Psychological Medicine

Research Article

Rich and mad in Victorian England1

Trevor Turnera1 c1

a1 Department of Psychological Medicine, St. Bartholomew's Hospital, London


Clinical analyses of 19th century psychiatric practice have been limited by the paucity of available records. Using the richly detailed casebooks of Ticehurst House Asylum, it was possible to study over 600 admissions and assess them using the Research Diagnostic Criteria. Over 80% of cases conformed to recognizable psychiatric illness, mainly schizophrenia and manicdepressive psychosis. Movement disorder, often equivalent to tardive dyskinesia, was noted in nearly one-third of schizophrenics. Violence, masturbation and severe psychopathology were also common features. The implications of these findings in terms of treatment, diagnosis and the rise of the asylum are discussed.


c1 Address for correspondence: Dr T. Turner, Department of Psychological Medicine, St Bartholomew's Hospital, West Smithfield, London EC1A7BE.


1 This paper was delivered as the 15th Annual Squibb Lecture in the History of Psychiatry at the Institute of Psychiatry, University of London, in November 1987.