Gender, age, and diagnosis: The rise and fall of involutional melancholia in american psychiatry, 1900-1980

Bulletin of the History of Medicine

Volumn 83, Issue 4, 2009, Pages 710-745

  Hirshbein, Laura D ^a  

^a NONE

Author keywords

Depression; Diagnosis; Gender; Menopause; Old age; Psychiatry

Indexed keywords

AGE; ARTICLE; CONVULSIVE THERAPY; FEMALE; GENDER IDENTITY; HISTORY; HUMAN; MAJOR DEPRESSION; MALE; POSTMENOPAUSE; PSYCHIATRY; PSYCHOLOGICAL ASPECT; PSYCHOTHERAPY; RISK FACTOR; SEX DIFFERENCE; UNITED STATES;

AGE FACTORS; CONVULSIVE THERAPY; DEPRESSIVE DISORDER, MAJOR; FEMALE; GENDER IDENTITY; HISTORY, 20TH CENTURY; HUMANS; MALE; POSTMENOPAUSE; PSYCHIATRY; PSYCHOTHERAPY; RISK FACTORS; SEX FACTORS; UNITED STATES;

EID: 75949129496     PISSN: 00075140     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Article

References (223)

1. William A. White, Outlines of Psychiatry (New York: Journal of Nervous and Mental Disease Publishing Co., 1907), pp. 163-70, quotation on pp. 163-64.
2. Myrna M. Weissman, "The Myth of Involutional Melancholia, " JAMA, 1979, 242 : 742-44.
3. For historical reflection on contingency in psychiatric diagnosis, .
4. see Charles E. Rosenberg, "Contested Boundaries: Psychiatry, Disease, and Diagnosis, " Perspect. Biol. Med., 2006, 49 : 407-24.
5. For an example of the sweeping claims made by psychiatrists of the time, see, for example, William C. Menninger, "The Role of Psychiatry in the World Today, " Am. J. Psychiatry, 1947, 104 : 155-63.
6. Norman Dain, "Critics and Dissenters: Reflections on 'Anti-Psychiatry' in the United States, " J. Hist. Behav. Sci., 1989, 25 : 3-25.
7. For an overview of the transitions from somatic psychiatry to psychoanalysis to biological psychiatry, see Edward Shorter, A History of Psychiatry: From the Era of the Asylum to the Age of Prozac (New York: Wiley, 1997).
8. Janet B. W. Williams and Robert L. Spitzer, "The Issue of Sex Bias in DSM-III: A Critique of 'A Woman's View of DSM-III' by Marcie Kaplan, " Am. Psychol., 1983, 38 : 793-98.
9. On the history of the emergence of the diagnosis of depression, see Laura D. Hirshbein, American Melancholy: Constructions of Depression in the Twentieth Century (New Brunswick, N.J.: Rutgers University Press, 2009).
10. I located articles about involutional melancholia through two methods: a twentiethcentury issue-by-issue survey of the American Journal of Psychiatry (including its early decades as the American Journal of Insanity), as well as a search through the Surgeon General's Index Catalogue. In addition, I followed up by pursuing citations of other papers located within these articles.
11. For the most comprehensive analysis of the development of American psychiatry, see Gerald N. Grob, Mental Institutions in America: Social Policy to 1875 (New York: Free Press, 1973).
12. and Grob, Mental Illness and American Society, 1875-1940 (Princeton, N.J.: Princeton University Press, 1983). For a review of treatment of the mentally ill, .
13. see Grob, The Mad Among Us: A History of the Care of America's Mentally Ill (Cambridge, Mass.: Harvard University Press, 1994).
14. See, for example, Edward C. Runge, "Our Work and Its Limitations, " Am. J. Insanity, 1899, 56 : 53-67;.
15. August Hoch, "On the Clinical Study of Psychiatry, " Am. J. Insanity, 1900, 57 : 281-95.
16. For contemporary enthusiasm for Kraepelin, see, for example, Edward Cowles, "Progress in the Clinical Study of Psychiatry, " Am. J. Insanity, 1899, 56 : 109-22.
17. Although Kraepelin visited the United States only once late in his life and did not garner much attention with the visit, his ideas were well known in the United States, thanks to the efforts of neurologist Smith Ely Jelliffe and psychiatrist Clarence Farrar.
18. See Eugen Kahn, "The Emil Kraepelin Memorial Lecture, " in Epidemiology of Mental Disorder, ed. Benjamin Pasamanick (Washington, D.C.: American Association for the Advancement of Science, 1959), pp. 1-38.
19. Dementia precox was later renamed schizophrenia after the work of Eugen Bleuler. See J. Hoenig, "Schizophrenia: Clinical Section, " in A History of Clinical Psychiatry: The Origins and History of Psychiatric Disorders, ed. German E. Berrios and Roy Porter (London: Athlone Press, 1995), pp. 336-48.
20. A. Ross Diefendorf, Clinical Psychiatry: A Textbook for Students and Physicians, Abstracted and Adapted from the Seventh German Edition of Kraepelin's "Lehrbuch Der Psychiatrie" (New York: The Macmillan Company, 1907).
21. Stanley W. Jackson, Melancholia and Depression: From Hippocratic Times to Modern Times (New Haven, Conn.: Yale University Press, 1986), pp. 207-11;.
22. German E. Berrios, The History of Mental Symptoms: Descriptive Psychopathology Since the Nineteenth Century (New York: Cambridge University Press, 1996), pp. 311-13.
23. See, for example, H. A. Tomlinson, "The Unity of Insanity, " Am. J. Insanity, 1906, 63 : 155-66.
24. For historical perspective on nineteenth-century psychiatric symptoms, see Jacques M. Quen, "Isaac Ray and His 'Remarks on Pathological Anatomy, '" Bull. Hist. Med., 1964, 38 : 113-26.
