain activity in healthy adults. The present study examined the effects of oxytocin on the neural basis of face processing in adults with Asperger syndrome (AS). METHODS: A group of 14 individuals with AS and a group of 14 neurotypical control participants performed a face-matching and a house-matching task during functional magnetic resonance imaging. The effects of a single dose of 24 IU intranasally administered oxytocin were tested in a randomized, placebo-controlled, within-subject, cross-over design. RESULTS: Under placebo, the AS group showed decreased activity in the right amygdala, fusiform gyrus, and inferior occipital gyrus compared with the control group during face processing. After oxytocin treatment, right amygdala activity to facial stimuli increased in the AS group. CONCLUSIONS: These findings indicate that oxytocin increases the saliency of social stimuli and in ASD and suggest that oxytocin might promote face processing and eye contact in individuals with ASD as prerequisites for neurotypical social interaction.