scholarly journals The symptom of depression in schizophrenia and its management

2000 ◽  
Vol 6 (3) ◽  
pp. 169-177 ◽  
Author(s):  
Ciaran Mulholland ◽  
Stephen Cooper
Keyword(s):  
Depressive Illness ◽  
Dementia Praecox ◽  
Important Criterion ◽  
Manic Depressive Illness ◽  
The Core ◽  
Manic Depressive ◽  
Affective Symptoms ◽  
Psychological Reaction ◽  
Depressive Subtypes ◽  
Core Symptoms

Depression is a frequently occurring symptom in schizophrenia. While today it is often underrecognised and under-treated, historically such symptoms were the focus of much attention. Affective symptoms were used by Kraepelin as an important criterion with which to separate dementia praecox from manic–depressive illness. Kraepelin also recognised the importance of depression as a symptom in schizophrenia and identified several depressive subtypes of the illness. Mayer-Gross emphasised the despair that often occurs as a psychological reaction to acute psychotic episodes and Bleuler considered depression to be one of the core symptoms of schizophrenia.

Historical Insights in Psychopharmacology

2018 ◽  
pp. 508-511
Author(s):  
S. Nassir Ghaemi
Keyword(s):  
20Th Century ◽  
Psychiatric Illness ◽  
Depressive Illness ◽  
Psychotropic Medications ◽  
Dementia Praecox ◽  
Manic Depressive Illness ◽  
Relevant Today ◽  
Manic Depressive ◽  
Basic Distinction ◽  
Psychiatric Conditions

The writings of two classic thinkers in psychiatry in the 19th and 20th centuries, Emil Kraepelin and Aubrey Lewis, are provided and examined for insights they provided into continuing problems in the diagnostic and treatment of psychiatric conditions today. Kraepelin was the famed great late 19th-century psychiatric leader from Germany who identified the basic distinction between schizophrenia (dementia praecox) and manic-depressive illness. He laid the foundations of much of psychiatric diagnosis that remains relevant today, and he was a committed defender of the biological approach to psychiatry, although he was conservative with the use of drugs, which were ineffective in his day. Lewis (1900–1975) was the most prominent figure in British psychiatry through most of the 20th century. He was the leader of the Institute of Psychiatry at the Maudsley Hospital for much of the middle of the 20th century. That institution in London was the most influential educational center for psychiatry in the nation. Through his leadership there, Lewis was extremely influential. He tended to be skeptical about the use of psychotropic medications, and emphasized social aspects of psychiatric illness.

Sous-groupes dans le domaine des états-limites

1982 ◽  
Vol 27 (5) ◽  
pp. 390-396
Author(s):  
Michael H. Stone
Keyword(s):  
Early Life ◽  
Antidepressant Medication ◽  
Depressive Illness ◽  
Clinical Syndrome ◽  
Manic Depressive Illness ◽  
Manic Depressive ◽  
Affective Symptoms ◽  
Borderline Patients ◽  
Broad Domain ◽  
Dexamethasone Suppression

The currently most popular definitions of “borderline” are those of Kernberg, Gunderson and Spitzer (now incorporated into the DSM-III). The Kernberg criteria define a level of function (between “Neurotic” and “Psychotic”); the Gunderson criteria, a more narrowly circumscribed clinical syndrome, phenomenologically distinct from schizophrenia and from the psychoneuroses. The DSM-III criteria are derived from these and other sources and define a broad domain that includes the other usages of “borderline.” Even the narrower definitions of borderline describe a collection of conditions heterogeneous with respect to hereditary, constitutional and psychosocial factors. Genetic, biochemical and clinical research suggests the appropriateness of dividing the borderline domain into a variety of sub-types. The largest proportion of borderline cases are effective (with prominent depressive symptoms; occasionally, with cyclothymic or hypomanic symptoms). Of these, some show strong “endogenous” features, as well as family pedigrees of manic-depressive illness. This category includes many patients with anorexia nervosa or with agoraphobia. In others, the affective symptoms seem more related to severe psychosocial stresses in early life (including physical abuse, parental deprivation, or incest). Smaller proportions within the borderline domain are occupied by schizotypal cases (many with hereditary linkage to core schizophrenia), or by organic cases (including temporal lobe epilepsy, or minimal brain damage, giving rise to the “episodic dyscontrol” syndrome). Biochemical and nerophysiological markers that may be useful in distinguishing among the borderline subtypes include measure of platelet MA O-activity, of dexamethasone suppression, of R.E.M. latency, motion-sickness susceptibility and of average evoked response to photic stimulation. Attention to subtypes is important in considering optimal treatment for borderline patients. Not all respond to analytically-oriented psychotherapy alone. Those with severe affective symptoms often require antidepressant medication or lithium. Affectively ill borderlines usually have a better prognosis than schizotypals. In cases of episodic dyscontrol, anti-epileptic drugs may be useful.

