Download PDF by Edward Shorter, Max Fink: Endocrine Psychiatry: Solving the Riddle of Melancholia

By Edward Shorter, Max Fink

The riddle of melancholia has stumped generations of medical professionals. it's a severe depressive ailment that frequently ends up in suicide and untimely dying. The disease's hyperlink to biology has been intensively studied. in contrast to virtually the other psychiatric sickness, melancholia victims have irregular endocrine services. checks able to isolating melancholia from different temper issues have been worthwhile discoveries, yet those assessments fell into disuse as psychiatrists misplaced curiosity in biology and medication. within the 19th century, theories concerning the position of endocrine organs inspired endocrine remedies that loomed prominently in perform. This curiosity light within the Thirties yet was once revived via the invention of the adrenal hormone cortisol and outlines of its irregular functioning in melancholic and psychotic depressed sufferers. New endocrine exams have been devised to plumb the secrets and techniques of temper issues. colourful contributors, Bernard Carroll and Edward Sachar, led this revival and for a time within the Nineteen Sixties and Nineteen Seventies in depth learn curiosity verified connections among hormone dysfunctions and behaviour. within the Nineteen Eighties, psychiatrists misplaced curiosity in hormonal methods mostly simply because they didn't correlate with the arbitrary type of temper problems. at the present time the relation among endocrines and behaviour were ignored.

This heritage strains the passion of organic efforts to resolve the secret of melancholia and their fall. utilizing brilliant language obtainable to kinfolk care practitioners, psychiatrists and lay readers, the authors suggest worthy, a almost certainly live-saving connection among drugs and psychiatry, has been misplaced.

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41 The conclusions strike us today as rather self-evident, but they were reached in 1925 and then forgotten in the surge toward psychoanalysis. 42 Meduna applied glucose-tolerance tests to patients whom we would now see as having delirious mania or catatonia. 43 German neuropsychiatrists often attributed an endocrine basis to melancholia. Karl Kleist, originator of the concept of ‘‘bipolar disorder’’ and professor of psychiatry at the University of Frankfurt, speculated in 1921 that the ‘‘autochthonous degeneration-psychoses’’ (by which he meant chronic nonreactive psychoses that did not deteriorate, unlike Kraepelin’s dementia praecox) had a large endocrine component.

In 1949, Reiss and Hemphill conducted a controlled experiment, giving one group of chronic schizophrenics in the Bristol Mental Hospital dehydroepiandrosterone, a steroid hormone midway on the pathway between cholesterol (where the pathway begins) and testosterone. ) To another group of chronic 38 Endocrine Psychiatry schizophrenics they administered a pituitary extract containing a heavy mixture of gonadotropic hormone (the pituitary hormones are peptides and glycoproteins, which are smaller than steroids with their distinctive ring system).

Combined with anorexia, delusions of alimentary disorder, and severe melancholic depression . . ’’12 The Bristol work did not just entail medicating menopause. Reiss and Hemphill also treated the ‘‘male climacteric’’ with testosterone. Anorexia nervosa was attributed to ‘‘hypopituitarism’’ (Simmonds’ disease), and, ‘‘if 17-keto-steroid output is low,’’ corticotrophic hormone was offered. (17-Keto-steroids are metabolites mainly of adrenal steroids; they are found in the urine). Hemphill wrote in 1944, ‘‘In no psychosis .

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