Bipolar disorder historical perspective: Difference between revisions
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* The connection between mania and melancholia dates back to the 2nd Century CE. | * The connection between mania and melancholia dates back to the 2nd Century CE. | ||
** Soranus of Ephesus (98-177 CE), a Greek physician, characterized mania and melancholia as separate illnesses. | ** Soranus of Ephesus (98-177 CE), a Greek physician, characterized mania and melancholia as separate illnesses. | ||
* German [[psychiatrist]] [[Emil Kraepelin]] ([[1856]]-[[1926]]) examined and classified the natural course of untreated bipolar | * German [[psychiatrist]] [[Emil Kraepelin]] ([[1856]]-[[1926]]) examined and classified the natural course of patients with untreated bipolar disorder years prior to the discovery of [[mood stabilizer]]s. | ||
** In 1902, Kraepelin created the term ''manic depressive psychosis'' to describe these patients. | ** In 1902, Kraepelin created the term ''manic depressive psychosis'' to describe these patients. | ||
* In 1957, Karl Leonhard, a German psychiatrist, coined the terms ''bipolar'' and ''unipolar'' to describe subclassifications of manic depressive psychosis (bipolar disorder). | * In 1957, Karl Leonhard, a German psychiatrist, coined the terms ''bipolar'' and ''unipolar'' to describe subclassifications of manic depressive psychosis (bipolar disorder). | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
- The connection between mania and melancholia dates back to the 2nd Century CE.
- Soranus of Ephesus (98-177 CE), a Greek physician, characterized mania and melancholia as separate illnesses.
- German psychiatrist Emil Kraepelin (1856-1926) examined and classified the natural course of patients with untreated bipolar disorder years prior to the discovery of mood stabilizers.
- In 1902, Kraepelin created the term manic depressive psychosis to describe these patients.
- In 1957, Karl Leonhard, a German psychiatrist, coined the terms bipolar and unipolar to describe subclassifications of manic depressive psychosis (bipolar disorder).
- Bipolar was used to describe cases with manic episodes.
- Unipolar was used to describe cases characterized by the presence of depressive episodes and the lack of manic episodes.
Historical Perspective
Varying moods and energy levels have been a part of the human experience since time immemorial. The words "melancholia" (an old word for depression) and "mania" have their etymologies in Ancient Greek. The word melancholia is derived from melas/μελας, meaning "black," and chole/χολη, meaning "bile" or "gall,"[1] indicative of the term’s origins in pre-Hippocratic humoral theories. Within the humoral theories, mania was viewed as arising from an excess of yellow bile, or a mixture of black and yellow bile. The linguistic origins of mania, however, are not so clear-cut. Several etymologies are proposed by the Roman physician Caelius Aurelianus, including the Greek word ania, meaning to produce great mental anguish, and manos, meaning relaxed or loose, which would contextually approximate to an excessive relaxing of the mind or soul (Angst and Marneros 2001). There are at least five other candidates, and part of the confusion surrounding the exact etymology of the word mania is its varied usage in the pre-Hippocratic poetry and mythologies (Angst and Marneros 2001).
The idea of a relationship between mania and melancholia can be traced back to at least the 2nd century AD.[2] Soranus of Ephesus (98-177 AD) described mania and melancholia as distinct diseases with separate etiologies [3]; however, he acknowledged that “many others consider melancholia a form of the disease of mania” (Cited in Mondimore 2005 p.49).
A clear understanding of bipolar disorder as a mental illness was recognized by early Chinese authors. The encyclopedist Gao Lian (c. 1583) describes the malady in his Eight Treatises on the Nurturing of Life (Ts'un-sheng pa-chien) [4]
The earliest written descriptions of a relationship between mania and melancholia are attributed to Aretaeus of Cappadocia. Aretaeus was an eclectic medical philosopher who lived in Alexandria somewhere between 30 and 150 AD (Roccatagliata 1986; Akiskal 1996). Aretaeus is recognized as having authored most of the surviving texts referring to a unified concept of manic-depressive illness, viewing both melancholia and mania as having a common origin in ‘black bile’ (Akiskal 1996; Marneros 2001).
The contemporary psychiatric conceptualization of manic-depressive illness is typically traced back to the 1850s. Marneros (2001) describes the concepts emerging out of this period as the “rebirth of bipolarity in the modern era.” On January 31, 1854, Jules Baillarger described to the French Imperial Academy of Medicine a biphasic mental illness causing recurrent oscillations between mania and depression. Two weeks later, on February 14, 1854, Jean-Pierre Falret presented a description to the Academy on what was essentially the same disorder. This illness was designated folie circulaire (‘circular insanity’) by Falret, and folie à double forme (‘dual-form insanity’) by Baillarger (Sedler 1983).
Emil Kraepelin (1856-1926), a German psychiatrist categorized and studied the natural course of untreated bipolar patients long before mood stabilizers were discovered. Describing these patients in 1902, he coined the term manic depressive psychosis. He noted in his patient observations that intervals of acute illness, manic or depressive, were generally punctuated by relatively symptom-free intervals in which the patient was able to function normally.[2]
After World War II, Dr. John Cade, an Australian psychiatrist, was investigating the effects of various compounds on veteran patients with manic depressive psychosis. In 1949 , Cade discovered that lithium carbonate could be used as a successful treatment of manic depressive psychosis.[3] Because there was a fear that table salt substitutes could lead to toxicity or death, Cade's findings did not immediately lead to treatments. In the 1950s, U.S. hospitals began experimenting with lithium on their patients. By the mid-'60s, reports started appearing in the medical literature regarding lithium's effectiveness. The U.S. Food and Drug Administration did not approve of lithium's use until 1970.[4]
The term "manic-depressive reaction" appeared in the first American Psychiatric Association Diagnostic Manual in 1952, influenced by the legacy of Adolf Meyer who had introduced the paradigm illness as a reaction of biogenetic factors to psychological and social influences.[5] Subclassification of bipolar disorder was first proposed by German psychiatrist Karl Leonhard in 1957; he was also the first to introduce the terms bipolar (for those with mania) and unipolar (for those with depressive episodes only).[6]
In 1968, both the newly revised classification systems ICD-8 and DSM-II termed the condition "manic-depressive illness" as biological thinking came to the fore.[7]
The current nosology, bipolar disorder, became popular only recently, and some individuals prefer the older term because it provides a better description of a continually changing, multidimensional illness.
References
- ↑ Liddell, Henry George and Robert Scott (1980). A Greek-English Lexicon (Abridged Edition). United Kingdom: Oxford University Press. ISBN 0-19-910207-4.
- ↑ Kraepelin, Emil (1921) Manic-depressive Insanity and Paranoia ISBN 0-405-07441-7
- ↑ Cade J. F. J. (1949). "Lithium salts in the treatment of psychotic excitement" (PDF). Medical Journal of Australia. 2: 349–352.
- ↑ P. B. Mitchell, D. Hadzi-Pavlovic (2000). "Lithium treatment for bipolar disorder" (PDF). Bulletin of the World Health Organization. 78 (4): 515–519.
- ↑ Goodwin & Jamison. p60-61
- ↑ Goodwin & Jamison. p62
- ↑ Goodwin & Jamison. p88