Neuropsychological Function in Manic-Depressive Psychosis Evidence for Persistent Deficits in Patients with Chronic, Severe Illness

1995 ◽  
Vol 167 (1) ◽  
pp. 51-57 ◽  
Author(s):  
A. P. McKay ◽  
A. F. Tarbuck ◽  
J. Shapleske ◽  
P. J. McKenna
Keyword(s):  
Young Patients ◽  
Poor Performance ◽  
Depressive Illness ◽  
Neuropsychological Deficits ◽  
Severe Illness ◽  
Manic Depressive Illness ◽  
Manic Depressive Psychosis ◽  
Manic Depressive ◽  
Affective Symptoms ◽  
Neuropsychological Investigation

BackgroundWhile neuropsychological deficits are recognised to occur in manic-depressive psychosis during episodes of depression and to reverse with clinical recovery, it is uncertain whether they can ever be seen outside episodes of illness.MethodForty-five patients meeting DSM–III–R criteria for major depression or bipolar disorder were screened using tests of memory, executive function and overall intellectual function. All testing was carried out during remission of affective symptoms.ResultsNone of 24 young patients and 11 elderly patients scored in the impaired range on any of the tests. However, five of ten patients with chronic, severe affective disorder were impaired on one or more of the measures. On more detailed neuropsychological investigation, these five patients were found to show a variable pattern of impairment, ranging from memory and executive deficits in relative isolation, to widespread poor performance.ConclusionsEnduring neuropsychological deficits may be a feature of chronic, severe manic-depressive illness.

Reducing American Diagnosis of Schizophrenia: Will the DSM III Suffice?

1983 ◽  
Vol 142 (4) ◽  
pp. 414-418 ◽  
Author(s):  
Sukdeb Mukherjee
Keyword(s):  
Depressive Illness ◽  
Turn Of The Century ◽  
Dementia Praecox ◽  
Manic Depressive Illness ◽  
Fundamental Feature ◽  
Associative Processes ◽  
Clinical Observations ◽  
Manic Depressive ◽  
American Psychiatry

At the turn of the century Kraepelin brought together the disparate syndromes of hebephrenia, dementia paranoides, and catatonia under the rubric of dementia praecox. At the same time he crystallized the concept of manic-depressive illness as an entity discrete and separate from the former syndrome. In the years since Kraepelin's classification first came to be adopted, the definitions and descriptions of these two major disorders have undergone many changes. In an attempt to comprehend the meaning and the mechanism of the psychoses, Bleuler was drawn by the emergent theories of psychoanalysis to extend Kraepelin's clinical observations into the realm of psychology. He renamed dementia praecox the schizophrenias, thus emphasizing his idea that the splitting of associative processes was a fundamental feature of the syndrome; and he added the subcategory of simple schizophrenia. American psychiatry, dominated until recently by psychoanalytic concepts, has been influenced more by Bleulerian than Kraepelinian contributions. However, it has not restricted itself to Bleulerian notions. As Kety (1980) remarked in his Maudsley Lecture, great liberties have been taken with the syndrome of schizophrenia; the essential features have been altered, primarily by an expansion of its boundaries.

