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MELANCHOLIA: The Medical Illness

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A severe psychiatric illness, Melancholia, has long been recognized. It was a feature of 19th Century psychopathology. In the 20th Century, it was subsumed under the sobriquet of "Depression" and lost. In the past 30 years, interest has been rekindled and the detailed characteristics of the illness have been described, as have the associated systemic dysfunctions of the neuroendocrine system. More important, effective treatments have been developed.

Scidata (talk) 21:36, 1 May 2009 (UTC)[reply]


Dürer's woodcut is actually entitled Melencholia and is usually referred to by that spelling.
S.

It is? if so please update this page & the Durer page

"The present classification of psychiatric disorders is ill-defined, offering poor guidelines for the treatment of the ambulatory and the severe mentally ill." I think that's a little biased, and has no proof. —Preceding unsigned comment added by Cannda180 (talkcontribs) 06:54, 6 September 2009 (UTC)[reply]


From the article:

It was characterized by "aversion to food, despondency, sleeplessness, irritability, restlessness," as well as the statement that "fear or depression that is prolonged means melancholia."

Can anyone say where those quoted passages are from?

Stanley Jackson, Melancholia and Depression: From Hippocratic Times to Modern Times, (Yale University Press, New Haven, 1986) p.30. cites Hippocrates, Works, 1: 263, 4:185. I am not sure how much of this [and in what form] should be included in the article.

I love that image used for this page. Studio1991 06:16, 17 Mar 2004 (UTC)

As far as I can tell, the first direct quote is probably from Hippocrates's On Epidemics. It's from the end of Sixteen Cases of Disease - Case i, and deals with a case which is not explicitly described as a melancholic disease. From Adams's translation :
In this case the urine throughout was black, thin, and watery; coma supervened; there was aversion to food, despondency, and insomnolency; irritability, restlessness; she was of a melancholic turn of mind.
I suspect that the quote was added to the article because of the "melancholic turn of mind" line.
The second direct quote is definitely from Hippocrates's Aphorisms (Section 6.23). Adams translates it :
If a fright or despondency lasts for a long time, it is a melancholic affectation.
Best, -- Docether 20:05, 19 January 2007 (UTC)[reply]

But the writing in the woodcut itself spells it "Melencolia"

Per this, I am changing the spelling. --MarkBuckles 03:22, 25 May 2006 (UTC)[reply]
Nevermind, see Melancholia I --MarkBuckles 03:26, 25 May 2006 (UTC)[reply]

melancholy

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wikipedia would be better with a page on "melancholy" as it is used contemporarily. should the modern use go on this page or another page? Id like to know the consensus before i begin work on this page that angers somebody. Spencerk 17:58, 3 March 2006 (UTC)[reply]

Durer's Solid

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The object in the woodcut is clearly not a truncated cube, as defined in the linked page. The truncated cube has no pentagonal faces, while the object in the woodcut has many. It is a symbol of melancholy in art, so I think it would be nice to know the correct name for it. Cgray4 13:58, 15 May 2006 (UTC)[reply]

You are correct. It is a truncated rhombohedron (but not cube, a cube being a special case of a rhombohedron). I've corrected the text with an external link to a mathematical discussion of the shape. I found the link and the correct name in the article about the artwork itself. Aleta 20:19, 1 January 2007 (UTC) (edit Aleta 04:00, 2 January 2007 (UTC))[reply]
It's an ENGRAVING not a woodcut Johnbod 20:53, 1 January 2007 (UTC)[reply]
Good point, even if it was meant as sarcasm. Wikipedia is an encyclopedia - accuracy matters. Since, according to Melancholia I, much has been written about the solid, apparently there are others who think it important that it was not a truncated cube. Aleta 21:27, 2 January 2007 (UTC)[reply]
Sarcasm? See a dictionary Johnbod 10:36, 9 January 2007 (UTC)[reply]
Sardonicism, pardon me. Aleta 23:46, 19 January 2007 (UTC)[reply]
try exasperation Johnbod 04:00, 20 January 2007 (UTC)[reply]

Name

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On the name thing, I definitely agree with Spencerk it should be listed under the modern name, although it is worth mentioning that it is derived from another word. Going back to old fashioned terms for stuff makes wikipedia go out of sync.

