[Introduction and transformation of the psychiatric term "anancasm". From Gyula (Julius) Donáth via Kurt Schneider to ICD-10].

The conceptual history of "anancasm" in psychiatry remains almost unexplored and this article will help to remove this deficit. It was the Budapest-based neuropsychiatrist Gyula Donáth (1849-1944) who first proposed this Greek-rooted term in 1897 as an international term for compulsive symptoms and as an independent mental illness similar to present-day obsessive compulsive disorders (ICD-10). By suggesting this term Donáth wanted to extend the concept of compulsion as proposed by his teacher Carl Westphal to other compulsive phenomena, psychomotor impulses and restrictions including echolalia, coprolalia, echokinesis, echopraxia, contemporary maladie des tics (present day Tourette's syndrome) and even intermittent dipsomania (craving for alcohol), paraphilias, sexual fetishes and homosexuality. In 1923 Kurt Schneider used this term for a subgroup of psychopathic personalities, the so-called insecure anancastic psychopaths. His concept was much different to that suggested by Donáth, with the only thing in common being the compulsory component. Schneider's anancasts suffered from feelings of insecurity and insufficiency and were forced to try to overcompensate by being excessively careful, meticulous and hyper-correct. Based on Schneider's concept anancasm has survived as a name for a subdivision of compulsive personality disorders in ICD-10; however, these rather complex personality defects were not what Donáth had in mind when he first suggested the term anancasm. The paper discusses further discrepancies between Donáth, Schneider and ICD-10.