Ludwig van Beethoven—a psychiatric perspective

Abstract

SummaryBiographical accounts of famous artists usually try to relate the life story to the works (and vice versa). This gives the work a special “colour”, often the context for understanding for today’s recipients. This interrelation is complex and often judgmental, sometimes manipulative. Thus, medical (including psychiatric), characterological and psychodynamic assessments and interpretations must be made with great caution. Primary sources may be scanty and diagnostic concepts may have changed (Mozart died of hitzigem Frieselfieber [prickly heat fever]; in Hölderlin’s lifetime, schizophrenia or bipolar disorder did not yet “exist”). The attempt at a diagnostic classification often says more about the author and his time than about the artist (for example, the assessment of Robert Schumann’s or Friedrich Hölderlin’s mental illness). Against this background, elements of Ludwig van Beethoven’s biography are presented from a psychiatric perspective. In summary, Beethoven can be diagnosed with an alcohol use disorder. A pronounced hyperthymic temperament is likely to have had a clearly positive influence on the course of the disorder. In particular, no influence of the alcohol use disorder on the musical quality of the work can be proven. A clear episodic course of affective symptoms as in bipolar disorder is not demonstrable. The deafness caused a severe reduction in quality of life.

The change in Beethoven’s music composition: Is there a role of his mental distress?

“…This information is not available for Beethoven. Some authors have interpreted this period of mental distress as a possible prolonged and transitory psychotic episode in Beethoven's life [11,25], others proposed another diagnosis as bipolar disorder [26,27]. Nevertheless, it remains difficult to describe Beethoven's distress during this period according to the DSM-5 classification despite numerous testimonies and correspondences [28].…”