25. See White, Outlines of Psychiatry (n. 1), pp. 164 -68.
26. See, for example, Henry M. Swift, "The Prognosis of Recurrent Insanity of the Manic Depressive Type, " Am. J. Insanity, 1907, 64 : 311-26.
27. E. Stanley Abbot, "Forms of Insanity in Five Years' Admissions To, and Discharges From, the Hospitals for the Insane in Massachusetts, " Am. J. Insanity, 1909, 66 : 111-22.
28. Theodore A. Hoch, "A Statistical Study of Manic-Depressive Insanity with Especial Reference to Physical Illness as an Etiological Factor, " Am. J. Insanity, 1912, 69 : 419-28, quotation on p. 423.
29. See, for example, J. W. Courtney, "Concerning the Raison D'Etre of the Term 'Involutional' as Applied to Melancholia, " Boston Med. Surg. J., 1916, 174 : 416-18.
30. See A. J. Rosanoff, "Exciting Causes in Psychiatry, " Am. J. Insanity, 1912, 69 : 351-401;.
31. Mary F. Brew, "A Study of Precipitating Factors in Involution Melancholia, " State Hospital Quarterly, 1925, 10 : 422-28.
32. Neurologists in this period also accepted involutional melancholia as a specific disease. See, for example, F. X. Dercum, "A Clinical Classification of Insanity, " J. Nerv. Ment. Dis., 1901, 28 : 489-514;.
33. John W. Stevens, "Manic-Depressive Insanity, With the Report of a Typical Case, " J. Nerv. Ment. Dis., 1904, 31 : 513-25.
34. See, for example, H. W. Mitchell and E. E. Southard, "Melancholia with Delusions of Negation: Three Cases with Autopsy, " J. Nerv. Ment. Dis., 1908, 35 : 300-314;.
35. Albert M. Barrett, "A Case of Pure Word-Deafness with Autopsy, " J. Nerv. Ment. Dis., 1910, 37 : 73-92.
36. E. E. Southard and Earl D. Bond, "Clinical and Anatomical Analysis of 25 Cases of Mental Disease Arising in the Fifth Decade, with Remarks on the Melancholia Question and Further Observations on the Distribution of Cortical Pigments, " Am. J. Insanity, 1914, 70 : 779-828. These authors specifically mentioned the work of Alzheimer and connected their work to existing research on brain pathology in old age. For more context on Southard's work, .
37. see Elizabeth Lunbeck, The Psychiatric Persuasion: Knowledge, Gender, and Power in Modern America (Princeton, N.J.: Princeton University Press, 1994). For information on Bond, .
38. see Lauren H. Smith, "Earl Danford Bond, M.D. 1878-1968, " Am. J. Psychiatry, 1969, 125 : 1260-62.
39. Part of the discussion concerning the distinctiveness of the disorder revolved around the issue of prognosis. See, for example, William A. White, "Types in Mental Disease, " J. Nerv. Ment. Dis., 1906, 33 : 254 -64.
40. Walter Lewis Treadway, "The Presenile Psychoses, " J. Nerv. Ment. Dis., 1913, 40 : 375-87, quotation on p. 387.
41. Involutional melancholia was included in the profession's first classification effort, the 1918 Statistical Manual for the Use of Institutions for the Insane. The 1918 manual reflected the efforts of a small group of psychiatrists to allow for more accurate diagnostic comparisons among mental hospitals. This diagnostic system was used in 1922, when mental hospital inmates were included in the national census for the first time. Committee on Statistics of the American Medico-Psychological Association and Bureau of Statistics of the National Committee for Mental Hygiene, Statistical Manual for the Use of Institutions for the Insane (New York: National Committee for Mental Hygiene, 1918);.
42. Horatio M. Pollock, "Development of Statistics of Mental Disease in the United States During the Past Century, " Am. J. Psychiatry, 1945, 102 : 1-16.
43. Frank Fenwick Young, "Involution Melancholia, " New Orleans Med. Surg. J., 1930, 83 : 375-79. There is unfortunately little information about race and depressive disorders in the published psychiatric literature over much of the century. For historical perspective on these issues, .
44. see Peter McCandless, Moonlight, Magnolias, and Madness: Insanity in South Carolina From the Colonial Period to the Progressive Era (Chapel Hill: University of North Carolina Press, 1996).
45. For the ways in which physicians constructed the importance of the diseases of aging, see Stephen Katz, Disciplining Old Age: The Formation of Gerontological Knowledge (Charlottesville: University Press of Virginia, 1996). On the increasing focus of medical professionals on chronic disease by midcentury, .
46. see Daniel M. Fox, "Health Policy and Changing Epidemiology in the United States: Chronic Disease in the Twentieth Century, " Trans. Stud. Coll. Physicians Phila., 1988, 10 : 11-31.
47. See, for example, E. V. Cowdry, ed., Problems of Ageing: Biological and Medical Aspects (Baltimore: Williams & Wilkins, 1939);.
48. Malford W. Thewlis, The Care of the Aged (Geriatrics) (St. Louis: C. V. Mosby, 1941).
49. On the history of medical and scientific attention to old age, see Carole Haber, Beyond Sixty-Five: The Dilemma of Old Age in America's Past (New York: Cambridge University Press, 1983);.
50. W. Andrew Achenbaum, Crossing Frontiers: Gerontology Emerges as a Science (New York: Cambridge University Press, 1995).
51. On the process of increasing medicalization of old age, see David Hackett Fischer, Growing Old in America (New York: Oxford University Press, 1978);.
52. W. Andrew Achenbaum, Old Age in the New Land: The American Experience Since 1790 (Baltimore: Johns Hopkins University Press, 1978). The medicalization of old age was by no means inevitable;.
53. see Thomas R. Cole, The Journey of Life: A Cultural History of Aging in America (New York: Cambridge University Press, 1992).
