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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Since the time of the ancient Greeks, physicians have recognized a certain relatedness between the mental states of depression and mania. In the mid-Nineteenth century, French alienists proposed a 'double' or 'circular' illness consisting of alternating depressed and manic episodes and at the beginning of the twentieth century, Emil Kraepelin introduced the term 'manic-depressive insanity.' Kraepelin's broad clinical experience resulted in compelling descriptions of the symptoms of mood disorders that have arguably never been surpassed. The Kraepelinian nosology continues to provide a touchstone for modern classification systems of the mood disorders.
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PMID:Kraepelin and manic-depressive insanity: an historical perspective. 1619 70

Recent studies have questioned current diagnostic systems that split mood disorders into the independent categories of bipolar disorders and depressive disorders. The current classification of mood disorders runs against Kraepelin's unitary view of manic-depressive insanity (illness). The main findings of recent studies supporting a continuity between bipolar disorders (mainly bipolar II disorder) and major depressive disorder are presented. The features supporting a continuity between bipolar II disorder and major depressive disorder currently are 1) depressive mixed states (mixed depression) and dysphoric (mixed) hypomania (opposite polarity symptoms in the same episode do not support a splitting of mood disorders); 2) family history (major depressive disorder is the most common mood disorder in relatives of bipolar probands); 3) lack of points of rarity between the depressive syndromes of bipolar II disorder and major depressive disorder; 4) major depressive disorder with bipolar features such as depressive mixed states, young onset age, atypical features, bipolar family history, irritability, racing thoughts, and psychomotor agitation; 5) a high proportion of major depressive disorders shifting to bipolar disorders during long-term follow-up; 6) a high proportion of major depressive disorders with history of manic and hypomanic symptoms; 7) factors of hypomania present in major depressive disorder episodes; 8) recurrent course of major depressive disorder; and 9) depressive symptoms much more common than manic and hypomanic symptoms in the course of bipolar disorders.
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PMID:The relationship of major depressive disorder to bipolar disorder: continuous or discontinuous? 1631 25

The nineteenth century was the site of radical changes in understanding mental illness. The professionalization of psychiatry consisted primarily of the discipline's aspiration to the status of an expert medical subspecialty. While all forms of insanity were eventually reframed in medical terms, melancholia--for moral and nosological reasons--assumed a special role that made it an ideal diagnosis for conceptual reframing. Our analysis of the journal literature of the nineteenth and early twentieth centuries in North America and Germany traces several ways in which melancholia was medicalized. As the care for the insane shifted into the professional realm of physicians and medical terminology came to replace prior descriptors of mental illness, melancholia was replaced by depression. In addition, the process of delineating affective pathology assumed a distinctly medical flavor. Finally, melancholia was firmly medicalized when its boundaries blurred with neurasthenia. Differences in how ordinary affective terms became medicalized in German and North American psychiatry illustrate the importance of local historical approaches.
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PMID:Medicalizing melancholia: exploring profiles of psychiatric professionalization. 1634 9

This is an attempt to evaluate the mental disorder that the novelist Virginia Woolf suffered, and to determine the relationship between her creativity and her insanity. What mostly characterizes her illness is the presence of typical phases of severely impairing depression and significant hypomania, culminating in suicide at the age of 59. This is a convincing life history of a bipolar II disorder, although the "broad bipolar spectrum" is less easy to define operational than bipolar disorder I. She was moderately stable as well as exceptionally productive from 1915 until she committed suicide in 1941. Virginia Woolf created little or nothing while she was unwell, and was productive between attacks. A detailed analysis of her own creativity over the years shows that her illnesses were the source of material for her novels.
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PMID:[Virginia Woolf as an example of a mental disorder and artistic creativity]. 1644 63

The cause of behavioural changes described by Alzheimer for his original case, Auguste D., has been recently reconfirmed by histological examination. However, there has been active speculation regarding the cause of behavioural changes exhibited by the political satirist Jonathan Swift (1667-1745) during the final three years of his life for over 250 years. Swift's symptoms of cognitive changes, memory impairment, personality alterations, language disorder and facial paralysis have all been apportioned differing levels of significance in various attempts at retrospective diagnosis. The various medical arguments put forward from the 18th through 20th centuries will be critically examined. The diagnoses considered refer to evolving theories of insanity, phrenology, localization of cortical function, hydrocephalus, psychoanalysis, aphasia, dementia and depression in ageing. Re-consideration of the attempts to re-diagnose Swift's final mental state by the leading neurological thinkers of the day, including Wilde (The Closing Years of Dean Swift's Life. Dublin: Hodges and Smith, 1849), Bucknill (1882), Osler [Osler's textbook Principles and Practice of Medicine (1892); published in St Thomas's Hospital Gazette (London) 1902; 12: 59-60), Brain (Irish Med J 1952: 320-1 and 337-346) and Boller and Forbes (J Neurol Sci 1998; 158: 125-133) reveal the changing attitudes regarding the significance of behavioural symptoms to neurological diagnosis from the 18th century to the present day.
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PMID:Language and memory disorder in the case of Jonathan Swift: considerations on retrospective diagnosis. 1702 10