On the article, I think their is something mayor missing in this article as it states: "It is now generally believed that melancholia was the same phenomenon as what is now called clinical depression." That is a bit harsh, everybody feels melancholic at times, it does not qaulify as a 'clinical depression', it is an emotion. Only when stretced to the extreme it can be called a depression. So jay for the backdrop and a little bit of history but where is the detailed description of (normal) melancholy? Oliver Simon 21:03, 26 September 2006 (UTC)[reply]

Greek spelling of "melancholia" (μελαγχολία)

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I corrected the Greek word "μελαγχολία" that had been mistakenly written as "μελανχολία". Anyone interested could check the Lidell-Scott dictionary or some texts: Galenus, De locis affectis libri, 8,193,10; Anonymus Medicus, De alimentis, 75,43; Palladius Medicus, Commentarii in Hippocratis librum sextum, 2,21,13.— Preceding unsigned comment added by 85.75.20.24 (talk)

It was me that made the changes. I couldn't find a source outside of Wikipedia that spelled it the way you did. It doesn't seem that gamma would be the appropriate letter for that. I don't think I've ever seen it used for an "n" sound. --Infosocialist 09:21, 23 February 2007 (UTC)[reply]
The ni letter is always converted to gamma when it is placed before the following consonants: kappa, gamma, chi. Examples: ἔγκυος < ἐν+κύω (=pregnant); ἐγχέω < ἐν+χέω (=I pour a liquid inside something).
Greek is my mother tongue. —The preceding unsigned comment was added by 85.75.251.245 (talk) 14:02, 23 February 2007 (UTC).[reply]
Interesting. Thanks for that. I'm just learning... And on my own. --Infosocialist 00:14, 24 February 2007 (UTC)[reply]

Ishaq ibn Imran

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It is referred to Ishaq ibn Imran as diagnosing a type of melancholia, but did he use the word 'melancholia', the word 'ḥuzn' as used by Avicenna or some other word? Or was his finding only later classified as melancholia? I unfortunately don't have access to the reference.

The word 'Melancholia' may in ancient times been referring to illnesses with several different labels today, such as clinical lycanthropy and schizophrenia, which this article should of course reflect. But we then need to stay as true as possible to the history and don't make their concepts vaguer than they were. If arabic scholars recognized a mood disorder with symptoms similar to schizophrenia as a separate mood disorder, this in fact has implications for today's debate on the "schizophrenia label". EverGreg (talk) 11:24, 17 January 2008 (UTC)[reply]

This has now been clarified by Jagged 85's edits on 25th of January 2008. Thanks! :-) EverGreg (talk) 15:16, 26 January 2008 (UTC)[reply]

Etymology

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Can someone explain how the etymology is simultaneously Greek and Arabic? How is that not a contradiction? —Preceding unsigned comment added by 67.86.37.47 (talk) 19:32, 1 February 2008 (UTC)[reply]

It's Arabic!

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I find it unfair to erase the arabic origin of the word from the inroduction, since the latin word itself is no more than a latinization of the word Milakhuliya, which i believe is some neologism that Ishaq coined for that precise condition, since it has no roots in the arabic language. —Preceding unsigned comment added by 41.250.113.58 (talk) 17:00, 23 August 2009 (UTC)[reply]

This is so patently absurd. Galen described the four humours, what, 800 years before Ishaq, but you want to believe that Ishaq coined the word melancholia? Ishaq wasn't describing melancholy for the first time; he was simply describing one form of it. Oh, and then there's this bit from the OED:
post-classical Latin melancholia (5th cent.; already in classical Latin as a Greek loanword)
Unless Ishaq was a time-traveller, I'd say the fact that the word existed in Latin 500 years before his existence is pretty good evidence that he didn't coin it. It had long existed in both Greek and Latin by his time, and if he invented anything, it was an Arabicization of one of those words, not the other way around. I'm removing the Arabic etymology accordingly.--76.28.236.209 (talk) 08:53, 26 April 2010 (UTC)[reply]
I added Hippocrate's passage and the Greek etyma references. The Cat and the Owl (talk) 09:28, 26 April 2010 (UTC)[reply]

Treatment

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Under the heading of Treatment is the reference to ECT, which is given its own sub-heading. However, it is not defined. Further something appears to be left out, as the flow of the paragraph is disjointed. Unless I am completely wrong, ECT is the acronym for Electroconvulsive thearapy. Its usage has neither a clarification of the acronym, nor does it have a reference to the ECT Wikopedia article. This needs editing. - KitchM (talk) 03:03, 26 August 2009 (UTC)[reply]

Citations: What a mess!

