Neurosis
Historical term for anxiety disorders, now obsolete in diagnosis.
Neurosis (plural: neuroses) is a term still in use primarily among followers of Freudian psychoanalysis to label mental disorders stemming from past anxiety, especially anxiety that has been repressed. More broadly, it has also been used in recent times to describe anxiety-related conditions in general. However, the term no longer appears as a diagnostic category or condition name in either the World Health Organization’s International Classification of Diseases (ICD) or the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM). The American Heritage Medical Dictionary stated in 2007 that the term is “no longer used in psychiatric diagnosis.”
Neurosis is distinct from psychosis, which involves a loss of contact with reality. Its descendant concept, neuroticism, refers to a personality trait marked by a tendency toward anxiety and mental breakdown. While neuroticism is also absent from DSM and ICD diagnoses, it remains a common label for one of the Big Five personality traits. A related concept appears in the ICD-11 under the name “negative affectivity.”
The term was coined by Scottish physician William Cullen in 1769, appearing in his *System of Nosology*. He used it to describe “disorders of sense and motion” arising from a “general affection of the nervous system.” The word combines the Greek *neuron* (nerve) with the suffix *-osis* (diseased or abnormal condition). Cullen applied the term to nervous symptoms that lacked a clear physiological explanation, though physical signs—such as exaggerated knee-jerks, loss of the gag reflex, and dermatographia—were often present and used in diagnosis into the 20th century.
French psychiatrist Philippe Pinel’s 1798 work *Nosographie philosophique* was heavily influenced by Cullen. Pinel divided medical conditions into five categories, one of which was “neurosis,” further split into four mental disorder types: melancholia, mania, dementia, and idiotism.
Morphine was first isolated from opium in 1805 by German chemist Friedrich Sertürner. After his third paper on the substance in 1817, morphine became widely known and was used to treat neuroses and other mental distress. Sertürner himself became addicted and warned of its terrible effects. In 1824, German psychologist Johann Friedrich Herbart introduced the concept of repression, discussing unconscious ideas competing for entry into consciousness. In 1857, British doctor Charles Locock noted the calming properties of potassium bromide; bromides were then used heavily for neuroses, leading to many cases of bromism. American doctor Weir Mitchell published his rest cure for non-psychotic mental disorders in 1875, with a fuller account in his 1877 book *Fat and Blood: and how to make them*. The original cure involved isolating women in bed, limiting communication to a nurse who discussed only unchallenging topics, a fattening milk diet, massage, and electrical applications. Later versions relaxed the isolation and diet and were also used for men; the book was revised and reprinted for decades.
Austrian psychiatrist Josef Breuer first applied psychoanalysis to treat hysteria in 1880–1882, treating Bertha Pappenheim. Her symptoms began when her father fell seriously ill during a family holiday in Ischl in mid-1880. While sitting at his sickbed at night, she experienced hallucinations and anxiety. The family initially ignored these, but in November 1880, Breuer began treating her. He encouraged her, sometimes under light hypnosis, to narrate stories, which partially improved her condition, though she continued to deteriorate overall. Breuer described her “remembering work” as slow and laborious; she recalled individual symptoms after they occurred, thereby “dissolving” them. He concluded the treatment on 7 June 1882, after she reconstructed the first night of hallucinations in Ischl, stating she had fully recovered. Accounts of the treatment’s success vary. Pappenheim never spoke of this episode later and opposed psychoanalytic treatment for people under her care. Breuer delayed publishing the case. Subsequent research suggests she may have had temporal lobe epilepsy, tuberculous meningitis, or encephalitis. She later ran an orphanage and founded and led the Jüdischer Frauenbund for twenty years.
Scottish psychiatrist Thomas Clouston coined the term “psychoneurosis” in his 1883 book *Clinical Lectures on Mental Diseases*, describing a condition covering what is now considered the schizophrenia and autism spectrums—symptoms soon better known as dementia praecox. French neurologist Jean-Martin Charcot came to believe psychological trauma caused some cases of hysteria, writing about this in his *Leçons sur les maladies du système nerveux* (1885–1887).
