Thomas A. Ban
Neuropsychopharmacology in Historical Perspective
Education in the Field in the Post-Neuropsychopharmacology Era
 
Background to An Oral History of the First Fifty Years
Special Areas (Volume Seven): 1. Child Psychiatry
(Bulletin 59)

            In the first six volumes of An Oral History of Neuropsychopharmacology different fields of inquiry within neuropsychopharmacology are reviewed (Ban 2011a). The first volume is dedicated to Behavioral Pharmacology, the second to Neurophysiology, the third to Neuropharmacology, the fourth to Psychopharmacology, the fifth to Neuropsychopharmacology per se and the sixth to Addiction (Ban 2011b; Fink 2011; Gershon 2011; Kleber 2011; Shorter 2011 and Sulser 2011).

            In Volume Seven, Special Areas, contributions to the developments of child psychiatry, gerontopsychiatry, psychiatric diagnosis and pharmacokinetics are presented. As in all other volumes in this series, interviewees in Volume Seven reflect on their contributions to research in their respective field of inquiry.

Child Psychiatry

            In the early years of the 20^th century a wide variety of disciplines from pediatrics to psychiatry, including education, criminology, psychology, psychoanalysis and child guidance were concerned with the health and welfare of children (Kanner 1958). It was only in the mid-1920s that August Homburger set the foundation of a subspecialty of psychiatry that was to become known as Child Psychiatry (Kanner 1959).  

            The term Child Psychiatry (Kinder Psychiatrie) was first used in the early 1930s by Moritz Tramer in the name of his journal, Zeitschrift fűr Kinderpsychiatrie.  The term was widely diffused in the English-speaking world through the title of Leo Kanner’s book, Child Psychiatry, published in 1935 (Kanner 1935). It was about the same time that the first psychiatric units for children, founded by Eugen Bleuler in Zurich, August Homburger in Heidelberg and Adolf Meyer in Baltimore, were opened (Mayer-Gross, Slater and Roth 1960).

            Developments which lead to Child Psychiatry began in the 1860s and ’70s with the separation of three genetically-distinct diagnostic populations within mental deficiency: (1) the Laurence-Moon-Biedl syndrome; (2) the Langdon-Down syndrome or mongolism; and (3) Tay-Sachs disease, or familial amaurotic idiocy (Down 1866, 1887; Laurence and Moon 1866; Lejeune, Garthier and Turpin 1959; Sachs 1887; Tay 1881).  Then, in 1934, the same year as the term “child psychiatry” was introduced, Fölling discovered “phenylketonuria,” an inborn error of metabolism, by detecting phenylpyruvic acid in the urine in a group of children with severe mental deficiency (Fölling1934; Garrod 1923). Three years later Penrose and Quastel demonstrated the absence of enzymes splitting phenylalanine in phenylketonuric children (Penrose and Quastel 1937). By the end of the 1930s Jervis had shown that phenylketonuria runs in families; he implicated an autosomal recessive gene in the pathogenesis of the disease (Jervis 1939). The first report on successful treatment of phenylketonuria with a diet low in phenylalanine was published more than 15 years later, in 1955, by Woolf, Griffiths and Moncrieff (Woolf, Griffiths and Moncrieff  1955).

            A major impetus for the development of child psychiatry was the encephalitis lethargica epidemic between 1917 and the late 1920s with the subsequent identification of three mental syndromes (diseases) of childhood (Villamsky, Foley and Gilamn 2007). The first, “hyperkinetic disease” (hyperkinetische Erkrankung), was described by Kramer and Polnow in 1932; the second, “elective mutism,” was discovered in 1934 by Tramer; and the third, “infantile autism,” was first presented by Kanner in 1943 (Kanner 1943, 1946; Kramer and Polnow 1932; Tramer 1934).

            Interest in pharmacotherapy in child psychiatry was triggered by the publication of Charles Bradley’s paper in 1938 on the behavior of children receiving Benzedrine (amphetamine sulfate) and his subsequent 1940 report with Bowen on improvement in school performance of children receiving amphetamine sulfate (Bradley 1938; Bradley and Bowen 1940). In the same year Cutler, Little and Strauss published the findings of their controlled study with Benzedrine in mentally deficient children (Cutler, Little and Straus 1940). By the early 1950s the amphetamines found their place in the treatment of hyperkinetic children (Bender and Cottington 1942; Bender and Nichtern 1956). There were also other drugs, e.g., diphenylhydantoin, an anticonvulsant, and diphenhydramine, an antihistamine, used in child psychiatry in the 1940s (Efron and Freedman 1953; Lindsley and Henry 1942; Pasamanick 1951; Walker and Kirkpatrick 1947).