scholarly journals Understanding of “Feeling” and “Self-Consciousness” on the Border of the XIX–XX Centuries and M. Loewy’s Concept of Depersonalization

Psychiatry ◽  
2021 ◽  
Vol 19 (2) ◽  
pp. 104-115
Author(s):  
N. Yu. Pyatnitskiy
Keyword(s):  
Emotional Disturbance ◽  
Female Student ◽  
Depressive Illness ◽  
Affective States ◽  
Manic Depressive Illness ◽  
The Core ◽  
Manic Depressive ◽  
Process Thinking ◽  
Clinical Description ◽  
Mental Acts

The aim was to review the understanding of the phenomena of “feeling” and “self-consciousness” in the concepts of the leading European scientists at the second half of XIX — beginning of the XX centuries.Method: H.R. Lotze, I.M. Sechenov, A. Bain, W. Wundt, G. Stoerring, Th. Lipps, K. Oesterreich, E. Kraepelin and some others are analyzed.Conclusion: while Th. Lipps, H.R. Lotze, W. Wundt and K. Oesterreich were striving for strict differentiation of the notions of “sensations” and “feelings”, A. Bain, I.M. Sechenov, G. Stoerring were not following an effi cient distinction of these phenomena. H.R. Lotze, I.M. Sechenov, A. Bain distinguished in the consciousness and self-consciousness the affective and intellectual components; Th. Lipps considered as the core of self-consciousness the feelings that were very manifold and accompanied different mental acts including the act of perception: “perceptions feeling”. G. Stoerring paid attention to the lack of the feeling of activity by depersonalization, and the Austrian psychiatrist and neurologist M. Loewy elaborated the concept of “ubiquitous” “action feelings” (Actionsgefuehle) that exist outside of “pleasure — displeasure” modality. According to M. Loewy’s concept every mental act is accompanied normally by two “feelings of act”: general and specifi c, in the abnormal case one or both of them may disappear. The clinical description of weakening or loss of the action feelings: impulse feeling, perception feeling of vital sensation, perception feelings of sensations from organs of sense, “feelings of the feeling process”, “thinking feeling”, M. Loewy accomplished by “personalizing” approach to the account of one of his patient, Russian female student. M. Loewy considered the depersonalization disorders in this case as a symbolic neurosis according to S. Freud and as a psychasthenia according to P. Janet. Although E. Kraepelin defi ned selfconsciousness as merely cognitive phenomenon he interpreted depersonalization as a kind of emotional disturbance including the disorders on the level of sensations in the frames of light depressive phase of the manic-depressive illness. The M. Loewy’s concept of the “action feelings” can be applied not only for the understanding of “neurotic” depersonalization but also for depersonalization cases on the ground of depressive and mixed phase affective states.

Diagnosis, classification, and differential diagnosis of mood disorders

2020 ◽  
pp. 681-690
Author(s):  
S. Nassir Ghaemi ◽  
Sivan Mauer
Keyword(s):  
Differential Diagnosis ◽  
Scientific Evidence ◽  
Unipolar Depression ◽  
Depressive Illness ◽  
Manic Depressive Illness ◽  
Bipolar Illness ◽  
Manic Symptoms ◽  
Manic Depressive ◽  
Biological Aspects ◽  
Depressive Subtypes

This chapter discusses DSM and non-DSM definitions and approaches to mood illness. Before 1980, the concept of manic–depressive illness (MDI) meant both bipolar illness and recurrent unipolar depression. Evidence on diagnostic validators since 1980 has not strengthened that claim and may be interpreted to support the original MDI concept, that is, that bipolar illness and unipolar depression are part of the same overall disease (MDI). As a corollary, the concept of major depressive disorder (MDD) may represent a spectrum of different depressive subtypes: mixed (depression with manic symptoms), melancholic, pure, vascular, and neurotic depression. Each subtype differs from the other, based on diagnostic validators of course, genetics, and biological aspects and/or treatment effects. The scientific evidence for this heterogeneity of MDD appears to weaken the claim dating to DSM-III in 1980 that this condition is a different diagnosis/illness from bipolar disorder. The differential diagnosis of mood conditions is described.

