Leon Eisenberg - Medical Accomplishments

Medical Accomplishments

The reasons Leon Eisenberg is listed as a famous figure in world and American psychiatry are numerous. Leon Eisenberg identified rapid return to school as the key to treatment in the management of the separation anxiety underlying school phobia. He completed the first outcome study of autistic children in adolescence and recognized patterns of language use as the best predictor of prognosis. Of the two first studies of the outcome of infantile autism, he reported the American study in the American Journal of Psychiatry in 1956, and the UK study was reported in JCPP shortly afterward by Victor Lotter and Sir Michael Rutter. That was a time when a narrow rather than a broad definition of autism was in fashion. It is of interest that the poor prognosis was evident both in the narrowly- and broadly-defined cases and that, because many of the cases now called autistic would have been called "mental retardation: moderate to severe", they would have joined other such children with a relatively poor outcome.

He was Principal Investigator (PI) on the first grant from the Psychopharmacology Branch of NIMH for RCTs in child psychopharmacology. From a concern for evidence-based care, well before the phrase was coined, he introduced randomized controlled trials (RCTs) in psychopharmacology and showed that "tranquilizing" drugs were inferior to placebo in the treatment of anxiety disorders, whereas stimulant drugs were effective in controlling hyperactivity. He completed the first RCTs of psychiatric consultation to social agencies and of the utility of brief psychotherapy in anxiety disorders. He published a forceful critique of Konrad Lorenz's instinct theory. He established the usefulness of distinguishing "disease" from "illness". He has highlighted the environmental context as a determinant of the phenotype emerging from a given genotype, and from the late 1990s through 2006, he had been involved with developing conferences and resources for medical educators in various specialties that would help them incorporate, into courses with their current and future students, the tidal wave of new information in genomics yet to puzzle future clinicians. This interest may have been encouraged by his stepson, Dr. Alan Guttmacher, Acting Head of the National Human Genome Research Institute. For many decades, Leon Eisenberg had criticized psychoanalysis from a number of platforms.

The scientific contributions of Dr. Eisenberg include:

• the first longitudinal follow-up of Leo Kanner's original cases of autism
• a study that identified the roots of social phobia in parental anxiety
• the first clinical trial of the effectiveness of psychiatric consultation in a social agency
• the first randomized controlled trial in childhood psychopharmacology
• the first randomized controlled trial of stimulant drugs in adolescents
• the first randomized clinical trial of brief psychotherapy
• a forceful critique of Lorenz’s theory of instincts and imprinting
• an early statement of the distinction between “disease” (what doctors deal with) and “illness” (what patients suffer)
• a widely-cited critique of the oscillation of psychiatry between brain-centered and mind-centered approaches arguing for the integration of the two
• a synthesis of the evidence on the importance of training primary care physicians to recognize and treat depression
• papers that highlight the molding of the brain structure by social experience
• publications putting inheritance in an environmental context as a determinant of risk and resilience.
• Called "the father of prevention science in psychiatry"

Specific publications referring to the above achievements are contained in his bibliography

Leon Eisenberg is proudest of the Diversity Lifetime Achievement Award he received in 2001 for his role in inaugurating affirmative action at HMS in 1968 and sustaining it as Chairman of the Admissions Committee from 1969 to 1974. He regards that as his most important contribution to Harvard Medical School.

With his wife, Dr. Carola B. Eisenberg, former Dean of Students, first at MIT, then at Harvard Medical School, he has been active with Physicians for Human Rights, which as an organization received a Nobel Peace Prize in 1997 for its International Campaign to Ban Landmines.

In mid-2009 (June 22, 2009), a Leon Eisenberg Chair in Child Psychiatry was named at Children's Hospital Boston. The first chairholder of the Leon Eisenberg Professorship in Child Psychiatry is David R. DeMaso, MD, HMS Professor of Psychiatry and Psychiatrist-in-Chief at Children's Hospital Boston.

His brief (~30 pages) autographical memoir (a walk through the history of psychiatry, yet to be published posthumously by Acta Psychiatrica Scandinavica - in mid- or late-2010) "Were we asleep at the switch?" was written from his home, but how can such a transformative life be encapsulated in a BRIEF memoir?