54. See Grob, Mental Illness and American Society (n. 10), pp. 180-87.
55. August Hoch and John T. MacCurdy, "The Prognosis of Involution Melancholia, " Am. J. Psychiatry, 1922, 78 : 433-73, quotation on p. 443.
56. Jesse F. Ballenger, Self, Senility, and Alzheimer's Disease in Modern America: A History (Baltimore: Johns Hopkins University Press, 2006).
57. D. Rothschild, "The Clinical Differentiation of Senile and Arteriosclerotic Psychoses, " Am. J. Psychiatry, 1941, 98 : 324 -33, quotation on p. 325.
58. George E. Reed and Karl Stern, "The Treatment, Pathology and Prevention of Mental Disorders in the Aged, " Can. Med. Assoc. J., 1942, 46 : 249-54, quotation on p. 250.
59. Nolan D. C. Lewis, "Mental Hygiene of the Senium, " Ment. Hyg., 1940, 24 : 436-47.
60. See also D. Ewen Cameron, "Behavioral Breakdowns, " Mod. Hosp., 1944, 63 : 84-88.
61. Maurice Grozin, "Involution Melancholia, " Medical Review of Reviews, 1931, 37 : 397-402, quotation on p. 397.
62. For a description of the relationship between mental illnesses in advancing age, see for example, Harold D. Palmer, Francis J. Braceland, and Donald W. Hastings, "Somato- Psychic Disorders of Old Age, " Am. J. Psychiatry, 1943, 99 : 856-63.
63. O. Diethelm and F. V. Rockwell, "Psychopathology of Aging, " Am. J. Psychiatry, 1943, 99 : 553-56.
64. Howard A. Rusk, "America's Number One Problem-Chronic Disease and an Aging Population, " Am. J. Psychiatry, 1949, 106 : 270-77, .
65. See, for example, W. F. Menzies, "Puerperal Insanity: An Analysis of One Hundred and Forty Consecutive Cases, " Am. J. Insanity, 1893, 50 : 147-85;.
66. H. A. Tomlinson, "The Puerperal Insanities, " Am. J. Insanity, 1899, 56 : 69-88;.
67. Robert Jones, "Puerperal Insanity, " Am. J. Insanity, 1903, 59 : 601-20. By the time American psychiatrists created their first official nomenclature in 1918, though, involutional melancholia was the only mental disorder mentioned that included reference to women's reproduction. On the history of puerperal insanity, .
68. see Nancy Theriot, "Diagnosing Unnatural Motherhood: Nineteenth-Century Physicians and 'Puerperal Insanity, '" Am. Stud., 1989, 30 : 69-88.
69. See, for example, Judith A. Houck, Hot and Bothered: Women, Medicine, and Menopause in Modern America (Cambridge, Mass.: Harvard University Press, 2006);.
70. S. E. Bell, "Changing Ideas: The Medicalization of Menopause, " in The Meanings of Menopause: Historical, Medical, and Clinical Perspectives, ed. R. Formanek (Hillsdale, N.J.: Analytic Press, 1990), pp. 43-63.
71. See also Lois W. Banner, In Full Flower: Aging Women, Power, and Sexuality (New York: Vintage Books, 1992).
72. For the broader context of menopause as a state of hormone deficiency, see Elizabeth Siegel Watkins, The Estrogen Elixir: A History of Hormone Replacement Therapy in America (Baltimore: Johns Hopkins University Press, 2007.
73. Ballenger, Self, Senility, and Alzheimer's Disease (n. 34), pp. 11-35.
74. On the history of male menopause, see Elizabeth Siegel Watkins, "The Medicalisation of Male Menopause in America, " Soc. Hist. Med., 2007, 20 : 369-88.
75. Alfred Gordon, "Psychoneuroses, Psychoses and Mental Deficiency in 2000 Cases Considered Especially from the Standpoint of Etiological Incidents and Sex, " Am. J. Insanity, 1917, 73 : 721-36, quotation on p. 732. Obviously, the interest in menopause paralleled the emergence of endocrinology and the idea of treating hormonal imbalance (of which menopause seemed to be a prime example). For some views on the sometimes uneasy relationship between endocrinology and psychiatry, .
76. see Edith R. Spaulding, "The Importance of Endocrine Therapy in Combination with Mental Analysis in the Treatment of Certain Cases of Personality Deviation, " Am. J. Psychiatry, 1922, 78 : 373-84;.
77. Beverley R. Tucker, "The Internal Secretions in Their Relationship to Mental Disturbance, " Am. J. Psychiatry, 1923, 79 : 259-72.
78. E. P. Ballentine, "A Study of the Outcome of Agitated Depressions of the Involution Period in Women, " State Hosp. Bull., 1912, 5 : 47-62, quotation on pp. 47-48. The journal in which Ballintine published her article evidently misspelled her name. For more on Ballintine, .
79. see Ellen S. More, Restoring the Balance: Women Physicians and the Profession of Medicine, 1850-1995 (Cambridge, Mass.: Harvard University Press, 1999).
80. Young, "Involution Melancholia" (n. 28). On the history of the discovery of the reproductive hormones, .
81. see Diana E. Long, "Physiological Identity of American Sex Researchers Between the Two World Wars, " in Physiology in the American Context, 1850-1940, ed. Gerald L. Geison (Bethesda, Md.: American Physiological Society, 1987), pp. 263-78;.
82. Nelly Oudshoorn, "On Measuring Sex Hormones: The Role of Biological Assays in Sexualizing Chemical Substances, " Bull. Hist. Med., 1990, 64 : 243-61;.
83. Diana Long Hall, "Biology, Sex Hormones and Sexism in the 1920's, " Philos. Forum, 1973-1974, 5 : 81-96;.
84. Vern L. Bullough, Science in the Bedroom: A History of Sex Research (New York: Basic Books, 1994).
85. William A. White, Outlines of Psychiatry, 10th ed. (Washington, D.C.: Nervous and Mental Disease Publishing Co., 1924), pp. 220-31, quotation on p. 221.
