["Imperial madness" - truth or legend?].

The notion of "imperial madness" was coined in the historical literature and belles-lettres of the 19th century. Around that time up to the first quarter of the 20th century, it was adopted by a few German psychiatrists. Two of them viewed "imperial madness" as ordinary forms of insanity which became excessive only due to reactions of the social environment. Another one, however, classified it as one of "mental borderland states" in between insanity and normality, although he conceived the final stage of the disorder as a paranoid one. In agreement with the historians he postulated that "imperial madness" resulted from unlimited power of predisposed rulers. In recent times the whole concept of "imperial madness" was referred to the realm of legends by historians of antiquity and other historically interested authors. Yet the existence of the phenomenon cannot be denied. Despite its rarity it has played and is still playing an important role with often catastrophic consequences in various cultures all over the world. Therefore, psychiatrists and other physicians as well as clinical psychologists should be acquainted with it. From a modern point of view, it is not a paranoid disorder but rather a syndrome of addiction-like behavioural excesses representing an intensification of a Hybris syndrome as described by Anglo-Saxon psychiatrists. According to the present authors' view, it should be classified nosologically as a chronic adjustment disorder. In this case, the underlying stresses need to be extended to situations of temptation (here: the temptation to abuse almost unlimited power). © Georg Thieme Verlag KG Stuttgart · New York.