Dementia praecox and manic-depressive psychosis

“Psychiatrists were well aware that, especially in difficult cases, the diagnosis turned on the quality of their reaction to the patient – simply, how they felt about him or her. Their reaction to patients they diagnosed manic-depressive was largely favorable. . . Looking at the dementia praecox patient, psychiatrists did not like what they saw: stolidity, catatonia, stupidness, disfiguring stigmata, and, most damning, overwhelming differentness. . . . [among psychotic patients] the men in this group were twice as likely as the women to receive a diagnosis of dementia praecox, to be classed as incurable and destined to deteriorate. Neither social class nor ethnicity came into play in this determination. . . . The most salient characteristics they saw in the manic patient were those associated in other contexts with an unbounded, out-of-control femininity that was at once frightening and alluring. In women this commonly took the form of an appealing ‘eroticism’” (Lunbeck, 146-151).