86. White retained this explanation in later editions: White, Outlines of Psychiatry, 14th ed. (Washington, D.C.: Nervous and Mental Disease Publishing Co., 1935), pp. 266-77.
87. This seems clearly based in assumptions about physiology at this time period, particularly the work by Claude Bernard on homeostasis. For a discussion of twentieth-century physiology and homeostasis, see Donald Fleming, "Walter B. Cannon and Homeostasis, " Soc. Res., 1984, 51 : 609-40.
88. Banner, In Full Flower (n. 43), pp. 273-310. For more on shifting views of femininity in the context of changing opportunities for women, .
89. see Sheila M. Rothman, Woman's Proper Place: A History of Changing Ideals and Practices, 1870 to the Present (New York: Basic Books, 1978).
90. Edward A. Strecker and Baldwin L. Keyes, "Ovarian Therapy in Involutional Melancholia, " New York Med. J., 1922, 116 : 30-34, quotation on p. 30.
91. Karl M. Bowman and Lauretta Bender, "The Treatment of Involution Melancholia with Ovarian Hormone, " Am. J. Psychiatry, 1932, 88 : 867-93. For perspective on the relationship of the pharmaceutical industry to medical research in this time period, .
92. see Nicolas Rasmussen, "The Drug Industry and Clinical Research in Interwar America: Three Types of Physician Collaborator, " Bull. Hist. Med., 2005, 79 : 50-80.
93. Lewis Danziger, Harold T. Schroeder, and Arthur A. Unger, "Androgen Therapy for Involutional Melancholia, " Arch. Neurol. Psychiatry, 1944, 51 : 457-61. The authors concluded that five out of nine of the men who received androgen injections recovered (they received placebo first and then active hormone).
94. Most of the studies on hormones were completed using female hormones in women, but at least one group from Brooklyn used male hormones in women to treat their menopause symptoms. They claimed improvement in all treated women. Lawrence Kurzrok, Charles H. Birnberg, and Seymour Livingston, "The Treatment of Female Menopause with Male Sex Hormone, " Endocrinology, 1939, 24 : 347-50.
95. This methodology was accepted at the time. For the history of changes in clinical research expectations and standards, see Harry M. Marks, The Progress of Experiment: Science and Therapeutic Reform in the United States, 1900-1990 (New York: Cambridge University Press, 1997).
96. In 1999, King Pharmaceuticals attempted to have Theelin reapproved by the FDA but withdrew it in 2001 when it appeared that there would not be sufficient market for it. PRNewswire, http://www.prnewswire.com/cgi-bin/stories.pl?ACCT= 104&STORY=/www/story/12-21-2001/0001638575&EDATE= (accessed 12 April 2008). A British group also experimented with Theelin in the 1940s.
97. See R. Gibson, "Involutional Melancholia: A Study of Twenty Cases Treated with Theelin, " J. Ment. Sci., 1943, 89 : 278-83.
98. Purcell G. Schube et al., "Involutional Melancholia: Treatment with Theelin, " Arch. Neurol. Psychiatry, 1937, 38 : 505-12. The group did not identify the sex of the patients who improved, though it is possible that they treated only women. The same investigators published a study in 1936 in which they treated forty women with Theelin injections;.
99. August A. Werner et al., "Involutional Melancholia: Probable Etiology and Treatment, " Arch. Neurol. Psychiatry, 1936, 35 : 1076-80.
100. C. C. Ault, Emmett F. Hoctor, and August A. Werner, "Theelin Therapy in the Psychoses, " JAMA, 1937, 109 : 1786-88, quotation on p. 1787.
101. C. C. Ault, Emmett F. Hoctor, and August A. Werner, "Involutional Melancholia: Additional Report, " Am. J. Psychiatry, 1940, 97 : 691-94, quotation on p. 691.
102. August A. Werner, Emmett F. Hoctor, and C. C. Ault, "Involutional Melancholia: A Review with Additional Cases, " Arch. Neurol. Psychiatry, 1941, 45 : 944 -52.
103. Herbert S. Ripley, Ephraim Shorr, and George N. Papanicolaou, "The Effect of Treatment of Depression in the Menopause with Estrogenic Hormone, " Am. J. Psychiatry, 1940, 96 : 905-13. The authors noted that the estrogen preparations were supplied by industry- the estradiol benzoate was supplied by the Schering Co., and the estrone was supplied by E. R. Squibb and Sons.
104. Herbert S. Ripley and George N. Papanicolaou, "The Menstrual Cycle with Vaginal Smear Studies in Schizophrenia, Depression and Elation, " Am. J. Psychiatry, 1942, 98 : 567-73.
105. Papanicolaou had used vaginal smears to uncover cellular changes in the menstrual cycle in guinea pigs in the late 1920s. For more on Papanicolaou and the development of the Pap smear, see Monica J. Casper and Adele E. Clarke, "Making the Pap Smear Into the 'Right Tool' For the Job: Cervical Cancer Screening in the USA, Circa 1940-1995, " Soc. Stud. Sci., 1998, 28 : 255-90.
106. Eugene Davidoff, E. C. Reifenstein, and Gerald L. Goodstone, "The Treatment of Involutional Psychoses with Diethyl Stilbestrol, " Am. J. Psychiatry, 1943, 99 : 557-64, quotation on p. 557. On the history of diethyl stilbestrol, .
107. see Susan E. Bell, "Gendered Medical Science: Producing a Drug for Women, " Fem. Stud., 1995, 21 : 469-500.
108. For example, John Campbell explained in 1949 with the second edition of his textbook of psychopathology written for general practitioners that he had added a section on involutional syndromes, "the nervous and mental reactions occurring at the menopausal age." John D. Campbell, Everyday Psychiatry, 2nd ed. (Philadelphia: J. B. Lippincott, 1949), p. vii.
