Descriptions of Disordered Eating in German Psychiatric Textbooks, 1803–2017

The most common eating disorders (EDs) according to DSM-5 are anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorder (BED). These disorders have received increasing attention in psychiatry due to rising prevalence and high morbidity and mortality. The diagnostic category “anorexia ner...

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Main Authors: Lukas Bergner, Hubertus Himmerich, Kenneth C. Kirkby, Holger Steinberg
Format: Article
Language:English
Published: Frontiers Media S.A. 2021-01-01
Series:Frontiers in Psychiatry
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fpsyt.2020.504157/full
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author Lukas Bergner
Hubertus Himmerich
Kenneth C. Kirkby
Holger Steinberg
author_facet Lukas Bergner
Hubertus Himmerich
Kenneth C. Kirkby
Holger Steinberg
author_sort Lukas Bergner
collection DOAJ
description The most common eating disorders (EDs) according to DSM-5 are anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorder (BED). These disorders have received increasing attention in psychiatry due to rising prevalence and high morbidity and mortality. The diagnostic category “anorexia nervosa,” introduced by Ernest-Charles Lasègue and William Gull in 1873, first appears a century later in a German textbook of psychiatry, authored by Gerd Huber in 1974. However, disordered eating behavior has been described and discussed in German psychiatric textbooks throughout the past 200 years. We reviewed content regarding eating disorder diagnoses but also descriptions of disordered eating behavior in general. As material, we carefully selected eighteen German-language textbooks of psychiatry across the period 1803–2017. Previously, in German psychiatry, disordered eating behaviors were seen as symptoms of depressive disorders, bipolar disorder or schizophrenia, or as manifestations of historical diagnoses no longer used by the majority of psychiatrists such as neurasthenia, hypochondria and hysteria. Interestingly, 19th and early 20th century psychiatrists like Kraepelin, Bumke, Hoff, Bleuler, and Jaspers reported symptom clusters such as food refusal and vomiting under these outdated diagnostic categories, whereas nowadays they are listed as core criteria for specific eating disorder subtypes. A wide range of medical conditions such as endocrinopathies, intestinal or brain lesions were also cited as causes of abnormal food intake and body weight. An additional consideration in the delayed adoption of eating disorder diagnoses in German psychiatry is that people with EDs are commonly treated in the specialty discipline of psychosomatic medicine, introduced in Germany after World War II, rather than in psychiatry. Viewed from today's perspective, the classification of disorders associated with disordered eating is continuously evolving. Major depressive disorder, schizophrenia and physical diseases have been enduringly associated with abnormal eating behavior and are listed as important differential diagnoses of EDs in DSM-5. Moreover, there are overlaps regarding the neurobiological basis and psychological and psychopharmacological therapies applied to all of these disorders.
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spelling doaj.art-57b32290d9294f0182c56b7eb9a127d42022-12-21T19:41:35ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402021-01-011110.3389/fpsyt.2020.504157504157Descriptions of Disordered Eating in German Psychiatric Textbooks, 1803–2017Lukas Bergner0Hubertus Himmerich1Kenneth C. Kirkby2Holger Steinberg3Archiv für Leipziger Psychiatriegeschichte, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Medizinische Fakultät der Universität Leipzig, Leipzig, GermanyDepartment of Psychological Medicine, King's College London, London, United KingdomDepartment of Psychiatry, University of Tasmania, Hobart, TAS, AustraliaArchiv für Leipziger Psychiatriegeschichte, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Medizinische Fakultät der Universität Leipzig, Leipzig, GermanyThe most common eating disorders (EDs) according to DSM-5 are anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorder (BED). These disorders have received increasing attention in psychiatry due to rising prevalence and high morbidity and mortality. The diagnostic category “anorexia nervosa,” introduced by Ernest-Charles Lasègue and William Gull in 1873, first appears a century later in a German textbook of psychiatry, authored by Gerd Huber in 1974. However, disordered eating behavior has been described and discussed in German psychiatric textbooks throughout the past 200 years. We reviewed content regarding eating disorder diagnoses but also descriptions of disordered eating behavior in general. As material, we carefully selected eighteen German-language textbooks of psychiatry across the period 1803–2017. Previously, in German psychiatry, disordered eating behaviors were seen as symptoms of depressive disorders, bipolar disorder or schizophrenia, or as manifestations of historical diagnoses no longer used by the majority of psychiatrists such as neurasthenia, hypochondria and hysteria. Interestingly, 19th and early 20th century psychiatrists like Kraepelin, Bumke, Hoff, Bleuler, and Jaspers reported symptom clusters such as food refusal and vomiting under these outdated diagnostic categories, whereas nowadays they are listed as core criteria for specific eating disorder subtypes. A wide range of medical conditions such as endocrinopathies, intestinal or brain lesions were also cited as causes of abnormal food intake and body weight. An additional consideration in the delayed adoption of eating disorder diagnoses in German psychiatry is that people with EDs are commonly treated in the specialty discipline of psychosomatic medicine, introduced in Germany after World War II, rather than in psychiatry. Viewed from today's perspective, the classification of disorders associated with disordered eating is continuously evolving. Major depressive disorder, schizophrenia and physical diseases have been enduringly associated with abnormal eating behavior and are listed as important differential diagnoses of EDs in DSM-5. Moreover, there are overlaps regarding the neurobiological basis and psychological and psychopharmacological therapies applied to all of these disorders.https://www.frontiersin.org/articles/10.3389/fpsyt.2020.504157/fulleating disordersanorexia nervosabulimia nervosahistory of psychiatryGerman psychiatry
spellingShingle Lukas Bergner
Hubertus Himmerich
Kenneth C. Kirkby
Holger Steinberg
Descriptions of Disordered Eating in German Psychiatric Textbooks, 1803–2017
Frontiers in Psychiatry
eating disorders
anorexia nervosa
bulimia nervosa
history of psychiatry
German psychiatry
title Descriptions of Disordered Eating in German Psychiatric Textbooks, 1803–2017
title_full Descriptions of Disordered Eating in German Psychiatric Textbooks, 1803–2017
title_fullStr Descriptions of Disordered Eating in German Psychiatric Textbooks, 1803–2017
title_full_unstemmed Descriptions of Disordered Eating in German Psychiatric Textbooks, 1803–2017
title_short Descriptions of Disordered Eating in German Psychiatric Textbooks, 1803–2017
title_sort descriptions of disordered eating in german psychiatric textbooks 1803 2017
topic eating disorders
anorexia nervosa
bulimia nervosa
history of psychiatry
German psychiatry
url https://www.frontiersin.org/articles/10.3389/fpsyt.2020.504157/full
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