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March 12, 1973

Sane: Insane

JAMA. 1973;223(11):1272. doi:10.1001/jama.1973.03220110050014

"If sanity and insanity exist, how shall we know them?" That question opens the provocative article by Rosenhan1 in which he discovers what happens to a pseudopatient— not a Baron-Munchausen-syndrome type—who seeks asylum at a psychiatric hospital.

Eight sane people, three women and five men of varied callings, gained secret admission to 12 psychiatric hospitals of varied degrees of age and presumed competence. All the pseudopatients were normal in the sense that they did not have and never had suffered symptoms of serious psychiatric disorders. They used pseudonyms to avoid subsequent stigmatization, and the six who were health professionals alleged other occupations to avoid the possibility of favored attention. All were promptly hospitalized when they told like stories of hearing voices that were often unclear but seemed to say "hollow" or "empty." Otherwise, each pseudopatient gave his life history just as it had happened and, after admission with a