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Thread. Medical Hysteria and #InternationalWomensDay

In 1882, Anna O is considered 'patient zero' for the diagnosis of "Hysteria"

#Hysteria was originally a diagnosis only given to women

Anna O fell ill in 1880 after her father died, possibly of Tuberculosis
2. Her symptoms: severe 'nervous' #cough, paralysis, numbness, vision/hearing/speech disturbances, hallucinations, #cognitive difficulties

She was diagnosed with "Hysteria" by Breuer and Freud in ~1882

3. Breuer claimed that he cured Anna O of #Hysteria using 'talking out' therapy (a very early forerunner to #psychotherapy)

His claim was false

4. We now know that Anna O most likely suffered from an 'organic disease', possibly neuro-tuberculosis

5. Of course, trying to cure an 'organic disease' using 'talk therapy' or #psychotherapy is not only non-scientific, it is also unethical and potentially dangerous

6. As more and more disease mechanisms have been uncovered by #biomedical research, the diagnosis of #Hysteria for many conditions has become untenable

But how often is Hysteria diagnosed today?

Actually, it is surprisingly common!

7. Since the 1970s, #psychiatry has switched the term #Hysteria for more palatable diagnostic terms; Somatic Symptom Disorder; Conversion Disorder; Functional Neurological Symptom Disorder

8. This recent @els_psychiatry review states, "Today, we understand that 'hysterical' symptoms are quite common, in one study representing 18% of neurology clinic patients"

9. This recent @els_psychiatry review also makes the alarming admission that "#Hysteria.. is still diagnosed in women 2-3 times as frequently as in men"

10. Other #psychiatry studies have estimated that "#psychogenic, medically unexplained, or #hysterical [patients] account for up to one third of new referrals"

Most are women

11. Unfortunately, many serious disabling diseases including Myalgic Encephalomyelitis/Chronic Fatigue Syndrome #MECFS, #Fibromyalgia and #endometriosis are very often misdiagnosed as Somatic Symptom Disorders (aka #Hysteria)

12. Such #psychiatric views on #Hysteria (and it's modern diagnostic synonyms) perpetuate the myth that women are more likely to get sick because they are weak-willed and over-emotional


13. that such emotional behaviours can be cured with 'talk therapy' as proposed by Breuer and Freud with Anna O in 1882

Treating patients with organic illnesses with #psychotherapy or cognitive behavioural therapy with the aim of recovery is unethical

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