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Possible causes of bipolar and its spectrum

Posted by Squiggles on February 14, 2007, at 10:20:07

I'm taking this from Kraepelin's book, Ch. X
entitled CAUSES. I would like to search
the authors, but it may be difficult.

He starts with a presupposition:

"Manic-depressive insanity in the sense here
delimited is a very frequent disease. About
10 to 15 per cent. of the admissions in our
hospital belong to it. The causes of the malady
we must seek, as it appears, essentially in *morbid predisposition*."

And he goes on to list various doctors with their theories about what causes it:

HEREDITARY:

Parental taint: 36%
Alcoholism: 33%
Some diseases not significant in a
hereditary role are epilepsy,
arteriosclerosis, dementia praecox.

Doctors' findings:

Vogt: 22% in father, 35.2% in mother

Kolpin: 7 out of 10 children of presumed manic depressive parents were manic-depressive

Rehm: 44 chilren of 19 families with psychic degeneration in 52%

Bergamasco: in 157 patients from 59 families,
109 belonged to manic-depressive insanity


AGE:

Friedmann: mild forms in attacks of excitement in young ages, only

Liebers: one case of true mania in a 5 yr. old boy

(the greatest number of cases begin in late teens and continue to early thirties)

SEX:

Kraepelin finds 70% in women and related
to sexual development, puerperium, and involusion;
in advanced age males are higher and arteriosclerosis may be significant;

Peixoto: men 6.2 %, women 6.8% with women starting earlier


PERSONAL IDIOSYNCRACY:

Reiss:

Temperaments-

Depressive: 64.2 depressive 8.3 manic 27.5 mixed
Manic 35.6 23.3 41.1
Irritable 45.5 24.4 30.1
Cyclothymic 35.3 11.7 53.0


EXTERNAL INFLUENCES:

(Kraepelin believes that these are subordinate
in comparison to innate):

Alcoholism:

In male patients 25% of malady, but Kraepelin interprets this as a result of the consequences of alcoholism;

Syphilis:

Kraepelin: 8%

Ziehen: acquired or inherited

Pilcz: coarse brain disease- 7 cases of apoplexy,
10 cases of tangible brain disease

Hoppe: cyst of the pia, brain scars

Saiz and Taubert: brain scars

Neisser: apoplexy with paralysis

Kraepelin: observed similar case to Neisser;
he also observes head injury as cause;

Monkemoller: in 56 cases of periodic insanity, he found 13 cases of cranical traumata, occuring many years after the injury;

BODILY ILLNESSES:

Typhoid, erysipelas, pneumonia, stomach, ear operations, pleurisy, cholera nostras, inluenza, blood-poisoining, haemoptysis,;

CONFINEMENT:

Beginning during or after pregnancy:

- very frequent

PSYCHIC INFLUENCES:

Situations of grief, for example:

- in 49 observations of death of relative, attacks occured 24 times; after dental operation; during pregnancy, fright, loss of livelihood, loos of love, self-abortion, and many others.

Kraepelin interprets these life miseries
"The certain conclusion, which can be drawn from these and similar extremely frequent experiences, leads us to this, that we must regard all alleged injuries as possibly sparks for the discharge of individual attacks, but that the real cause of the malady must be sought in *permanent internal changes", which at least very often, perhaps always, are innate..."

NATURE OF DISEASE:

("About the nature of manic-depressive insanity we are still in complete uncertainty." - K)

Theories:

Maynert: Periodic disturbances of vasomotor innervation;

Lange: Metabolic

Stegmann: Diminution of Uric Acid Excretion

Pardo: Coprology (intestinal bacteria)

Parhon and Marbe: Insufficiency of thyroid gland activity

Muratow: Endocrinological - suprarenals

Stransky: Metabolic (Basedow's disease), as well as auto-intoxication, such as alcohol and products of fatigue;

Morel and Doutrebente and Anglade and Jaquin:
- Epilepsy

Thalbitzer (after Helweg): diseased vasomotor paths;

--------------

Well, there you have it-- a very rough sketch of what some doctors though regarding the causes of this psychosis. Searching the works of these theories may be difficult, but rewarding in seeing the development of their ideas to the present searches.

/Squiggles



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