109. See, for example, Margo Horn, Before It's Too Late: The Child Guidance Movement in the United States, 1922-1945 (Philadelphia: Temple University Press, 1989);.
110. Theresa R. Richardson, The Century of the Child: The Mental Hygiene Movement and Social Policy in the United States and Canada (Albany: State University of New York Press, 1989).
111. Psychologist G. Stanley Hall used the model of his older Adolescence as a framework for his later work, Senescence. Other psychologists also used the concepts of adjustment to old age as a mirror to the adjustments of adolescence.
112. See G. Stanley Hall, Senescence: The Last Half of Life (New York: Appleton and Company, 1922);.
113. Hall, Adolescence: Its Psychology and Its Relations to Physiology, Anthropology, Sociology, Sex, Crime and Religion and Education (New York: D. Appleton, 1905);.
114. Lillien J. Martin and Clare de Gruchy, Salvaging Old Age (New York: Macmillan Company, 1930).
115. Eleanora B. Saunders, "A Study of Depressions in Late Life With Special Reference to Content, " Am. J. Psychiatry, 1932, 88 : 925-54, quotation on p. 925.
116. See, for example, Harold D. Palmer, Donald W. Hastings, and Stephen H. Sherman, "Therapy in Involutional Melancholia, " Am. J. Psychiatry, 1941, 97 : 1086-1115;.
117. W. Malamud, S. L. Sands, and I. Malamud, "The Involutional Psychoses: A Socio-Psychiatric Study, " Psychosom. Med., 1941, 3 : 410-26.
118. For World War II-era psychiatrists' use of adjustment in their descriptions and treatment of veterans, see Hans Pols, "War Neurosis, Adjustment Problems in Veterans, and an Ill Nation: The Disciplinary Project of American Psychiatry During and After World War II, " Osiris, 2007, 22 : 72-92.
119. Psychoanalytic ideas were certainly not accepted by all psychiatrists at the time, as Abraham Myerson found when he surveyed the profession about opinions about Freud and his theories in 1939. Still, the use of psychoanalytic concepts to explain disease had become quite common by this time period. Abraham Myerson, "The Attitude of Neurologists, Psychiatrists and Psychologists Towards Psychoanalysis, " Am. J. Psychiatry, 1939, 96 : 623-41. For more context on the history of psychoanalysis within American psychiatry, .
120. see Nathan G. Hale, Jr., The Rise and Crisis of Psychoanalysis in the United States: Freud and the Americans, 1917-1985 (New York: Oxford University Press, 1995).
121. Ross McC. Chapman, "The Control of Sleeplessness, " Am. J. Psychiatry, 1924, 80 : 491-502, quotation on p. 493.
122. Gerald H. J. Pearson, "An Interpretative Study of Involutional Depression, " Am. J. Psychiatry, 1928, 85 : 289-335, quotation on pp. 334 -35.
123. For descriptions of conflicts that would help explain cases of melancholia, see, for example, Chester L. Carlisle, "Depressions Which Followed Apparent Success, " Am. J. Psychiatry, 1938, 95 : 729-32;.
124. Sandor Rado, "The Problem of Melancholia, " Int. J. Psychoanal., 1928, 9 : 420-38. For a discussion of personality traits commonly seen in patients with involutional melancholia, .
125. see, for example, W. B. Titley, "Prepsychotic Personality of Patients with Involutional Melancholia, " Arch. Neurol. Psychiatry, 1936, 36.
126. A. A. Brill, response to symposium on mental diseases in old age, Am. J. Psychiatry, 1932, 88 : 951. For fears about women and gender roles, .
127. see Carroll Smith-Rosenberg, "The New Woman as Androgyne: Social Disorder and Gender Crisis, 1870-1936, " in Disorderly Conduct: Visions of Gender in Victorian America (New York: Oxford University Press, 1985), pp. 245-96.
128. Brill, response to symposium (n. 77), p. 951.
129. See, for example, Edrita G. Fried and Karl Stern, "The Situation of the Aged Within the Family, " Am. J. Orthopsychiatry, 1948, 18 : 34 -36.
130. See, for example, Walter R. Miles, "Training, Practice and Mental Longevity, " Science, 1935, 81 : 79-87;.
131. Sydney Kinnear Smith, "Mental Diseases in the Elderly, " Cal. West. Med., 1932, 36 : 193-94;.
132. Fredrick A. Willius, "Adjustment to the Advancing Years of Life, " Med. Clin. North Am., 1940, 24 : 1271-75.
133. See, for example, M. Ralph Kaufman, "Psychoanalysis in Late-Life Depressions, " Psychoanal. Q., 1937, 6 : 308-55. For Freud's original statement that men over fifty could not learn, .
134. see Sigmund Freud, "On Psychotherapy (1905), " in The Standard Edition of the Complete Psychological Works of Sigmund Freud (London: Hogarth Press, 1953), pp. 257-68.
135. Jonathan Sadowsky has persuasively pointed out that psychoanalysis and somatic psychiatry could easily coexist and usually did during this time period; Jonathan H. Sadowsky, "Beyond the Metaphor of the Pendulum: Electroconvulsive Therapy, Psychoanalysis, and the Styles of American Psychiatry, " J. Hist. Med. Allied Sci., 2006, 61 : 1-25.
136. See Deborah Blythe Doroshow, "Performing a Cure for Schizophrenia: Insulin Coma Therapy on the Wards, " J. Hist. Med. Allied Sci., 2007, 62 : 213-43. On the discovery of insulin, .
137. see Michael Bliss, The Discovery of Insulin (Chicago: University of Chicago Press, 1984). For a contemporary explanation of insulin therapy, .
