ABSTRACT
American psychiatry was dominated by Freud’s theo ries for the first half of the 20th century. These views held sway until the advance of biologic approaches to psychi atry, which have become increasingly prominent over the past 30 years. Biological psychiatrists aimed to replace Freud’s theories of psychopathology (based on ideas of imbalances of psychological forces) with what they felt was a more scientific approach. In their view, psychopa thology was secondary to disruptions of physiology that had their foundation in genetic vulnerability. This frame work placed greater emphasis on genetic abnormalities leading to physiologic changes, with their phenomenologic expression in psychiatric disorders. In the early phase of biological psychiatry, there was a great emphasis on finding the genetic basis for psychiatric disorders, and little emphasis on the role of environment in the genesis of psychopathology. As is often true in the history of the development of ideas, the biological psychiatrists effec tively leaped backward over 50 years of psychoanalysis to psychiatrists such as Kraepelin (1919). He also believed that psychiatric disorders had their basis in constitutional abnormalities that had their expression in the brain, and performed neuroanatomic studies of the brains of schizo phrenics in order to find a lesion to explain their illness.