            The first reports on chlorpromazine in child psychiatry in the United States were published in 1955 by Bein and Herold and Gatski (Bein and Herold 1955; Gatski 1955). It was also in 1955 that the first papers appeared on the use of myanesin and glutamic acid in children. By the end of the 1950s there were also reports on findings with reserpine and meprobamate (Freedman, Kramer and Robertiello 1955; Lombard, Gilbert and Donofrio 1955; Rosenblum, Calahan, Buonoconto, Graham and Detarick 1958).

            The first book on research in pediatric psychopharmacology was published in 1959 (Kraft, Marcus, Wilson et al 1959).

References:

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Bender L, Cottington F. The use of amphetamine sulfate (Benzedrine) in child psychiatry. Amer J Psychiatry 1942; 99: 116-21.

Bender L, Nichtern S. Chemotherapy in child psychiatry. New York State J Med 1956; 56: 2791-5.

Bradley C. The behavior of children receiving Benzedrine. Am J Psychiatry 1938; 96: 641 - 58.

Bradley C, Bowen M. School performance in children receiving amphetamine (Benzedrine). American Journal of Orthopsychiatry 1940; 10: 782- 8.

Cutler M, Little JW, Strauss AA. Effect of Benzedrine on mentally deficient children. Amer J Ment Deficiency 1940; 45: 59-63.

Down JLH. Observation on an ethnic classification of idiots. Reports London Hospitals 1866; 3: 259-62.

Down JLH. On some of the mental affections of childhood and youth. London: J & A Churchill; 1887.

Efron AS, Freedman AM. The treatment of behavior disorders in children with Benadryl. J Pediat 1953; 42: 261-6.

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Freedman AM, Kramer MW, Robertiello RC, Effron AS. The treatment of behavior disorders in children with Tolserol. J Pediat 1955; 47: 369-72.

Garrod AE. Inborn Errors of Metabolism. Second Edition. London; Froude and Hodder & Stroughton; 1923.

Gatski RL. Chlorpromazine in the treatment of mentally maladjusted children.  JAMA 1955; 157: 1298-300.

Jervis GA. The genetics of phenylpyruvic oligophrenia. J ment Sci 1939; 85: 719-62.

Kanner L. Child Psychiatry. Springfield/Baltimore: Charles C. Thomas; 1935.

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Kramer F, Polnow H. Über eine hyperkinetische Erkrankung im Kindersalter. Monatschrift fűr Psychiatrie und Neurologie 1932; 22: 1-5.

Laurence JZ, Moon RC. Four cases of retinitis pigmentosa occurring in the same family and accompanied by general imperfection of development. Ophtalmic Reviews (London) 1866; 2: 32-41.

Lejeune J, Garthier M, Turpin R. Les chromosomes humaines en culture des tissues. CR Acad  Sci (Paris) 1959; 248: 602-3.

Lindsley DB, Henry CE. The effect of drugs on behavior and the electroencephalogram of children with behavior disorders. Psychosom Med 1942; 4: 140-9.

Lombard JP, Gilbert JG, Donofrio AF. The effect of glutamic acid upon the intelligence, social maturity and adjustment of a group of mentally retarded children.  Amer J Ment Def 1955; 60: 122-32.

Mayer-Gross W, Slater E, Roth M. Clinical Psychiatry. Second edition.  London: Cassell; 1960.

Pasamanick B. Anticonvulsant drug therapy of behavior problem children with abnormal electroencephalogram.  AMA Arch Neurol & Psychiat 1951; 65: 752-66.

Penrose  LS, Quastel JH. Metabolic studies in phenylketonuria Biochem J  1937; 31: 166-74

Rosenblum S, Calahan RJ, Buonoconto R, Graham BD, Detarick RW. The effects of tranquilizing medications (reserpine) on behavior and test performance of maladjusted high-grade retarded children.  Amer J Ment Def 1958; 62: 663-71.

Sachs B. An arrested cerebral development with special reference to cortical pathology. Journal of Nervous and Mental Diseases 1887; 14: 541-4.

Tay W. Symmetrical changes in the region of the yellow spot in each eye of an infant. Ophthalmological Society J 1981; 1: 55-7.

Tramer M. Elective Mutismus bei kindern. Zeitschrift  fűr Kinderpsychiatrie 1934; 1: 30-6.

Villansky JA, Foley P, Gilamn S.  Children and encephalitis lethargica: A historical review. Pediatric Neurology 2007; 37: 79-84.

Walker CF, Kirkpatrick BB. Dilantin treatment of behavior problem in children with abnormal EEGs.  Amer J Psychiatry 1947; 103: 484-92. 

Woolf LL, Griffiths R, Moncrieff A. Treatment of phenylketonuria with a diet low in phenylalanine. Brit med J 1955; 7: 57-64.

February 28, 2019