Campbell's 1953 Book on "Manic-Depressive Disease": A Counter-Factual History of the DSM Symptomatic "A Criteria" for Major Depression.

ABSTRACT: The DSM-III symptomatic criteria for major depression (MD) were derived from those proposed by Feighner and colleagues in 1972, which closely resembled those published by Cassidy in 1957. I here present a counter-factual history in which Feighner carefully read a key reference in Cassidy, a large 1953 follow-up study by Campbell of depressed patients with detailed tables of depressive signs and symptoms. In this alternative timeline, the Feighner criteria for MD were modified by Campbell's results, which then changed DSM-III and subsequent MD criteria sets. The historical pathway to the current DSM MD criteria was contingent on a range of historical events and could easily have been different. This story is not meant to criticize DSM MD criteria that perform well. Rather, it suggests that these criteria represent a useful but fallible set of symptoms/signs that index but do not constitute MD and therefore are not to be reified.

The New York Herald's Very First Report on Dr. Horace Well's Arrest and Suicide-An Original Article Found in New York City Public Library.

The accounts of Dr. Wells' personal life, particularly those of his tempestuous final days, have remained somewhat speculative. On January 24, 1848, a troubled Dr. Wells raced outside of his home and practice on Chambers Street and threw sulfuric acid (vitriol) on two alleged "loose" Broadway girls. We were able to find an original copy of an article published by the New York Herald in the New York City Public Library describing the events of Well's final days.

Reactive Depression: Lost in Translation!

The old classification of depression as reactive and endogenous, which are still observed in clinical practice, both cannot be accommodated under the current rubric of major depression. This is because psychiatric nosology under the Diagnostic and Statistical Manual of Mental Disorders (DSM) and its latest fifth edition (DSM-V) is still descriptive and not etiologic. The aim of this review was to revisit reactive and endogenous categories of depression from the perspective of today's understanding of etiological pathways. From an epigenetic perspective, the old dichotomy of reactive versus endogenous is interrelated through the impact of the environment (e.g., stress). This includes familial or prenatal depression, where the environmental impact is before birth, or childhood depression, where the early life stress is the precipitating factor to genetic susceptibility. In conclusion, searching for both environmental impact (e.g., stressors) and genetic predispositions in depression, even at a clinical level, could help clinicians with better therapeutic decisions.

[Psychiatric disorder of Sylvia Plath].

Sylvia Plath was one of the most famous American poets in the twentieth century. Plath was diagnosed with depression after her first suicide attempt when she was 20 years old. Her major depression (without psychotic symptoms) recurred several times. Plath never had a manic episode, but there were probable hypomanic periods in her life. She died by violent suicide when she was 30. Sylvia Plath took a bottle of sleeping pills and stuck her head in a gas oven. Several factors may have contributed to Plath's psychiatric disorder and suicide. The author reviews the etiological factors and course of psychiatric disorder based on the Unabridged Journals of Sylvia Plath and the literature. Her family history was positive and her premorbid personality was vulnerable to depression. There were histrionic, narcissistic and borderline features in her personality. The probable diagnoses of Plath were bipolar II. affective disorder and mixed personality disorder.

A brief history of polarity in mood and its diagnostic evolution.

BACKGROUND: We reviewed the historical development of diagnostic nomenclature and classification systems of mood disorders. METHODS: A literature search in PubMed and Google Scholar was performed using multiple search terms. Also, the criteria and classification of various mood disorders were reviewed and compared across all editions of DSM. We also reviewed several books and the references of the found articles. RESULTS: This review describes the historical development of the concepts and diagnostic nomenclature of mood disorders, including the encompassing of most of the now major depressive disorder under the prior manic-depressive illness. Additionally, we examine how mood disorders have been developed, classified, and split into subcategories historically until the current classification. We observed that the modern nosology (DSM-5) leans a bit more toward a spectrum approach. CONCLUSIONS: The pendulum has swung a bit from splitting toward lumping. The current diagnostic system blurs some of the boundaries between bipolar and unipolar disorders, as in the case of changing nomenclature to "mixed features" in both types of illnesses. This is supported by many experts (and some studies) who advocate for the spectrum concept in mood at the phenotypic level. The spectrum concept is more supported by evidence and further examination driven by both unconfined clinical observations and biological anchor points and markers to scientifically examine the zones of rarity and boundaries between disorders. This would be more fruitful than the arbitrary DSM number of criteria or episode durations and the artificial separation of manic-depressive illness.

The genealogy of major depression: symptoms and signs of melancholia from 1880 to 1900.

