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The genealogy of the clinical syndrome of mania: signs and symptoms described in psychiatric texts from 1880 to 1900

Published online by Cambridge University Press:  11 October 2017

K. S. Kendler
K. S. Kendler*
Affiliation:
Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
*
Author for correspondence: K. S. Kendler, M.D., (E-mail: kenneth.kendler@vcuhealth.org)
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Abstract

In 1800, mania was conceptualized as an agitated psychotic state. By 1900, it closely resembled its modern form. This paper reviews the descriptions of mania in Western psychiatry from 1880 to 1900, when Kraepelin was training and developing his concept of manic-depressive illness. Psychiatric textbooks published 1900–1960 described 22 characteristic manic symptoms/signs the presence of which were recorded in 25 psychiatric textbooks and three other key documents published 1880–1900. Descriptions of mania in these nineteenth century textbooks closely resembled those in the twentieth century, recording a mean (s.d.) of 15.9 (2.3) and 17.0 (2.3) of the characteristic symptoms, respectively (p = 0.12). The frequency with which individual symptoms were reported was substantially correlated in these two periods (r = +0.64). Mendel's 1881 monograph, Kraepelin's first description of mania in 1883 and the entry for mania in Tuke's Dictionary of Psychological Medicine (1892) described a mean (s.d.) of 19 (1.7) of these characteristic symptoms. These descriptions of mania often contained phenomenologically rich descriptions of euphoria, hyperactivity, grandiosity, flight of ideas, and poor judgment. They also emphasized several features not in DSM criteria including changes in character, moral standards and physical appearance, and increased sense of humor and sexual drive. Fifteen authors described key symptoms/signs of mania most reporting elevated mood, motoric hyperactivity and accelerated mental processes. By 1880, the syndrome of mania had been largely stabilized in its modern form. In the formation of his concept of manic-depressive illness, Kraepelin utilized the syndrome of mania as described in the psychiatric community in which he was trained.

Keywords

history of psychiatryKraepelinmanianineteenth century
Type
Review Article
Information
Psychological Medicine , Volume 48 , Issue 10 , July 2018 , pp. 1573 - 1591
Copyright
Copyright © Cambridge University Press 2017 

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