Thursday, 25.02.2021

Carl Lange: On periodical depressions and their pathogenesis.
Speech delivered to the Medical Society of Copenhagen, 19 January 1886*

 
Hector Warnes’ comment

 

            Thank you for posting Carl Lange's presentation on Periodical depression. It was given in 1886, long after Jean-Pierre Falret (1854; Pichot 2004)  described la folie circulaire in which he noted that the patient had  periods of mania and periods of depression with "a lucid interval”; much later, in nearly 1900, Kraepelin renamed it. 

            With a brilliant clinical acumen Lange described what appeared to be a unipolar depression often in its mitis (mild) appearance. We know that many bipolar disorder patients do not show the full-blown symptomatology and are even able "to weather" their symptoms quite well without requiring treatment. Some even are in psychoanalytic treatment for many years and are treated like neurotics or, as Hagop Akiskal likes to call them, "subaffective variants of mood disorders" (Akiskal 1996)  It also reminded me of Lindemann's  (1944) description of pathological grief and anniversary reactions; of recurrent chronic fatigue syndrome (at time linked to immunological dysfunction and viral infections); auto-immune disorders which often follow a cyclical course; Hashimoto's thyroiditis; and so on.  It is amazing how many medical, neurological and psychiatric illnesses follow a cyclical course independent of the treatment they receive.  I would love the opinion of Jules Angst who wrote quite a bit on the history of the bipolar disorder.

 

References:

Akiskal HS. The temperamental foundations of affective disorders. London: Gaskell. 1996.

Falret J-P. Mémoire sur la folie circulaire. Bulletin de l'Académie Imperiale de Médecine. 1854; 19: 382–400.

Lindemann E. Symptomatology and Management of acute Grief. Amer J of Psychiat 1944; 101: 141-9.

Pichot P. Circular insanity, 150 years on. Bull Acad Natl Med. 2004; 188:275-84. [In French].

 

*Translated by John Schioldann

 

March 28, 2019