How deep are the historical roots of our concept of major depression (MD)? I showed previously that psychiatric textbooks published in 1900-1960 commonly described 18 characteristic depressive symptoms/signs that substantially but incompletely overlapped with the current DSM (Diagnostic and Statistical Manual of Mental Disorders) MD criteria. I here expand that inquiry to the key years of 1880-1900 during which our major diagnostic categories of manic-depressive illness (MDI) and dementia praecox were developed. I review the symptoms of depression/melancholia in 28 psychiatric textbooks and 8 other relevant documents from this period including monographs, reviews and the first portrayal of melancholia Kraepelin in 1883. Descriptions of melancholia in the late nineteenth and twentieth century textbooks closely resembled each other, both reporting a mean of 12.4 characteristic symptoms, and emphasizing core features of mood change and alterations in cognitive content and psychomotor behavior. The detailed monographs, reviews and the early description of Kraepelin were more thorough, reporting a mean of 16.6 of these characteristic symptoms. These nineteenth century texts often contained phenomenologically rich descriptions of changes in mood and cognition, loss of interest and anhedonia and emphasized several features not in DSM including changes in volition/motivation, posture/facial expression and derealization/depersonalization. In the early nineteenth century, melancholia was often defined primarily by delusions or as the initial phase of a unitary psychosis transitioning to mania and then dementia. By 1880, the concept of depression as an independent mood disorder with characteristic symptoms/signs and a good prognosis had stabilized. Kraepelin incorporated this syndrome into his diagnostic concept of MDI, changing its name to 'Depressive States', but did not alter its underlying nature or clinical description.

中文翻译：

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严重抑郁症的家谱：1880年至1900年的忧郁症的症状和体征。

我们的重大抑郁症（MD）概念的历史根源有多深？我以前曾证明，在1900-1960年出版的精神病学教科书通常描述了18种特征性抑郁症状/体征，与当前的DSM（精神障碍诊断和统计手册）MD标准实质上但不完全重叠。在这里，我将调查范围扩展到1880-1900年的关键年份，在此期间，我们开发了躁狂抑郁症（MDI）和praecox痴呆的主要诊断类别。我在此期间的28篇精神病学教科书和其他8篇相关文献中回顾了抑郁症/忧郁症的症状，其中包括专着，评论和1883年对忧郁症Kraepelin的首次描写。19世纪末和20世纪教科书中关于忧郁症的描述彼此非常相似，两者均报告了平均12.4个特征性症状，并强调了情绪变化的核心特征以及认知内容和精神运动行为的改变。详细的专着，评论和对Kraepelin的早期描述都比较详尽，报告这些特征性症状的平均值为16.6。十九世纪的这些文本通常包含丰富的现象学描述，描述了情绪和认知的变化，兴趣丧失和快感不足，并强调了DSM中没有的一些功能，包括意志/动机，姿势/面部表情和去现实/人格解体的变化。在19世纪初期，忧郁症通常主要是由妄想来定义的，或者是单一精神病向躁狂症然后是痴呆转变的初始阶段。到1880年，抑郁症是一种独立的情绪障碍，具有特征性的症状/体征和良好的预后，这一观念已经稳定下来。Kraepelin将此综合征纳入其MDI的诊断概念，将其名称更改为“抑郁状态”，但并未改变其基本性质或临床描述。