Some Psychiatric Disorders

A. Non-organic disease

B. Organic brain disease

Diseases in group B, unlike those in A, are diseases whose consequences would be identifiable at an autopsy.

Introduction: Mental Illness Having already regarded alcoholism as a mental disturbance, we now consider other psychiatric disorders. It is a complicated group of disorders and more difficult to categorise than physical diseases, but the list above attempts a simple, if somewhat dated, classification. At some stage in their lives at least 25% of the Western population will report psychological illness. The question is where variations within a socially accepted range of normality merge into an illness. There have been repeated attempts to assess the role of madness in creativity. Is mental illness a positive driving force or an inhibition when considering the end product, be that a painting, novel or symphony? In a review of mental illness the names of great composers featured less than those of painters, poets or writers.

If we consider composers discussed in other chapters, it is clear that many fit into the list. Ravel (Chapter 3) had pre-senile dementia, and Rachmaninov (Chapter 10) and Elgar (Chapter 2) were melancholic, if not frankly depressive. Sibelius (Chapter 2) sometimes drank too much. Musorgsky (Chapter 5) did suffer from alcoholic dementia. Donizetti, Smetana and Wolf (Chapter 4) developed general paralysis of the insane (GPI). This chapter is confined to composers with major non-organic psychiatric problems (group A) which were sufficient to affect their compositional abilities or become life-threatening and/or to require periods of institutional care.

It is interesting to reflect on past psychiatric care. Straitjackets and padded cells are all but gone, and with them immersion in hot and cold baths.