Endocrine Psychiatry: Solving the Riddle of Melancholia

by Edward Shorter, Max Fink

Overview

The riddle of melancholia has stumped generations of doctors. It is a serious depressive illness that often leads to suicide and premature death. The disease's link to biology has been intensively studied. Unlike almost any other psychiatric disorder, melancholia sufferers have abnormal endocrine functions. Tests capable of separating melancholia from other mood disorders were useful discoveries, but these tests fell into disuse as psychiatrists lost interest in biology and medicine. In the nineteenth century, theories about the role of endocrine organs encouraged endocrine treatments that loomed prominently in practice. This interest faded in the 1930s but was revived by the discovery of the adrenal hormone cortisol and descriptions of its abnormal functioning in melancholic and psychotic depressed patients. New endocrine tests were devised to plumb the secrets of mood disorders. Two colorful individuals, Bernard Carroll and Edward Sachar, led this revival and for a time in the 1960s and 1970s intensive research interest established connections between hormone dysfunctions and behavior. In the 1980s, psychiatrists lost interest in hormonal approaches largely because they did not correlate with the arbitrary classification of mood disorders. Today the relation between endocrines and behavior have been disregarded.

This history traces the enthusiasm of biological efforts to solve the mystery of melancholia and their fall. Using vibrant language accessible to family care practitioners, psychiatrists and interested lay readers, the authors propose that a useful, a potentially live-saving connection between medicine and psychiatry, has been lost.

Product Details

ISBN-13:	9780199737468
Publisher:	Oxford University Press
Publication date:	05/12/2010
Edition description:	New Edition
Pages:	208
Product dimensions:	6.20(w) x 9.30(h) x 0.90(d)

About the Author

Edward Shorter, PhD
Professor of the History of Medicine
Hannah Chair in the History of Medicine
Professor of Psychiatry
Faculty of MedicineUniversity of Toronto

Max Fink, MD
Professor of Psychiatry and Neurology Emeritus
School of Medicine
State University of New York at Stony Brook
New York, NY

Table of Contents

Table of contents
Preface
Ch 1 Introduction
Ch 2 Early Days
Ch 3 Cortisol
Ch 4 Barney Carroll and Ed Sachar
Ch 5 The DST in Use
Ch 6 Trouble
Ch 7 "The most exciting development in the endocrine study of depression"
Ch 8 The Fall of Endocrine Psychiatry
Ch 9 Afterword, by Max Fink

Editorial Reviews

Reviewer: Sheila Lahijani, MD (Rush University Medical Center)
Description: This is a historical overview of the relationship between endocrine diseases, associated biochemical markers, and mood disorders. It places a strong emphasis on the development of psychiatry and its influences from biologically-minded clinicians.
Purpose: In a chronological and comprehensible manner, the book presents the successes and failures of the evolving interface of medicine and psychiatry with a special focus on endocrine disorders and depression. It also highlights the people involved over time and the challenges they encountered.
Audience: This book is appropriate for any readers who are curious about the historical influences of biological factors on psychiatric illness. Ideally, any clinicians practicing in internal medicine, psychiatry, or both may be interested in this information.
Features: With a strategic organization, the book effectively provides the necessary introduction in the first several chapters, while the latter chapters present the challenges and shortcomings of endocrine psychiatry. One chapter is dedicated to Barney Carroll and Ed Sachar, who were pivotal physician-researchers in the investigation of endocrine dysfunction and behavior.
Assessment: Although there are other books that survey similar themes, this book is different in its presentation and formulaic design. The authors present the myriad successes and failures in the research and understanding of endocrine diseases and psychiatric illnesses. They specifically discuss biochemical markers in a historical context, and they particularly concentrate on many of the individuals involved. They use an almost story-telling format and provide many accounts of the various individuals who have involved themselves in the understanding of the interface of medicine and psychiatry.

Doody's Review Service

"Is the timing right for this sort of publication? Probably. As the title implies a fall has occurred so it is hard to say whether it will be of interest. In reality I would say rise, fall, another rise with the concept of CRH antagonists for depression in the 1990s and in the past couple of years (peaking now) another all because they don't work for depression. Dr. Fink is an internationally known expert on ECT. . . . I would buy a copy and enjoyed reading the chapters provided."
—E. Sherwood Brown, M.D., P.h.D
Associate Professor, Director, Psychoneuroendocrine Research Program,
Department of Psychiatry, University of Texas Southwestern Medical Center
Dallas, TX

"Dr. Max Fink is one of the originators of modern psychiatric therapeutics, and his historical perspectives would be of interest. I personally would buy this book."
—Owen M. Wolkowitz, MD
Professor of Psychiatry, UCSF School of Medicine
San Francisco, CA

"With a strategic organization, the book effectively provides the necessary introduction in the first several chapters, while the latter chapters present the challenges and shortcomings of endocrine psychiatry." —Doody's

From the Publisher