Depression In Emil Kraepelin's Description Of Depression

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Review of Literature

The Beginnings
In fifth century that Hippocrates and his associates gave the description of depression as “Fear or sadness that last a long time mean melancholia” (Hippocrates, 1923–1931, Vol. IV, p. 185) in Greek. They defined it in a way similar to what we understand it as presently having deep sadness, worthlessness, helplessness and hopelessness as the core symptoms and related symptoms like decreased interest in usual activities, social detachment, decreased sleep and appetite, easy fatigability, repetitive focus on negative ideas and also used the above mentioned features to differentiate from sadness which was understood to be reaction to loss but it indicated a disorder if the symptoms were disproportionate
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Kraepelin following a study by Dreyfus in 1907 recognized that melancholia and depressive episode in a manic-depressive illness could not be differentiated in any form from each other and were the result of the same etiology and it was then he decided to merge them. Neurotic depression was still then considered to be different and was viewed discreetly. It has been this approach of Kraepelin that has been credited as a source of inspiration for DSM system.
DSM 1 manual was also greatly influenced by Sigmund Freud and Adolf Meyer an American psychiatrist in a way that melancholia was grouped under psychotic disorders along with schizophrenia and paranoid reactions, as all the patients did show misinterpretation of reality along with delusions and
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In DSM 3 the necessary duration of the illness required was also reduced to 2 weeks in comparison to 1 month initially and the numbers of symptoms to be included were reduced to five from six.
MDD also included both psychotic and psychoneurotic forms of depression which were included under different categories in DSM 1 and DSM 2 (18) but DSM 3 only excluded bereaved people from the diagnosis but did not exclude in case the symptoms arose of other significant life events like break in romantic relationship or loss of job or failure to achieve the desired goal, giving a notion that responses to all the above and similar situations were not expectable, something contrary to the century old understanding of natural response to undesirable loss in the life. Thus the above decision taken while formulating DSM 3 has been argued to make the diagnosis of depression less scientifically valid but finally in DSM 5 after the bereavement criteria (a remnant to disproportionate to cause) was also removed. DSM Task Force reasoned that removal of “bereavement exclusion” does not make it a disease but instead it directs that if grief extends more than 2 weeks it morphs into depression and it is then it requires a medication

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