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At the moment the citations are all messed up as superscripts are being used rather than the proper wikipedia style. This means all the citation numbers are now incorrect. Also the article references ref 1 which is a deadlink. Thanks for taking the time to add citations but please could those who have inserted the references update them to the wikipedia style see http://en.wikipedia.org/wiki/Citing_Wikipedia Thanks. 194.83.139.177 (talk) 15:05, 5 October 2009 (UTC)[reply]

This appears to be because someone copied and pasted in an entire article, "Resurrecting melancholia" by M. Fink & M. A. Taylor, from the journal "Acta Psychiatrica Scandinavica" Volume 115, pages 14–20, February 2007. This text, half the article, has now been removed. - 220.101 talk\Contribs 06:23, 21 September 2010 (UTC)[reply]

Religious melancholy

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This article is a bit weak on the medieval and christian theological discussion of melancholy. We had an unsourced contribution which may have rectified this or may have been a personal opinion. I can't tell but is preserving the contribution below. EverGreg (talk) 17:11, 4 April 2010 (UTC)[reply]

The traditional definition of melancholy which originates from Burton, is that melancholy is a fear and sadness without cause. Saying that melancholy is a condition that is without cause is a cause for concern. Modern psychoanalysis suggests that this 'without cause' suggests that the melancholic individual is mourning a loss or even more specific a lack of something. One form of melancholy is religious melancholy which stems as far back as the Baroque epoch. After the secularization of religious institutions and the distrust in religious figures, people started turning away from God, and turned inwards to a more spiritual and less institutionalized form of finding God. See pantheism for more information. It is believed that melancholy originates from the loss of godly devotion and critical skepticism. On a materialistic viewpoint, the melancholic cannot be at a loss, if they never possessed that over which is mourned, e.g. the conflict between the first and second born son. If the second born son is melancholic, yet despises his first born brother because he is first in line to the throne, or for the family riches, or the receiver of the father's love, we speak of the melancholic second born as being melancholic because of a lack of something. In comparison to the 'loss of something' that one sees with religious melancholy, we cannot speak of a 'loss of something' if that person never had it in the first place. Understanding that the individual ins melancholic due to a 'lack of something' suggest a need for something, e.g. perfection or completion, thus seting the seeds of narcissistic attitudes.

This would need a discussion of the relation of melancholia and acedia. Brianshapiro (talk) 22:44, 20 August 2013 (UTC)[reply]

Misuse of sources

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This article has been edited by a user who is known to have misused sources to unduly promote certain views (see WP:Jagged 85 cleanup). Examination of the sources used by this editor often reveals that the sources have been selectively interpreted or blatantly misrepresented, going beyond any reasonable interpretation of the authors' intent.

Please help by viewing the entry for this article shown at the cleanup page, and check the edits to ensure that any claims are valid, and that any references do in fact verify what is claimed. Tobby72 (talk) 18:42, 12 September 2010 (UTC)[reply]

The changes in question is the following: [1] There are two references to check. EverGreg (talk) 08:20, 21 September 2010 (UTC)[reply]
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I have removed half of this article as it appears to be a direct copy, c/w footnote 'markers' of the article "Resurrecting melancholia" by M. Fink & M. A. Taylor from Acta Psychiatrica Scandinavica Volume 115, pages 14–20, February 2007.