- coined_by
- William Cullen
- field
- Psychiatry, Psychoanalysis
- original_meaning
- Disorders of sense and motion from nervous system affection
- current_status
- No longer used in ICD or DSM diagnoses
- descendant_term
- Neuroticism (Big Five personality trait)
Verified Timeline
Lore & Background
The term neurosis was coined by Scottish doctor William Cullen to refer to "disorders of sense and motion" caused by a "general affection of the nervous system". It was first used in print in Cullen's System of Nosology, first published in Latin in 1769. Cullen used the term to describe various nervous disorders and symptoms that could not be explained physiologically. Physical features, however, were almost inevitably present, and physical diagnostic tests, such as exaggerated knee-jerks, loss of the gag reflex and dermatographia, were used into the 20th century. French psychiatrist Phillipe Pinnel's Nosographie philosophique ou La méthode de l'analyse appliquée à la médecine (1798) was greatly inspired by Cullen. It divided medical conditions into five categories, with one being "neurosis". This was divided into four basic types of mental disorder: melancholia, mania, dementia, and idiotism. Morphine was first isolated from opium in 1805, by German chemist Friedrich Sertürner. After the publication of his third paper on the topic in 1817, morphine became more widely known, and used to treat neuroses and other kinds of mental distress. The tranquilising properties of potassium bromide were noted publicly by British doctor Charles Locock in 1857. Over the coming decades, this and other bromides were used in great quantities to calm people with neuroses. American doctor Weir Mitchell first published an account of his rest cure for non-psychotic mental disorders in 1875. His 1877 book "Fat and Blood: and how to make them" gave a fuller explanation. The cure originally involved women being isolated in bed, only communicating with a nurse trained to talk about unchallenging topics, a fattening diet of milk, plus massage and the application of electricity.
Reader's Guide
Austrian psychiatrist Josef Breuer first used psychoanalysis to treat hysteria in 1880–1882. Bertha Pappenheim was treated for a variety of symptoms that began when her father suddenly fell seriously ill in mid-1880 during a family holiday in Ischl. While sitting up at night at his sickbed she was suddenly tormented by hallucinations and a state of anxiety. Breuer encouraged her, sometimes under light hypnosis, to narrate stories, which led to partial improvement of the clinical picture, although her overall condition continued to deteriorate. According to Breuer, the slow and laborious progress of her "remembering work" in which she recalled individual symptoms after they had occurred, thus "dissolving" them, came to a conclusion on 7 June 1882 after she had reconstructed the first night of hallucinations in Ischl. "She has fully recovered since that time" were the words with which Breuer concluded his case report. The term psychoneurosis was coined by Scottish psychiatrist Thomas Clouston for his 1883 book Clinical Lectures on Mental Diseases. French neurologist Jean-Martin Charcot came to believe that psychological trauma was a cause of some cases of hysteria. He wrote in his book Leçons sur les maladies du système nerveux, (1885-1887): "Quite recently male hysteria has been studied by Messrs. Putnam [1884] and Walton [1883] in America, principally as it occurs after injuries, and especially after railway accidents." Austrian psychiatrist Sigmund Freud was a student of Charcot in 1885–6. In 1893 Freud credited Charcot with being the source of "all the modern advances made in the understanding and knowledge of hysteria." Breuer came to mentor Freud. The pair released the paper "Ueber den psychischen Mechanismus hysterischer Phänomene. (Vorläufige Mittheilung.)" in January 1893. This paper was reprinted and supplemented with case studies in the pair's 1895 book Studien über Hysterie (Studies on Hysteria). Of the book's five case studies, the most famous became that of Breuer's patient Bertha Pappenheim (given the pseudonym "Anna O."). This book established the field of psychoanalysis. French neurologist Paul Oulmont was mentored by Charcot. In his 1894 book Thérapeutique des névroses (Therapy of neuroses), he lists the neuroses as being hysteria, neurasthenia, exophthalmic goitre, epilepsy, migraine, Sydenham's chorea, Parkinson's disease.
Did You Know?
- The term neurosis was coined by Scottish doctor William Cullen and first used in print in his System of Nosology, published in Latin in 1769.
- Morphine was first isolated from opium in 1805 by German chemist Friedrich Sertürner, and after 1817 it was used to treat neuroses; Sertürner later warned of its addictive effects.
- American doctor Weir Mitchell's rest cure for neuroses, first published in 1875, originally involved women being isolated in bed, a fattening diet of milk, massage, and the application of electricity.
- Breuer's patient Bertha Pappenheim (pseudonym "Anna O.") was treated from 1880–1882; Breuer concluded her recovery on 7 June 1882, stating "She has fully recovered since that time."
- French neurologist Paul Oulmont's 1894 book Thérapeutique des névroses listed neuroses as including hysteria, neurasthenia, exophthalmic goitre, epilepsy, migraine, Sydenham's chorea, and Parkinson's disease.
Frequently Asked Questions
What did Neurosis originally refer to?
In Cullen's framing, it covered anxiety-related conditions he attributed to a general malaise of the nervous system. The label later became a central grouping in Freudian psychoanalytic theory for disorders such as phobias and obsessions.
Is Neurosis still used as a diagnosis in modern psychiatry?
No. Neither the ICD nor the DSM retains it as an active diagnostic category, so clinicians no longer assign the term to patients in current practice.
What evolved out of the old concept of Neurosis?
The idea survives in a repackaged form as the Big Five personality trait called Neuroticism, which measures a person's general tendency toward emotional instability and negative affect rather than labeling a specific disorder.
Which academic fields is the term Neurosis tied to?
It sits at the crossroads of psychiatry and psychoanalysis, having been most prominently shaped, debated, and eventually retired within Freudian and post-Freudian theoretical frameworks.
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