History

There is indeed a long and rich tradition of Psychiatry at the NYU Langone School of Medicine and at Bellevue Hospital in particular.

Lauretta Bender, a child neuropsychiatrist born in 1897, is best known as the creator of the Bender-Gestalt Test. She worked at Bellevue Hospital from 1930–1956. In 1938, Dr. Bender wrote a Monograph entitled: A Visual Motor Gestalt Test and Its Clinical Use. The test consists of reproducing 9 figures that are printed on cards. The figures were derived from the work of the famous Gestalt psychologist Wertheimer. The Bender-Gestalt test, as it is now often called, is typically among the top five tests used by clinical psychologists. It measures perceptual motor skills and perceptual motor development, and gives an indication of neurological intactness. It is also used as a test of personality and of emotional problems.

Dr. Bender was a contemporary of David Wechsler, Ph.D., creator of the famous intelligence tests that bear his name and which are still in use today: the Wechsler Adult Intelligence Scale (WAIS) and the Wechsler Intelligence Scale for Children (WISC). Wechsler became chief psychologist at Bellevue Psychiatric Hospital in 1932, where he stayed until 1967. The Wechsler Adult Intelligence Scale (WAIS) was developed first in 1939 and then called the Wechsler-Bellevue Intelligence Test. From these he derived the Wechsler Intelligence Scale for Children (WISC) in 1949 and the Wechsler Preschool and Primary Scale of Intelligence (WPPSI) in 1967. Wechsler originally created these tests to find out more about his patients at the Bellevue clinic as he found the then current Binet IQ test unsatisfactory. The tests are based on his philosophy that intelligence is "the global capacity to act purposefully, to think rationally, and to deal effectively with [one's] environment."

The Wechsler scales introduced many novel concepts and breakthroughs to the intelligence testing movement. First, he did away with the quotient scores of older intelligence tests (the Q in "I.Q."). Instead, he assigned an arbitrary value of 100 to the mean intelligence and added or subtracted another 15 points for each standard deviation above or below the mean the subject was. Rejecting a concept of global intelligence, he divided the concept of intelligence into two main areas: verbal and performance (non-verbal) areas each further subdivided and tested with a different subtest. These conceptualizations are still reflected in the most recent versions of the Wechsler scales, which even today remains the most commonly administered psychological tests.

During these “glory days” of Bellevue Psychiatry, another contemporary of Bender and Wechsler was Paul Ferdinand Schilder MD, an Austrian doctor and researcher, born in Vienna in 1886, who graduated medicine there in 1909. In 1930, he went to New York to become Director of Clinical Psychiatry at Bellevue Hospital. He did work in several diseases that now carry his name as follows: Addison-Schilder Syndrome, Schilder-Addison Complex or Adrenoleukodystrophy, Schilder's Disease or diffuse myelinoclastic sclerosis (a variant of multiple sclerosis), Schilder-Foix Disease, and Schilder-Stengel Syndrome. Unfortunately, his career was cut short when he was killed in a traffic accident in 1940.

In 2007, NYU School of Medicine marked the passing of Stella Chess MD, a child psychiatrist who helped develop and popularize the influential theory that children are born with distinct temperaments that can powerfully affect their outlook and relationship with their parents. The theory arose from groundbreaking research into human development that began in 1956, when Dr. Chess and her husband, Alexander Thomas MD, a former Director of Psychiatry at Bellevue Hospital Center, initiated the New York Longitudinal Study. Working with two other researchers, Herbert G. Birch and Margaret E. Hertzig, Dr. Chess and Dr. Thomas followed 133 children from infancy through adulthood and tried to observe patterns of behavior over that period. They observed nine dimensions of behavior and concluded that most of their subjects fell into three broad categories. Their findings — that children could be described as “easy,” “difficult” or “slow to warm up” — described aspects of an inherent temperament and became critically important when matched with a parent’s personality, especially with that of the child’s mother. The theory suggests that contrast between the mother’s personality and her child’s temperament can result in anxiety or behavior problems. Initial results from the study were published in the American Journal of Psychiatry in 1960.

Over time, Chess and Thomas found that temperament was not necessarily fixed but could change in response to shifts in environment. Further, they concluded that a majority of emotionally traumatized children were not damaged in the longer term and often recovered in therapy. Both findings were received as encouraging news by parents, who read about them in popular books like “Know Your Child” (1987) and “Temperament and Development” (1977), written by Dr. Chess and Dr. Thomas to bring the fruits of their research to the public eye. Along with Dr. Birch, the two also wrote a practical guide, “Your Child Is a Person” (1965).

In other work during the 1960s and ’70s, Dr. Chess studied psychiatric disorders in children who had contracted rubella, or German measles, and explored the possibility that the rubella virus was a cause for an autistic syndrome. Dr. Chess received her medical degree from New York University in 1939. Subsequently, she taught at New York Medical College before moving to NYU as an Associate Professor of Child Psychiatry in 1966. She became a Professor of Child Psychiatry in 1970, and then served as Director of our Department’s Child and Adolescent Psychiatric Division.

This “golden age” of NYU/Bellevue Psychiatry accelerated and accrued under the visionary leadership of Samuel Bernard Wortis MD, who served from 1942 through 1969. During this time, NYU Psychiatry became the most powerful and best funded Department in the NYU School of Medicine, as well as the leading Department of Psychiatry in the country. Wortis additionally chaired the Department of Neurology through 1962 and was Dean of the Medical School from 1960-1963, immediately preceding Saul J. Farber’s first appointment to that position. Samuel Wortis’ obituary states that “his colleagues attribute a large share of the progress of that great institution (NYU School of Medicine) to his ability, wisdom, and dedication”.

Wortis was triple board certified in psychiatry, neurology, and internal medicine and was “an internationally known psychiatrist and neurobiologist.” His impact on American and international psychiatry was inestimable; “Wortis can truly be said to have been one of the architects of modern eclectic psychiatric practice” (Am J Psychiatry, 1970: 161).

Many leaders in the field were nurtured in this department. Together with Arnold J Friedhoff, Wortis established the Margaret S. Millhauser Laboratories in the Department of Psychiatry, which played a fundamental role in the development of psychiatry as a neuroscience.

In 1963, Wortis recruited Samuel Gershon, a pioneer lithium researcher from Australia, to head a new Neuropsychopharmacology Research Unit at Bellevue, which spanned several floors of the previous Bellevue building. This highly productive and innovative pre-clinical and clinical research team included a legion of fellows, associates, and residents from all over the world who went onward from NYU to transform psychiatric research worldwide. This is widely considered to have been the first translational neuroscience program. Gershon’s group laid the foundation for our current psychopharmacology in mood and psychotic disorders. Among scores of accomplishments, they identified a role for serotonin synthesis inhibitors in treating depression, which laid the ground work for developing selective serotonin reuptake inhibitor (SSRI) antidepressants. They also published the first textbook on Lithium (Gershon, Samuel and Shopsin, Baron, eds., Lithium: Its Role in Psychiatric Research and Treatment; Plenum Press, 1973), which is credited with the introduction of lithium treatment in clinical practice.

The precocious, powerful intellectual force of the department through the 1970’s had changed the face of psychiatry, ushering in the era of neurochemistry and pharmacological research, as well as expanding leadership in clinical care and public psychiatry.

Our vision is to continue writing the next chapters in the history of the Department and be the “best of the best” departments of psychiatry in the world.