Good catch, thanks. EverGreg (talk) 08:14, 21 September 2010 (UTC)[reply]
No problemo, I am just very surprised no one picked it up earlier. What I twigged to was the unlinked footnotes, which another editor made into superscripts! - 220.101 talk\Contribs 09:35, 21 September 2010 (UTC)[reply]
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This sections appears to reference a psychological state unlike the that of the main article and specially attributes negative psychological causes to reasons specific to a particular religious viewpoint. The description provided more closely matches the religious topic Dukkha — Preceding unsigned comment added by Thetrek (talkcontribs) 03:16, 30 December 2011 (UTC)[reply]

Romanticism, modernism, and melancholia

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The article says "In the 20th century, much of the counterculture of modernism was fueled by comparable alienation and a sense of purposelessness called 'anomie'." To start off with, I don't know that modernism was a 'counter-culture' -- at first, maybe -- but it very quickly became absorbed into the mainstream culture of academic institutions. Regardless, I don't know that there's necessarily a one-to-one relationship between melancholy, and angst; angst is what modernists were concerned with and the cause of anomie, and of ennui. Its more of a condition of anxiety than what was called 'melancholic depression', although to be sure, in humorism, anxiety and depression could both be products of black bile and were both driven out by the same remedies. Yet, much of modernism was also fueled by an opposing sentiment, jouissance, or joie de vivre. Romantics put a lot of positive characteristics behind melancholy, considering it a higher state of awareness. Victorians were influenced by romanticism, and modernists often ended up looking down on the bourgeois culture of Victorian society as being repressed and internalized, joyless and preferring death over life. Angst and jouissance, while entirely different types of states of mind, were both antagonistic values to repressed, bourgeois culture. Expressionism, to some degree, incorporated melancholia, but was soon attacked as 'too bourgeois' itself and as a latent product of romanticism. Brianshapiro (talk) — Preceding undated comment added 22:14, 20 August 2013‎

Requested move

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The following discussion is an archived discussion of a requested move. Please do not modify it. Subsequent comments should be made in a new section on the talk page. Editors desiring to contest the closing decision should consider a move review. No further edits should be made to this section.

The result of the move request was: No move. This discussion has gotten quite confused in a short order of time, but I think we've achieved consensus on a few key points. First, we have a general agreement that this article is (or should be) about melancholia as one of the four temperaments. As such, there is no agreement that "melancholy" is a better title for it. There is also considerable question and confusion over whether this is really the primary topic of "melancholy" compared to depression (mood) and other uses, and therefore question over whether it should remain a redirect here. As such, I will close as no move for Melancholia, and will take the additional step of moving Melancholy (disambiguation) to Melancholy. Several editors suggested Melancholy be redirected to depression (mood); this possibility may be worth exploring in its own RM. Cúchullain t/c 20:20, 5 June 2014 (UTC)[reply]



MelancholiaMelancholyWP:COMMONNAME by a mile. Try Google, Google Books, Google Scholar, or JSTOR—"melancholy" is far more common. BDD (talk) 16:16, 22 May 2014 (UTC)[reply]