scholarly journals T93. RESHAPING THE DIAGNOSTIC BORDERS OF SCHIZOPHRENIA: THE LOOK OF HISTORY OF PSYCHIATRIC PRACTICES

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S267-S267
Author(s):  
Julie Clauss ◽  
Anne Danion-Grilliat ◽  
Marianna Scarfone ◽  
Volker Hess ◽  
Christian Bonah
Keyword(s):  
Depressive Illness ◽  
Qualitative Approach ◽  
Psychiatric Clinic ◽  
Dementia Praecox ◽  
Manic Depressive Illness ◽  
Essential Point ◽  
Diagnostic Practices ◽  
Manic Depressive ◽  
History Of ◽  
The Impact

Abstract Background The diagnostic concept of Schizophrenia as defined by DSM and ICD is increasingly being questioned. It is criticized above all for its lack of validity. It refers to very heterogeneous disorders in terms of signs and symptoms but also in terms of evolution and heritability. Clinicians and researchers are therefore considering how to rethink this concept, in the absence of known physiopathological mechanisms and etiology, by integrating various advances in fields such as genetics, molecular biology, brain imaging and cognitive sciences. However, the renewal of the concept of schizophrenia has yet to be explored in terms of its potential impact on psychiatric practice. It is an essential point because this diagnostic concept does not correspond to a theoretical entity that exists for itself but it is a tool of psychiatrists’ daily practice when they seek to name the disorders presented by a patient. Thus, a renewal of the concept of schizophrenia would necessarily have an impact on the diagnoses made by psychiatrists and we know how important the diagnosis in psychiatry is: for the medical care but also for the personal history of the patient. This impact that a renewal of the concept of schizophrenia could have on the diagnostic practices of psychiatrists can be better understood through the analysis of a historical example: the introduction of the concept of Schizophrenia at the Psychiatric Clinic of Strasbourg in France during the period 1920–1930. The concept of Schizophrenia was first discussed in 1908 by the swiss psychiatrist Eugen Bleuler at the Annual Meeting of the German Psychiatric Association in Berlin. At the Psychiatric Clinic of Strasbourg, it was first used by psychiatrists in 1922. How did this then new concept find its place among the other diagnostic concepts that had been used until then in this institution? Methods In an attempt to answer this question, we implemented a methodology that combined a quantitative and a qualitative approach. The first is a retrospective descriptive statistical study whose objective is to establish the evolution of the proportion of the different diagnoses made at the Psychiatric Clinic of Strasbourg during the period 1920–1930. This study includes all hospitalized patients and uses admission records for data collection. This quantitative approach was complemented by a qualitative approach that consists in reconstructing the diagnostic trajectory of some patients with a diagnosis of schizophrenia after the period of introduction of this concept. The diagnoses made during their previous hospitalizations were systematically collected and analyzed, this time using the medical records of these patients as sources. Results The diagnostic concept of Schizophrenia seems to have replaced the one of Dementia praecox within the diagnostic practices: the latter was given extensively in 1924, but hardly any longer in 1928. However, in the same period of time, other diagnostic concepts of the field of psychosis like Manic-depressive Illness were less commonly used while others like Catatonia were increasingly employed. The reconstruction of patients’ diagnostic trajectories tends to show that the diagnostic of schizophrenia would have taken over from the diagnostic of Dementia Praecox but also from some of the diagnoses of Manic-depressive Illness, Hebephrenia and Psychopathy. Discussion This historical perspective makes it possible to understand the impact on psychiatrist’s diagnostic practices of a “nosological innovation” that is theoretical, such as the renewal of the concept of schizophrenia could be. In the diagnostic practices, one diagnostic concept would not simply replace another, but it’s introduction could induce a broader reshaping of diagnostic mapping.

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