A comparison of symptoms recorded from the same patients by an asylum doctor and 'a Constant Observer' in 1823

Abstract

The difficulty in finding descriptions of schizophrenic symptoms until after the start of the nineteenth century has led to the suggestion that this disease may not have existed before that time. A writer who described himself as 'a constant observer' and who was in close contact with many of the mentally ill in a large asylum at the beginning of the nineteenth century presents a different picture of prevalent symptoms of mental illness to those descriptions found in the same patients' case notes written by their doctors. This investigation is not an attempt to decide whether schizophrenia did or did not exist during certain periods of history, especially as the material investigated pertains to the eighteen-twenties and not the turn of that century, with which the 'recency hypothesis' is concerned. However, this is intended as a contribution towards our understanding of how accurately 'schizophrenia-like' symptoms were reported by doctors almost two hundred years ago. The validity of these reports will affect inferences about the prevalence of the disorder in history.