Thomas A. Ban

Emil Kraepelin’s (1899) “manic-depressive (melancholic) psychosis” was derived by separating patients on the basis of the ”course”  and the ”outcome” of their clinical manifestations. It included all episodic psychoses with full remission between episodes, regardless whether the episodes included both “manic” and “depressive (melancholic)” syndromes, or were exclusively “manic”, “melancholic” or “mixed”.

The clinical features of both, the manic syndrome and the melancholic syndrome were based originally on the information Kraepelin (1899, 1913) collected on his “counting cards” (Zählenkarten), a symptom check list that included only ten items: nervousness, restlessness, irritability, depression, psychomotor retardation, aggression, grandiosity, negativistic behavior, hallucinations and paranoid ideas (Bech 2012; Kraepelin 1908-15; Weber and Engstrom1997). Yet, as time passed the symptoms of the core syndromes were crystallized and by the 1960s, those operating within the frame of reference of Kraepelin’s (1899) “nosology”, defined the “manic syndrome” as “hyperthymia” (elevated mood)  with “acceleration of mental (including psychomotor) activity” and  “sleep disturbance”, and the “melancholic syndrome” as  “dysthymia” (depressed mood) with “deceleration (slowing) of mental  (including psychomotor) activity”, and “sleep disturbance”. Furthermore, in recognition of the variations of clinical (psychopathological) manifestations in both syndromes, several “manic syndromes” and several “melancholic syndromes” were identified. The manic syndromes included “anxious mania”, “delirious mania”, “dysphoric mania”, “furious mania”, “hypochondriacal mania”, “querulous  mania”, “simple mania”, “stuporous mania”, “transitory mania” and “unproductive mania; and the melancholic syndromes included “anxious melancholia”, “agitated melancholia”, “hypochondriacal melancholia”, “simple melancholia” and “stuporous melancholia” (Nyiro 1962).

References:

Bech P. Clinical Psychometrics. Copenhagen: Willey-Blackwell; 2012

Kraepelin E. Psychiatrie. Ein Lehrbuch fuer Studierende und Aerzte. 8 Aufl. Leipzig: Barth; 1908-1915.

Kraepelin E. Psychiatrie. Ein Lehrbuch fuer Studierende und Aerzte. 8 Aufl. Leipzig: Barth; 1913.

Nyiro Gy. Psychiatria. Budapset:medicina; 1962.

Weber MM, Engstrom EJ. Kraepelin;s diagnostic cards; the confluence of clinical research and preconceived categories. History of Psychiatry 1997; 8: 375-85.

Thomas A. Ban
November 12, 2015