This volume offers a supra-regional view of how psychiatry developed in Central and Eastern Europe during the long nineteenth century. Case studies from the German lands, the Habsburg monarchy, and the Russian Empire show that the field did not follow a single linear story of medical progress. Instead, it grew through circulation of ideas, local adaptation, and often ongoing negotiation among institutions and actors. The chapters trace psychiatry’s Enlightenment roots in debates on the soul and passions, then follow its legal and institutional consolidation under absolutist and later constitutional regimes. They also examine changing diagnostic and therapeutic practices and the everyday encounters they produced among doctors, patients, clergy, and administrators. Rejecting a core–periphery model, the book presents these regions as sites of conceptual innovation and institutional experimentation. By pairing local specificities with transnational connections, it helps rethink psychiatry’s history as culturally, politically, and socially deeply embedded in nineteenth-century Europe.