Modern medicine has many roots on greco-roman practice of the medical art. The authors analyse the work De Medicina by Aulus Cornelius Celsus. They look upon the nature of the medical knowledge, the principles of ethics, causality and describe the mental disorders (phrenitis, depression, third insanity, seizure disorder and womb disease), with special detail to signs and symptoms, treatment and prognosis. An association with current medical knowledge is established.
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PMID:[Ethics, knowledge and psychiatry: in Aulus Cornelius Celsus' De Medicina]. 1828 40

Kraepelin's basic attitude to the classification of psychoses was data-oriented and flexible. In his latter years he was close to revising his own celebrated dichotomy between manic-depressive insanity and dementia praecox in order to take account of a large group of intermediate psychoses, which today are called schizo-affective. His concept of a continuum from healthy to ill has stood the test of time and corresponds to modern epidemiological findings. Kraepelin's unitarian concept of manic-depressive insanity did not survive. It was differentiated and broken down into several subgroups, and a proportional diagnostic spectrum with a continuum from mania via bipolar disorders to depression has recently even been proposed. Bipolar disorders would in that case be comorbid disorders of mania plus depression. In contrast to Kraepelin's unitarian view the long-term prognosis of subgroups of mood disorders varies considerably. Overall it is nevertheless astonishing how much of Kraepelin's legacy has survived.
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PMID:Diagnosis and course of affective psychoses: was Kraepelin right? 1851 22

Emil Kraepelin proposed to separate psychiatric disorders with psychotic features into two major categories, dementia praecox (later schizophrenia) and manic-depressive insanity (later bipolar disorder and major depression). Over the past century, there have been many efforts to categorize conditions that do not fit readily in either group. These conditions include many cases of acute psychotic illnesses of limited duration, with recovery between recurrences. For some of these conditions, Karl Kleist proposed the term cycloid psychosis: acute features were psychotic, as in schizophrenia, but the course was episodic, as in manic-depression. His concept was later elaborated by Karl Leonhard and Carlo Perris, and validated by modern studies. Leonhard described three overlapping cycloid subtypes (anxiety-beatific, excited-inhibited confusional, and hyperkinetic-akinetic motility dysfunction forms); Perris proposed a more unitary syndrome with operational diagnostic criteria; and recent investigators have considered relatively affective versus thought-disordered subtypes. The cycloid concept is not explicitly included in standard international diagnostic schemes, but both DSM-IV and ICD-10 have broad categories for acute, recurrent psychotic disorders, whose validity remains insecure. We present two cases of probable cycloid psychosis, review the history of the concept, and propose that it be reconsidered as a clinically useful category whose validity and utility for prognosis and treatment can be further tested.
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PMID:Cycloid psychoses revisited: case reports, literature review, and commentary. 1856 38

This paper reviews concepts of depression, including history and classification. The original broad concept of melancholia included all forms of quiet insanity. The term depression began to appear in the nineteenth century, as did the modern concept of affective disorders, with the core disturbance now viewed as one of mood. The 1980s saw the introduction of defined criteria into official diagnostic schemes. The modern separation into unipolar and bipolar disorder was introduced following empirical research by Angst and Perris in the 1960s. The partially overlapping distinctions between psychotic and neurotic depression, and between endogenous and reactive depression, started to generate debate in the 1920s, with considerable multivariate research in the 1960s. The symptom element in endogenous depression currently survives in melancholia or somatic syndrome. Life stress is common in various depressive pictures. Dysthymia, a valuable diagnosis, represents a form of what was regarded earlier as neurotic depression. Other subtypes are also discussed.
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PMID:Basic concepts of depression. 1897 41

In the history of the nosographies in psychiatry, the affective disorders were gradually distinguished from the other categories of mental disorders, until being considered as separate illness entities, such as what Kraepelin named manic-depressive insanity at the end of the 19th century. The latter will be subsequently divided in two main categories, the bipolar disorder on the one hand and recurrent depression on the other hand, this separation being still current, and extensively diffused by the mean of the Diagnostic and Statistical Manual of Mental Disorders (DSM). The DSM, whose revisions largely determine the evolution of the contemporary nosographic models, mainly relies on a categorical approach of the mental disorders. The next revision will probably continue to follow this kind of approach, even if the use of dimensional components could also be developed. In the future, true nosographic advances can be waited from clinical epidemiology studies, as those which recently made it possible to highlight various sub-types of affective disorders on the basis of clinical, biographical or temperamental characteristics. Etiological approaches, centered on the pathophysiology of the affective disorders, could also contribute to build nosographic models on the basis of an objective knowledge on these diseases.
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PMID:[Affective disorders: Evolution of nosographic models]. 2123 53


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