138. see Kenneth E. Appel, Clifford B. Farr, and Harold K. Marshall, "Insulin Therapy in Undernourished Psychotic Patients: Preliminary Report, " JAMA, 1928, 90 : 1788-89. For a description of the administrative challenges of insulin, .
139. see Harry J. Worthing et al., "The Organization and Administration of a State Hospital Insulin-Metrazol-Electric Shock Therapy Unit, " Am. J. Psychiatry, 1943, 99 : 692-97.
140. On the history of metrazol, see Niall McCrae, "'A Violent Thunderstorm': Cardiazol Treatment in British Mental Hospitals, " Hist. Psychiatry, 2006, 17 : 67-90. On clinician descriptions of patients' dread of metrazol, .
141. see, for example, A. E. Bennett, "Metrazol Convulsive Shock Therapy in Affective Psychoses, " Am. J. Med. Sci., 1939, 198 : 695-701;.
142. William C. Menninger, "An Evaluation of Metrazol Treatment, " Bull. Menninger Clin., 1940, 4 : 95-104;.
143. Eugene Ziskind, Esther Somerfeld-Ziskind, and Louis Ziskind, "Metrazol and Electric Convulsive Therapy of the Affective Psychoses, " Arch. Neurol. Psychiatry, 1945, 53 : 212-17.
144. Edward Shorter and David Healy, Shock Therapy: A History of Electroconvulsive Treatment in Mental Illness (New Brunswick, N.J.: Rutgers University Press, 2007). For a contemporary description of the benefits of ECT, .
145. see Lothar B. Kalinowsky and Paul H. Hoch, Shock Treatments and Other Somatic Procedures in Psychiatry (New York: Grune & Stratton, 1946). For a somewhat negative account of the history of ECT, .
146. see Timothy W. Kneeland and Carol A. B. Warren, Pushbutton Psychiatry: A History of Electroshock in America (Westport, Conn.: Praeger, 2002).
147. Shorter and Healy, Shock Therapy (n. 85).
148. Although a few psychiatrists attempted shock therapies with senile patients, the results were mixed. See Ballenger, Self, Senility, and Alzheimer's Disease (n. 34).
149. Palmer, Hastings, and Sherman, "Therapy in Involutional Melancholia, " p. 1087 (n. 71). In contrast, the authors pointed out that testosterone therapy in men seemed to work quite well.
150. See also A. Kennedy, "The Treatment of Mental Disorders by Induced Convulsions, " J. Neurol. Psychiatry, 1940, 3 : 49-82.
151. For these authors' exclusion of cognitive impairment in the diagnosis, see Harold D. Palmer and Stephen H. Sherman, "The Involutional Melancholia Process, " Arch. Neurol. Psychiatry, 1938, 40 : 762-88.
152. Benjamin Malzberg, "The Outcome of Electric Shock Therapy in the New York Civil State Hospitals, " Psychiatr. Q., 1943, 17 : 154 -63.
153. See also J. A. Bianchi and C. J. Chiarello, "Shock Therapy in the Involutional and Manic-Depressive Psychoses, " Psychiatr. Q., 1944, 18 : 118-26;.
154. Kenneth J. Tillotson and Wolfgang Sulzbach, "A Comparative Study and Evaluation of Electric Shock Therapy in Depressive States, " Am. J. Psychiatry, 1945, 101 : 455-59.
155. A. E. Bennett and C. B. Wilbur, "Convulsive Shock Therapy in Involutional States After Complete Failure with Previous Estrogenic Treatment, " Am. J. Med. Sci., 1944, 208 : 170-76, quotation on p. 170. In the first major textbook of shock therapy, author Lothar Kalinowsky mentioned hormone treatments in passing and commented that these treatments had been replaced by shock.
156. See Kalinowsky and Hoch, Shock Treatments and Other Somatic Procedures in Psychiatry (n. 85), p. 175.
157. See also, Kalinowsky and Hoch, Shock Treatments, Psychosurgery and Other Somatic Treatments in Psychiatry (New York: Grune and Stratton, 1952), p. 184. In a later edition, hormone treatments received more attention, especially for premenstrual mood states;.
158. Kalinowsky and Hanns Hippius, Pharmacological, Convulsive and Other Somatic Treatments in Psychiatry (New York: Grune and Stratton, 1969), pp. 352-53.
159. Eugene Davidoff and Angelo Raffaele, "Electric Shock Therapy in Involutional Psychoses, " J. Nerv. Ment. Dis., 1944, 99 : 397-405, quotation on p. 404.
160. Paul E. Huston and Lillian M. Locher, "Involutional Psychosis: Course When Untreated and When Treated With Electric Shock, " Arch. Neurol. Psychiatry, 1948, 59 : 385-94.
161. See also Paul E. Huston and Lillian M. Locher, "Manic-Depressive Psychosis: Course When Treated and Untreated With Electric Shock, " Arch. Neurol. Psychiatry, 1948, 60 : 37-48.
162. One Connecticut psychiatrist pointed out that patients diagnosed with involutional melancholia made up less than one percent of the Norwich State Hospital population between 1930 and 1940. Sidney Drobnes, "Prognostic Factors in the Involutional Psychoses, " Am. J. Psychiatry, 1943, 99 : 818-21.
163. Reginald J. Young, "The Rorschach Diagnosis and Interpretation of Involutional Melancholia, " Am. J. Psychiatry, 1950, 106 : 748-49.
164. Isadore Leo Fishbein, "Involutional Melancholia and Convulsive Therapy, " Am. J. Psychiatry, 1949, 106 : 128-35.
165. Saul H. Rosenthal, "The Involutional Depressive Syndrome, " Am. J. Psychiatry, 1968, 11(Suppl.): 21-35, quotation on p. 23.
166. One small group attempted to resurrect the concept in 1984 without much success. See Richard P. Brown et al., "Involutional Melancholia Revisited, " Am. J. Psychiatry, 1984, 141 : 24 -28.
