The Treatment of the Special Forms of Mental Disease
Francis X. Dercum in Rest, Suggestion, 2019
Chloral is a poison depressant to the heart and vasomotor apparatus. Dyspnea, vertigo, and general sense of weakness are among the symptoms likely to be present. In well-established cases there are marked nervousness, marked insomnia, and a certain degree of mental weakness, as manifested by loss of will-power and failure of memory. In some cases an emotional depression is present which may simulate melancholia. The patient is weak, his movements are tremulous, and he frequently complains of palpitation of the heart. These symptoms must be combated by food, by rest and by other physiologic measures, and by tonics, such as digitalis, strophanthus, and strychnin. When the habit has been long continued and the doses large, the patient occasionally suffers from attacks of delirium closely resembling delirium tremens. Chloral, it should be added, has been so largely displaced by other hypnotics that chloralism is at present a very infrequent condition.
Psychiatric Diagnosis: The State of the Art
Mark S. Gold, R. Bruce Lydiard, John S. Carman in Advances in Psychopharmacology: Predicting and Improving Treatment Response, 2018
There is an additional requirement in DSM III that three of a group of other behavioral disturbances also be present. (See Table 7). The choice of those specific characteristics remains a controversial area. In a thorough review of a variety of methodological approaches, Nelson and Charny32 conclude there is consistent support for the following symptoms as associated with melancholic depression: distinct quality of depressed mood, diurnal variation with worsening in the morning, psychomotor change, and inappropriate or excessive guilt. A surprising finding was lack of discriminating significance for changes in sleep, appetite, and weight. These latter three features had long been held to be vegetative disturbances in autonomous depression, and are included in the DSM III melancholia criteria. Their more recent review34 suggests that severity of depression, loss of interest, and decreased concentration should be substituted as features in future categorizations, and sleep and eating disturbances be omitted.
Classification, explanation and experience
Ulrike Steinert in Systems of Classification in Premodern Medical Cultures, 2020
Do we see here an interaction between traditional or popular disease concepts and the schematisations of doctors – or perhaps rather the traces of a traditional or popular concept which is developed in different ways in different technical (and semi-technical) authors? It is perhaps tempting, albeit with insufficient evidence, to think so. What is clear is that by the time of the first/second century CE, melancholia has acquired some kind of distinct status, and is associated with a somewhat complex and sometimes contradictory set of symptoms. Clear, too, that both medical and other authors, while having recourse to the single, overarching concept of melancholia, at the same time employ that concept in complex and differentiated ways, identifying types or varieties within it, in an attempt to explain a challenging range of patient experiences and symptoms.
“I’d Have Divorced My Husband If Not for Korean Dramas” – Vietnamese Women’s Consumption of Television Romance and Melancholia
Published in Studies in Gender and Sexuality, 2022
Most academic discussions concerning Sigmund Freud’s notion of melancholia focus on his 1917 groundbreaking essay “Mourning and Melancholia.” According to Freud, melancholia is a form of prolonged depression that derives from unmourned loss. Addressing melancholia and mourning as correlated forms of grief with some similar depressive traits, Freud draws the distinction between the two psychic phenomena. He sees mourning as a painful yet necessary process that allows individuals to let go of a loved object. This mourning comes to a conclusion with the libido being withdrawn and detached from the lost loved object (Freud, 1917). In contrast, Freud views melancholia as an ongoing process that may remain unresolved due to patients’ unawareness or inadequate awareness of their loss. This lack of awareness differentiates melancholia distinctly from mourning, in which patients tend to be very conscious of the loss (Freud, 1917).
Routinely accessible parameters of mineralocorticoid receptor function, depression subtypes and response prediction: a post-hoc analysis from the early medication change trial in major depressive disorder
Published in The World Journal of Biological Psychiatry, 2022
Jan Engelmann, Harald Murck, Stefanie Wagner, Lea Zillich, Fabian Streit, David P. Herzog, Dieter F. Braus, Andre Tadic, Klaus Lieb, Marianne B. Műller
The socio-demographic and clinical characteristics of patients were assessed relying on patients´ self-reports. Depression severity was assessed by the Hamilton Depression Rating Scale (HAMD17; Hamilton 1960) and the Inventory of Depressive Symptoms (interview [IDS-C30]; self-rating [IDS-SR30]) (Rush et al. 2000) in weekly intervals from baseline to week 8 by trained and blinded raters (Wagner et al. 2011). Melancholic depression was assessed by the German version of the M.I.N.I. International Neuropsychiatric Interview (MINI, Sheehan et al. 1998). Melancholic depression is characterised by loss of interest, bad mood, daily fluctuation of mood, waking up too early, feeling restless, and a negative view of the patient´s self. The atypical depression, assessed by the IDS clinician rating, exhibits symptoms like increased appetite, increased weight, extended sleep duration, loss of physical energy, increased interpersonal sensitivity and maintained mood responsiveness. Anxious depression was assessed by the HAMD17 single items: feeling anxious or tense, panic/phobic symptoms, bodily symptoms, constipation/diarrheal and hypochondriasis (Baumeister and Parker 2012).
Melancholia: does this ancient concept have contemporary utility?
Published in International Review of Psychiatry, 2020
Gabriele Sani, Leonardo Tondo, Juan Undurraga, Gustavo H. Vázquez, Paola Salvatore, Ross J. Baldessarini
Since 1980, many efforts have been made to develop a more coherent and clinically useful scheme for conceptualizing and diagnosing anticipated subgroups within the broad MDD category. Hoped-for clinical utility would include both more reliable and scientifically plausible diagnostic schemes, improved prognosis, or clinical prediction of the likely future course of depressive illness, as well as improved prediction of treatment response and more reliable selection of specific treatments. A proposed contribution to these important efforts has been to revisit the old concept of melancholia, as a particularly distinct and readily recognizable form of severe depression, and possibly a separate syndrome with a unique pathophysiology and predictable responses to particular treatments (Taylor & Fink, 2006). The present discussion addresses the evolution and current status of the concept of melancholia.
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