How deep are the historical roots of our concept of major depression (MD)? I showed previously that psychiatric textbooks published in 1900-1960 commonly described 18 characteristic depressive symptoms/signs that substantially but incompletely overlapped with the current DSM (Diagnostic and Statistical Manual of Mental Disorders) MD criteria. I here expand that inquiry to the key years of 1880-1900 during which our major diagnostic categories of manic-depressive illness (MDI) and dementia praecox were developed. I review the symptoms of depression/melancholia in 28 psychiatric textbooks and 8 other relevant documents from this period including monographs, reviews and the first portrayal of melancholia Kraepelin in 1883. Descriptions of melancholia in the late nineteenth and twentieth century textbooks closely resembled each other, both reporting a mean of 12.4 characteristic symptoms, and emphasizing core features of mood change and alterations in cognitive content and psychomotor behavior. The detailed monographs, reviews and the early description of Kraepelin were more thorough, reporting a mean of 16.6 of these characteristic symptoms. These nineteenth century texts often contained phenomenologically rich descriptions of changes in mood and cognition, loss of interest and anhedonia and emphasized several features not in DSM including changes in volition/motivation, posture/facial expression and derealization/depersonalization. In the early nineteenth century, melancholia was often defined primarily by delusions or as the initial phase of a unitary psychosis transitioning to mania and then dementia. By 1880, the concept of depression as an independent mood disorder with characteristic symptoms/signs and a good prognosis had stabilized. Kraepelin incorporated this syndrome into his diagnostic concept of MDI, changing its name to 'Depressive States', but did not alter its underlying nature or clinical description.

Neurociencia española en tiempos de Don Quijote (I) / Spanish neuroscience in times of Don Quixote

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Use of cortical stimulation in neuropathic pain, tinnitus, depression, and movement disorders.

Medical treatment must strike a balance between benefit and risk. As the field of neuromodulation develops, decreased invasiveness, in combination with maintenance of efficacy, has become a goal. We provide a review of the history of cortical stimulation from its origins to the current state. The first part discusses neuropathic pain and the nonpharmacological treatment options used. The second part covers transitions to tinnitus, believed by many to be another deafferentation disorder, its classification, and treatment. The third part focuses on major depression. The fourth section concludes with the discussion of the use of cortical stimulation in movement disorders. Each part discusses the development of the field, describes the current care protocols, and suggests future avenues for research needed to advance neuromodulation.

Illness narrative, depression, and sainthood: an analysis of the writings of Mother Teresa.

In 2007, the letters of The Blessed Mother Teresa to her confessors were published for the public in a book entitled Come Be My Light. What surprised many readers was that Mother Teresa felt very distant from God and described feeling great "darkness" for many years. This paper draws parallels between the writings of Mother Teresa and those of writers' illness narratives describing the psychiatric condition of Depression. The author provides this textual analysis to explore Mother Teresa's experience within a psychiatric paradigm (Major Depressive Disorder), in comparison with and contrast to the spiritual paradigm of a "Dark Night of the Soul."

[From shock therapies to new neuromodulation techniques]. / Des thérapies de choc aux nouvelles techniques de neuromodulation.

The first shock therapies date back to 1933 with the Sakel therapy. Electric induction experiments led to electroconvulsive therapy first used by Ugo Cerletti and Lucio Bini in 1938. Today, transcranial magnetic stimulation offers new therapeutic perspectives for the treatment of mental disorders. Similarly, deep brain stimulation techniques have been developed for the treatment of compulsive obsessive disorders and severe and treatment-resistant depression.

Geriatric psychopharmacology: evolution of a discipline.

The development of geriatric psychopharmacology was built on advances in geriatric psychiatry nosology and clinical pharmacology and on increased investment in aging research by the National Institute of Mental Health and by academic institutions. Application of the US Food and Drug Administration's geriatric labeling rule provided further impetus. Developments in the knowledge about 3 principal classes of medications (antidepressants, antipsychotics, and treatments for Alzheimer's disease) illustrate the trajectory of geriatric psychopharmacology research. Nonetheless, the loss of information about age effects that has resulted from applying age exclusion criteria in studies limited to either younger adults or geriatric patients is regrettable. Antidepressant trials have moved from studying younger and medically well "geriatric" samples to focusing on "older old" persons and those with significant medical comorbidity including coronary artery disease, cerebrovascular disease, and dementia. Increased specificity is reflected in studies of relationships between specific neuropsychological deficits, specific brain abnormalities, and antidepressant responsiveness. Clinical trials in older adults have demonstrated that the efficacy of antipsychotic medications continues across the lifespan, but that sensitivity to specific side effects changes in older age, with poor tolerability frequently mitigating the benefits of treatment. Treatments for Alzheimer's disease have fallen within the purview of geriatric psychopharmacology. The research focus is increasingly shifting from treatments to slow the course of cognitive decline to studies of early diagnosis and of interventions designed to prevent the development of deficits in vulnerable individuals. The importance of geriatric psychopharmacology will grow further as the average lifespan increases all over the world.

[Rudolph, crown-prince: the myth of a lost illusion]. / Rudolf trónörökös: egy elveszett illúzió mítosza.