167. David Healy, The Creation of Psychopharmacology (Cambridge, Mass.: Harvard University Press, 2002).
168. For thoughtful inquiry into changes in medicine with the introduction of medications, see Jeremy A. Greene, Prescribing by Numbers: Drugs and the Definition of Disease (Balti more: Johns Hopkins University Press, 2007);.
169. Andrea Tone, The Age of Anxiety: A History of America's Turbulent Affair with Tranquilizers (New York: Basic Books, 2008).
170. In turn, the medications that had helped patients who looked depressed were then labeled as antidepressants. David Healy, The Antidepressant Era (Cambridge, Mass.: Harvard University Press, 1997.
171. Laura D. Hirshbein, "Science, Gender, and the Emergence of Depression in American Psychiatry, 1952-1980, " J. Hist. Med. Allied Sci., 2006, 61 : 187-216.
172. For case-study analysis of the relationship between diseases and medications in the second half of the century, see Andrea Tone and Elizabeth Siegel Watkins, eds., Medicating Modern America: Prescription Drugs in History (New York: New York University Press, 2007).
173. William J. Turner, Francis J. O'Neill, and Sidney Merlis, "The Treatment of Depression in Hospitalized Patients Before and Since the Introduction of Antidepressant Drugs, " Am. J. Psychiatry, 1962, 119 : 421-26.
174. See also Gerald L. Klerman and Eugene S. Paykel, "Depressive Pattern, Social Background, and Hospitalization, " J. Nerv. Ment. Dis., 1970, 150 : 466-78.
175. See, for example, Eugene S. Paykel and Marcia N. Dienelt, "Suicide Attempts Following Acute Depression, " J. Nerv. Ment. Dis., 1971, 153 : 234 -43. During this time period, psychiatrists were increasingly concerned with depression in children.
176. See, for example, Leon Cytryn and Donald H. McKnew, "Proposed Classification of Childhood Depression, " Am. J. Psychiatry, 1972, 129 : 149-55.
177. See, for example, Myron G. Sandifer, Ian C. Wilson, and Linda Green, "The Two- Type Thesis of Depressive Disorders, " Am. J. Psychiatry, 1966, 123 : 93-97;.
178. Martin G. Blinder, "The Pragmatic Classification of Depression, " Am. J. Psychiatry, 1966, 123 : 259-69.
179. Robert A. Woodruff, George E. Murphy, and Marijan Herjanic, "The Natural History of Affective Disorders-I. Symptoms of 72 Patients at the Time of Index Hospital Admission, " J. Psychiatric Res., 1967, 5 : 255-63, quotation on p. 255.
180. Some continued to emphasize the role of hormones, but more in terms of the ways in which hormones affected illness. See, for example, S. H. Kraines, "The Physiological Basis of the Manic-Depressive Illness: A Theory, " Am. J. Psychiatry, 1957, 114 : 206-11.
181. Other nomenclatures through the years included H. B. Logie, ed., Standard Classified Nomenclature of Disease (New York: Commonwealth Fund, 1933);.
182. American Psychiatric Association, Diagnostic and Statistical Manual: Mental Disorders (Washington, D.C.: American Psychiatric Association, 1952);.
183. American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 2nd ed. (Washington, D.C.: American Psychiatric Association, 1968). For historical perspective on the formation of the first edition of the DSM, .
184. see Gerald N. Grob, "Origins of DSM-I: A Study in Appearance and Reality, " Am. J. Psychiatry, 1991, 148 : 421-30.
185. See, especially, John P. Feighner et al., "Diagnostic Criteria for Use in Psychiatric Research, " Arch. Gen. Psychiatry, 1972, 26 : 57-63;.
186. R. L. Spitzer, Jean Endicott, and E. Robins, "Research Diagnostic Criteria, " Psychopharmacol. Bull., 1975, 11 : 22-25.
187. For an example of professional arguments about this method of making diagnoses, see, for example, Gerald L. Klerman et al., "A Debate on DSM-III, " Am. J. Psychiatry, 1984, 141 : 539-53.
188. See Robert L. Spitzer and Janet B. W. Williams, "American Psychiatry's Transformation Following the Publication of DSM-III, " Am. J. Psychiatry, 1994, 151 : 459-60.
189. See Beck's annotations to a memo from Spitzer and Janet B. W. Forman, 15 March 1979, Major Depressive Disorder Folder, Robert Spitzer Papers, American Psychiatric Association, Washington, D.C.
190. The other criteria included poor appetite, insomnia, psychomotor agitation or retardation, loss of interest or pleasure, loss of energy, feelings of worthlessness or guilt, complaints of difficulty thinking, and thoughts of death. American Psychiatric Association, DSM-III (n. 111), pp. 213-15. The criteria became broader (to capture a larger population of patients) with subsequent editions of the DSM. For a critique of the overinclusiveness of the DSM depression criteria, .
191. see Allan V. Horwitz and Jerome C. Wakefield, The Loss of Sadness: How Psychiatry Transformed Normal Sorrow Into Depressive Disorder (New York: Oxford University Press, 2007).
192. Nancy C. Andreasen to Spitzer, 17 April 1978, Major Depressive Disorder Folder, Box 2, Robert Spitzer Papers, American Psychiatric Association, Washington, D.C. Tricyclic medications, including drugs such as imipramine, were some of the earliest classes of medications identified as antidepressants.
193. Ronald Bayer and Robert L. Spitzer, "Neurosis, Psychodynamics, and DSM-III: A History of the Controversy, " Arch. Gen. Psychiatry, 1985, 42 : 187-96.
194. Involutional melancholia was explicitly folded in with other types of depressive illnesses as the new diagnostic criteria were developed in anticipation of the DSM-III.
195. See Robert L. Spitzer, Jean Endicott, and Eli Robins, "Clinical Criteria for Psychiatric Diagnosis and DSM-III, " Am. J. Psychiatry, 1975, 132 : 1187-92;.
