Virginia Institute for Psychiatric and Behavioral Genetics,Virginia Commonwealth University,Richmond, VA,USA.
Psychol Med. 2018 Jul;48(10):1573-1591. doi: 10.1017/S0033291717002768. Epub 2017 Oct 11.
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.
1800 年，躁狂被概念化为一种激动的精神病状态。到 1900 年，它已经非常接近现代形式。本文回顾了 1880 年至 1900 年期间西方精神病学中躁狂的描述，当时克雷丕林正在培训并发展他的躁郁症概念。1900 年至 1960 年出版的精神病学教科书描述了 22 种典型的躁狂症状/体征，这些症状/体征的存在被记录在 25 本精神病学教科书中，以及另外 3 份发表于 1880 年至 1900 年的关键文件中。这些 19 世纪教科书中对躁狂的描述与 20 世纪的描述非常相似，分别记录了 15.9（2.3）和 17.0（2.3）个特征性症状（p=0.12）。这两个时期个体症状的报告频率具有实质性相关性（r=+0.64）。孟德尔 1881 年的专着、克雷丕林 1883 年对躁狂的首次描述以及图克的《心理医学词典》（1892 年）中躁狂条目都描述了这 19 个特征性症状中的 19（1.7）个。这些对躁狂的描述通常包含丰富的描述，如欣快、多动、夸大、思维奔逸和判断力差。它们还强调了一些 DSM 标准中没有的特征，包括性格、道德标准和外貌的变化，以及幽默感和性驱动力的增加。15 位作者描述了躁狂的关键症状/体征，大多数报告情绪升高、运动过度活跃和精神过程加速。到 1880 年，躁狂综合征已基本稳定在现代形式。在他的躁郁症概念的形成中，克雷丕林利用了他所接受的培训的精神病学界中描述的躁狂综合征。