The personality of Rudolf, the crown prince of Austria-Hungary evokes considerable interest even generations later. He had a charismatic and contradictory character that raised many hopes which he was not able to fulfill. His traumatic upbringing, the unhappy union of his parents and his mother's life-long depression all had a severe and damaging impact on him. Furthermore, his father's missing acknowledgement, Rudolf's own troubled marriage, his social isolation, alcoholism and morphine addiction along with his own depression and multiple physical illnesses have all contributed to the vulnerability of his personality. The author analyzes the developments that led to Rudolf s suicide in Mayerling and the impact of his life and death on the later myths about him.

Gender, age, and diagnosis: the rise and fall of involutional melancholia in American psychiatry, 1900-1980.

Between 1900 and 1980, American psychiatrists employed a diagnosis of involutional melancholia to characterize older individuals, primarily postmenopausal women, who had constellations of depressive symptoms and specific personality traits. American interest in this diagnosis represented a confluence of social and psychoanalytic assumptions about gender, increased interest in old age, and the development of somatic therapies by the middle of the century. In the decades after the introduction of psychiatric medications, however, involutional melancholia lost its significance as a specific disease and was absorbed into the broader category of major depressive disorder.

The impairment of Presidents Pierce and Coolidge after traumatic bereavement.

The impact of bereavement in heads of government has been little studied. Two US presidents lost their teenaged sons in a traumatic manner, leaving them profoundly affected as they struggled to serve in office. We describe the bereavements of Presidents Franklin Pierce and Calvin Coolidge, using biographical and source material. Pierce and Coolidge were adversely affected by their bereavements, which almost certainly rendered them less effective in the discharge of their duties. The loss of their sons had a devastating effect on both men and deprived their presidential service of significant personal meaning. Lincoln's resilience in similar circumstances offers a contrasting perspective, however. We conclude that the psychiatric consequences of losing a child can adversely affect heads of government, may cause clinically significant distress, altered behavior, and reduced ability to provide effective leadership.

[Masked depression--history and present days]. / Depresja maskowana--historia i wspólczesnosc.

Masked depression is a special form of an atypical depression. In the 70's and 80's years it was often identified at patients who complained on somatic diseases, without any distinguishable organic disorder. Depression symptoms were of secondary importance, with lesser intensification, some of them didn't appear at all. The psychiatrists of the time created a lot of terms to describe them, i.e.: a depression equivalent, a vegetative equivalent, a depression without a depression, a hidden depression. Current classifications: ICD-10 (International Classification of Diseases, 10th Revision) and DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, published by the American Psychiatric Association) do not contain the term masked depression. It doesn't mean that have disappeared the problem of atypical depression syndrome with a picture significantly different from the commonly known. The american scientists claim that such group contains 6-7% of depression disorders. The lack of proper diagnosis and disease entity qualification leads to serious somatic and psychological consequences for patients. Improper diagnosis and treatment of a patient limits his or her social and professional life, forms suicide rate and makes high costs of diagnosis and treatment.

'Interrupted by fits of weeping': Cicero's major depressive disorder and the death of Tullia.

The letters of Marcus Tullius Cicero (106-43 Bc), the Roman statesman, lawyer, orator and author, were analysed as part of a larger study that systematically examined ancient Greek and Roman literature to recover descriptions of mental illness. A degree of necessary caution was exercised, but the wealth of material revealed in the letters about Cicero's physical and emotional state enable a diagnosis of Major Depressive Disorder to be made with some certainty according to the DSM-IV-TR. Cicero appears to have experienced increasingly severe bouts of suicidal depression that seriously impaired his relationships with his friends, family and political colleagues, and possibly shortened his life. His last depressive episode following the death of his daughter Tullia is addressed here in some detail.

Autopathography and depression: describing the 'despair beyond despair'.

The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, emphasizes diagnosis and statistically significant commonalities in mental disorders. As stated in the Introduction, "[i]t must be admitted that no definition adequately specifies precise boundaries for the concept of 'mental disorder' " (DSM-IV, 1994, xxi). Further, "[t]he clinician using DSM-IV should ... consider that individuals sharing a diagnosis are likely to be heterogeneous, even in regard to the defining features of the diagnosis, and that boundary cases will be difficult to diagnose in any but a probabilistic fashion" (DSM-IV, 1994, xxii). This article proposes that it may be helpful for clinicians to study narratives of illness which emphasize this heterogeneity over statistically significant symptoms. This paper examines the recorded experiences of unusually articulate sufferers of the disorder classified as Major Depression. Although sharing a diagnosis, Hemingway, Fitzgerald, and Styron demonstrated different understandings of their illness and its symptoms and experienced different resolutions, which may have had something to do with the differing meanings they made of it. I have proposed a word, autopathography, to describe a type of literature in which the author's illness is the primary lens through which the narrative is filtered. This word is an augmentation of an existing word, pathography, which The Oxford English Dictionary, Second Edition, defines as "a) [t]he, or a, description of a disease," and "b) [t]he, or a, study of the life and character of an individual or community as influenced by a disease." The second definition is the one that I find relevant and which I feel may be helpful to clinicians in broadening their understanding of the patient's experience.