196. Robert L. Spitzer, Janet B. W. Williams, and Andrew E. Skodol, "DSM-III: The Major Achievements and an Overview, " Am. J. Psychiatry, 1980, 137 : 151-64.
197. See "Notes from the Conference on DSM-III, " 13-15 October 1983, DSM Correspondence, Box 2, Robert Spitzer Papers, American Psychiatric Association, Washington, D.C.
198. Betty Friedan was an early critic of psychiatry's role in oppressing women;.
199. Betty Friedan, The Feminine Mystique (New York: Dell Publishing, 1963). For an account of the women's movement in the 1970s, .
200. see Sara M. Evans, Personal Politics: The Roots of Women's Liberation in the Civil Rights Movement and the New Left (New York: Knopf, 1979). For more on women's criticism of psychiatrists' opinions about women during this time period, .
201. see Barbara Ehrenreich and Deirdre English, For Her Own Good: 150 Years of the Experts' Advice to Women (Garden City, N.Y.: Anchor Press, 1978).
202. Weissman, "Myth of Involutional Melancholia" (n. 2);.
203. see also Weissman and Eugene S. Paykel, The Depressed Woman: A Study of Social Relationships (Chicago: University of Chicago Press, 1974).
204. Gerald L. Klerman, "Age and Clinical Depression: Today's Youth in the Twenty-First Century, " J. Gerontol., 1976, 31 : 318-23, quotation on p. 319. Klerman certainly captured the sense of turmoil in the time in which he was writing. For a social and cultural history of the 1970s, .
205. see Bruce J. Schulman, The Seventies: The Great Shift in American Culture, Society, and Politics (Cambridge, Mass.: Da Capo Press, 2001). For a reflection on the youth culture upheavals of the 1960s, .
206. see Todd Gitlin, The Sixties: Years of Hope, Days of Rage (New York: Bantam Books, 1987).
207. Gerald L. Klerman and Myrna M. Weissman, "Increasing Rates of Depression, " JAMA, 1989, 261 : 2229-35, quotation on p. 2229.
208. See Thomas J. Craig and Pearl A. Van Natta, "Presence and Persistence of Depressive Symptoms in Patient and Community Populations, " Am. J. Psychiatry, 1976, 133 : 1426-29.
209. Some geriatricians, responding to the shifts in psychiatric priorities, continued to emphasize the importance of correctly diagnosing depression in older people. See, for example, Monica D. Blumenthal, "Depressive Illness in Old Age: Getting Behind the Mask, " Geriatrics, 1980, 35 : 34 -43;.
210. Ira Lazar and Toksoz B. Karasu, "Evaluation and Management of Depression in the Elderly, " Geriatrics, 1980, 35 : 47-53;.
211. Joseph T. Okimoto et al., "Screening for Depression in Geriatric Medical Patients, " Am. J. Psychiatry, 1982, 139 : 799-802.
212. See Francis G. Gosling, Before Freud: Neurasthenia and the American Medical Community, 1870-1910 (Urbana: University of Illinois Press, 1987);.
213. Mark S. Micale, Approaching Hysteria: Disease and Its Interpretations (Princeton, N.J.: Princeton University Press, 1995).
214. In the 1970s, even as they cited the older literature, researchers continued to try estrogen for women with depression. See, for example, Edward L. Klaiber et al., "Estrogen Therapy for Severe Persistent Depressions in Women, " Arch. Gen. Psychiatry, 1979, 36 : 550-54. Researchers in recent decades have insisted on the role of hormones in women's mental illness.
215. See Ellen Leibenluft, ed., Gender Differences in Mood and Anxiety Disorders: From Bench to Bedside (Washington, D.C.: American Psychiatric Press, 1999). Psychiatrists are still looking to estrogen to augment treatment for depression, even with popular and medical concerns about the drawbacks to hormone therapy.
216. See Jack M. Gorman, "Gender Differences in Depression and Response to Psychotropic Medication, " Gend. Med., 2006, 3 : 93-109.
217. Paula J. Caplan, They Say You're Crazy: How the World's Most Powerful Psychiatrists Decide Who's Normal (Reading, Mass.: Addison-Wesley, 1995).
218. Elizabeth Watkins has pointed out that hormone replacement was increasingly used for a broad population of women in the 1960s and 1970s; Elizabeth Siegel Watkins, "'Educate Yourself': Consumer Information about Menopause and Hormone Replacement Therapy, " in Tone and Watkins, eds., Medicating Modern America (n. 102), pp. 63-93. It is interesting that hormone therapy became more widespread-for a larger potential population of women-at the same time the relatively smaller diagnostic group of patients with involutional melancholia disappeared. Although clinical trials in the twenty-first century have suggested that hormone replacement confers little or no benefit to women, physicians still have a strong attachment to the idea of administering hormones to postmenopausal women.
219. Adriane Fugh-Berman and Anthony R. Scialli, "Gynecologists and Estrogen: An Affair of the Heart, " Perspect. Biol. Med., 2006, 49 : 115-30.
220. This was true for the majority of clinical trials of medication from the 1950s through the 1990s. For example, see Milton Greenblatt, George H. Grosser, and Henry Wechsler, "Differential Response of Hospitalized Depressed Patients to Somatic Therapy, " Am. J. Psychiatry, 1964, 120 : 935-43;.
221. Sidney Malitz and Maureen Kanzler, "Are Antidepressants Better Than Placebo?" Am. J. Psychiatry, 1971, 127 : 1605-11;.
222. Jonathan R. T. Davidson et al., "Platelet Monoamine Oxidase Activity and the Classification of Depression, " Arch. Gen. Psychiatry, 1980, 37 : 771-73.
223. See also Hirshbein, "Science, Gender, and the Emergence of Depression in American Psychiatry" (n. 101).