Moral Insanity

MORAL INSANITY, insanitas moralis, moral madness. Under this name, the English psychiatrist Prichard in 1835 attempted to isolate as a special pathological form a group of cases characterized by an exclusive impairment of the emotional and volitional sphere in the presence of a normal, sometimes even highly developed intellect (old French psychiatrists called such cases "folie raisonnante"). Later, the term proposed by Prichard began to be used to designate psychopaths in whom a congenital absence of so-called moral feelings is usually observed in the foreground. Kraepelin, not considering moral insanity a separate nosological entity, refers the corresponding cases to the number of psychopathies (see), isolating a special amorphous group of "enemies of society" that is not sharply demarcated from adjacent forms. Kurt Schneider in his classification of psychopaths refers them to the group of "heartless" (Gemütslose) psychopaths. Bearing in mind the congenital nature of the defect, this group of psychopaths is often called "morally defective." Modern constitutional psychiatry believes that the terms moral insanity, "morally defective," and "enemies of society" should not be used at all in clinical psychiatry, because these terms introduce the principle of social evaluation, whereas all other psychiatric classification strives for grouping according to biological or, in extreme cases, descriptive-psychological characteristics. Asocial, amoral misdemeanors can be committed by psychopaths who are very diverse from a clinical and biological point of view; amorosity can also be manifested by cold, dull, impulsive schizoids and egoistic epileptoids prone to flashes of angry excitement, and others. Meggendorf, investigating the genealogy of "morally defective psychopaths," found that they most often come from families where there are many schizoids and affect-epileptoids. Finally, it must not be forgotten that amoral and asocial behavior is based on purely social, rather than biological-pathological causes.