endocrine psychiatry solving the riddle of melancholia may 2010

[...]... from the organ where they are produced to the organ which they affect by means of the blood stream.’’18 Endocrine psychiatry did not attract as many adherents as the psychiatry of brain weakness, but it had the advantage of an experimental basis The findings of endocrine psychiatry were the first convincing accounts of how body processes produce the symptoms of mental illness Beginnings of Endocrine Psychiatry. .. at the Institute of Psychiatry of the Maudsley Hospital in London pointed out in 1963, on the threshold of the new endocrine psychiatry, ‘‘For the past 70 years psychiatrists have treasured the illusion that the solution of several etiological problems in psychiatry only awaited advances in the endocrinological field.’’ They pointed out that Emil Kraepelin, the founder of the modern classification of. .. concept of the brain as a gland was first advanced in 400 B.C by Hippocrates, but that so little had been learned about the endocrine functions of the brain over the next 2,350 years.’’1 Indeed, for the endocrine functions of the brain to make much impact on psychiatry, it was important to acknowledge that the brain, rather than the mind, is the origin of psychiatric symptoms The essence of biological psychiatry. .. antibiotics to solve the riddle of bacterial illness and to insulin to solve the riddle of diabetes Endocrine psychiatry has a certitude of promise that warrants this journey There’s a second reason for this writing, too, one that sees psychiatrists as physicians The endocrine glands direct the attention of psychiatry to the entire body, not just to the regions above the neck The entire body once figured... life.’’16 At this writing, the study of the endocrine system gives us a window to the brain, making us spectators at the genesis of psychiatric illness Let us see what the window shows us of melancholia This page intentionally left blank 2 Early Days The brain is the largest of the endocrine organs In 1987, Philip Gold, head of neuroendocrine research at the National Institute of Mental Health, noted,... Charles Nemeroff and colleagues once pointed out.9 Yet the profession of psychiatry marginalized the study of the endocrine system Clinicians tutored in psychoanalysis and psychotherapy found its wet complexity daunting compared with the comfortable humanism of the interview with its reports of dreams The rush toward neurotransmitters in the 1960s elbowed aside aspects of research that were less profitable... later, ‘‘due to the absorption of the juice of the healthy thyroid gland by the tissues of the patient.’’ Murray thought, ‘‘It seems reasonable to suppose that the same amount of improvement might be obtained by simply injecting the juice or an extract of the thyroid gland of a sheep beneath the skin of the patient.’’16 This he did in 1891, with spectacular success, becoming, along with the two Portuguese... brain cells Today, they are called neurotransmitters, and the bulk of research in psychiatry is focused on them rather than the endocrines The third system is the immune system, defined as the science of neuropsychoimmunology (The immune system is the tissue-defense response to a foreign protein, as from a pathogen or malignant cell The response is marked by the release of cytokines and other chemicals... even of the obstructions in his lower abdomen.’’11 For psychiatrists of Chiarugi’s generation, the tides of the body were intimately linked to the passions of the spirit; once rid of the ‘‘bilious matter’’ in the stomach, the patient was restored to psychic health By the time of English psychiatrist Henry Maudsley, physician to the West London Hospital in the 1860s, a proper ‘‘physiological psychiatry, ’’... sheet-anchored the practice of seeing symptoms as the result of physiological events sweeping across the entire body, not just as a result of psychological dysphoria or unconscious conflict Endocrine psychiatrists are the descendants of the psychiatric tradition of physiological psychiatry, beginning with the Ancients and progressing to the organic psychiatrists of the nineteenth century and 1: Introduction 13 the . alt="" Endocrine Psychiatry This page intentionally left blank Endocrine Psychiatry Solving the Riddle of Melancholia Edward Shorter, PhD Jason A. Hannah Professor of the History of Medicine Professor. physicians. The endocrine glands direct the attention of psychiatry to the entire body, not just to the regions above the neck. The entire body once figured prominently in the understanding of mental. antibiotics to solve the riddle of bacterial illness and to insulin to solve the riddle of diabetes. Endocrine psychiatry has a certitude of promise that warrants this journey. There’s a second reason