| Abstract [eng] |
During the interwar period, the concept, diagnosis and treatment of mental disorders changed rapidly. During this period, a more modern approach emerged, with greater attention to the search for the origins of diseases, the scientific classification of mental disorders, and application of effective treatment methods. However, there is a lack of detailed research to assess the perception, diagnosis and treatment methods of mental disorders in Vilnius region. This study aims to determine how mental disorders were perceived, diagnosed, and treated in Vilnius during the interwar period (1918-1939). We intended to identify the challenges of organising psychiatric care in Vilnius during the interwar period; to reveal the prevailing concepts of mental disorders and compare them with the theories prevailing in Western Europe at the time; to assess the characteristics of the diagnostic, treatment and prevention methods of mental disorders in Vilnius during the interwar period, and to compare them with the diagnostic and treatment methods used in Western Europe. To achieve this aim and fulfil the tasks, we analysed primary and secondary sources. Primary sources were collected from the archives of Vilnius University library, published in Polish and German by Vilnius psychiatrists. Secondary sources, published by psychiatrists from other European countries, were found in international databases (PubMed, Google Scholar, ResearchGate, ScienceDirect). To assess the concept, diagnostics, and treatment of mental disorders in interwar Vilnius, descriptive and historical methods were applied. To compare the levels of achievements of Vilnius psychiatry school with other European psychiatric institutions, comparative analysis and analogy methods were used. The retrospective diagnostic method helped to clarify some diagnoses, using modern medical knowledge. Mental disorders were claimed to be the result of the interaction of biological, psychological, and social factors in interwar Vilnius. Diagnostics was mainly based on clinical symptoms, monitoring the course of the disease and the assessment of changes in the autonomic nervous system. In the absence of effective treatment methods, Vilnius psychiatric institutions focused mostly on non-drug treatment methods – psychoeducation, implementation of structured environment, staff training, work-focused treatment, and social reintegration. Although Vilnius psychiatrists aimed to modernise psychiatry, restrictive methods, such as sedative medications, physical restraint, and patient isolation, were also employed. In interwar Vilnius, as well as in other psychiatric hospitals in Europe, various experimental treatment methods were used - from urine therapy to insulin shock therapy. We have not found any data that leukotomies were applied in Vilnius hospitals at the time. 5 In summary, interwar Vilnius psychiatrists were interested in new diagnostic and treatment methods emerging in Europe. They sought to apply them in their practice, but organisational, legal, and financial constraints in the healthcare system of the Second Polish Republic limited their implementation. Nevertheless, a mental disorder was increasingly viewed as a separate disease that required specific treatment, professional care and an environment suitable for the patient. Psychiatric practice in the interwar Vilnius region reflected a transitional period in the history of medicine, when the traditional model of treatment of mental disorders was gradually replaced by modern, science-based psychiatry. |
