History of psychiatry in Sweden during a millennium

This report covers a millennium, from year 1000 when Sweden had only 0.4 million people until today's 9.4 million. In the 13th century, the first Swedish legal text about the mentally ill and the first hospital to treat them are documented. Control, care and cure of the ill have been shaped by social and cultural changes from time to time, e.g. King Gustav Vasa introduced a paradigm shift of care after the Reformation, when he altered Catholic buildings into state hospitals. He also ordered that medical texts should no longer be written in Latin but in Swedish. The first book dealing with mental illnesses was published in 1578. Laypersons ran the mental hospitals for centuries until the medical perspective and doctors were engaged in the 1800 s. To advance the hospital doctors' competence and skill, a Swedish Psychiatric Association was established in 1905. Severely psychotic patients could not be effectively treated until the introduction of chlorpromazine in the 1950s and there is still no cure available. Following the deinstitutionalization, from more than 35,000 beds 50 years ago down to about 4500 today, the request for outpatient treatment increased. Mandatory training in psychotherapies for all psychiatrists started in the 1970s. A major "psychiatry reform", with the hope of improving the situation for the mentally ill, and to reduce the stigma, was introduced in Sweden in 1995. The historic long-term effect of the reform cannot yet be fully evaluated.