Mental disorders and economic crisis--a study on the development of admission into the psychiatric hospitals of Prussia between 1876 and 1906.

Social causes of mental disorders are a long-standing issue of controversy in psychiatric epidemiology. Following Brenner's (1977) analysis, we analysed the correlation between admissions to psychiatric hospitals and the employment figures for almost 3 decades of the last century in Prussia. The employment figures were taken as an indicator of social stress, whereas the admission figures were taken as an indicator of the incidence of mental disorders. Two groups with different diagnoses were considered in the analysis; nowadays they would more or less correspond to "functional psychosis" (ICD 295-299) and "alcoholic psychosis" (ICD 291). Three other groups, i.e. epilepsy, progressive paralysis and severe learning disabilities, served as control groups to check the influence of modifications in help-seeking behaviour. In contrast to Brenner's mono-causal social stress model, there were no significant correlations for the group of functional psychoses for men or for women, whereas the admissions of males with alcoholic psychoses showed the expected trend to a high degree. The three control groups showed no obvious correlation with employment figures, arguing against a main effect of a modification of help-seeking behaviour on the results in the two experimental groups. Results are discussed and interpreted with regard to contemporary results in psychiatric epidemiology.