Nope. --BDD (talk) 20:30, 22 May 2014 (UTC)[reply]
Support, then. Wikipedia is not a dictionary and therefore we can ignore any redirect of melancholy to depression/sadness/etc. This is the only encyclopedic usage of the term "melancholy". Primary topic is clear, so let's go with the common name. Red Slash 03:21, 24 May 2014 (UTC)[reply]
  • Support. Melancholy in modern usage simply means 'sad'; this meaning diverged from the mediaeval usage in the sixteenth century. Until then 'Melancholy' (Black bile) was one of the 4 Galenic humours, derived from the Aristotelian elements, and the 'Melancholy Complexion' described a man who suffered from fearfulness, bad dreams and dark reflections, all somewhat 'neurotic', so the word 'melancholy' is both a noun and an adjective, and has both mediaeval and modern senses. The term 'melancholia' appears to name a disease associated with the Melancholy Complexion and humour. All of this means that 'Melancholy' is the more general term in English; arguably Melancholia is a separate term (could be a subsection or a subsidiary article). The existing article describes Melancholy in general and should be so named. Chiswick Chap (talk) 11:39, 23 May 2014 (UTC)[reply]
  • Oppose The fact that melancholy redirects here is not at all reason to move this article. If anything melancholy might redirect somewhere else, but I think that would be a loss for those looking for this article. Possibly a new notice at the top of the page? CFCF (talk · contribs · email) 12:08, 23 May 2014 (UTC)[reply]
The existing redirect is no evidence either way. 'Melancholia' will in any case remain as a search term if anyone chooses to use it, so no loss is involved. Chiswick Chap (talk) 12:10, 23 May 2014 (UTC)[reply]
  • Comment I'm not so sure the article is about just the medical concept - the "Cult" section seems to be about "melancholy" more generally. Perhaps it would be possible to produce two separate articles - one strictly on the ancient medical concept and one on "melancholy" more generally. But probably it is not possible to split the two concepts - and so long as that is true, it doesn't really matter whether it ends up at the one or the other. Furius (talk) 12:26, 23 May 2014 (UTC)[reply]
I agree that Depression (mood) is the correct encyclopedic target for "melancholy". walk victor falk talk 12:32, 23 May 2014 (UTC)[reply]
This is becoming confused. Depression (mood) is the right target for the modern sense of 'melancholy', but not for the mediaeval sense. Chiswick Chap (talk) 12:37, 23 May 2014 (UTC)[reply]
I don't really agree that "Depression (mood) is the right target for the modern sense of 'melancholy'". Firstly, in modern usage it retains something of its older sense of being a frame of mind, and permanent disposition, while the essence of a mood is that it is transient. Secondly it is just rather different, with elements of pessimism and morbidity that aren't necessarily part of a depressed mood. Wiki CRUK John (talk) 14:17, 23 May 2014 (UTC)[reply]
Whichever we choose, there should be a {{redirect}} to either melancholia or depression (mood), to help the readers looking for the other subject. walk victor falk talk 12:44, 23 May 2014 (UTC)[reply]
To spell it out: Melancholy redirects here. See melancholia/depression (mood). walk victor falk talk 12:47, 23 May 2014 (UTC)[reply]
Note, I also fixed the dab pages for Melancholia (disambiguation) and Melancholy (disambiguation). Chiswick I think those changes will satisfy you? And Victor, the hat for this page refers to the dab page Melancholia (disambiguation) which says "see also" Melancholia (disambiguation) which has a link to depression (mood) - is that good enough? Jytdog (talk) 12:49, 23 May 2014 (UTC)[reply]
I also note that as of right now, melancholy redirects to Depression (mood) - i just did the search. So I just changed the redirect of Melancholy to Melancholy (disambiguation) Jytdog (talk) 12:51, 23 May 2014 (UTC)[reply]
Someone must have changed it in the last hour then. Wiki CRUK John (talk) 14:17, 23 May 2014 (UTC)[reply]
You have tidied up some of the mess, well done, but the article's title remains strange (and matches a disambiguation entry, so it's not better than 'Melancholy'). Basically nobody uses 'melancholia' even in history of science books any more, so the article's title just looks a bit weird/old-fashioned/ill-informed. I think therefore that 'Melancholia' should redirect to 'Melancholy'. Chiswick Chap (talk) 12:56, 23 May 2014 (UTC)[reply]
I hear you! I am not sure on what basis you say that the term is no longer used in history of science.... but in any case, what if we renamed this to "Melancholia (temperament)"? Jytdog (talk) 13:06, 23 May 2014 (UTC)[reply]
Thanks... the hatnote is now broken, but why don't we just call it Melancholy (temperament)? Easier, and it seems you've already created the other search term to redirect there... It's quite hard to prove a negative, beyond assuring you it's the case. Even back in 1964, for instance, Lewis, a man very comfortable with Latin, could write
"Elyot's symptoms of the Melancholy Complexion run: 'lean...moche watch...dreams fearful...stiff in opinions...anger long and fretting'. Hamlet diagnoses himself as melancholy (II, ii, 640)..." (The Discarded Image, Cambridge, 1964. p172)
So I'd rephrase the question, why does anyone want to keep 'melancholia'? It seems quite inappropriate to use a Latin term when an English one has been around since at least the 16th century. Chiswick Chap (talk) 13:59, 23 May 2014 (UTC)[reply]
i went ahead and boldly made the change to Melancholia (temperament)... Jytdog (talk) 13:52, 23 May 2014 (UTC)[reply]
that's the 3rd edit conflict ... you are changing things very quickly, but not necessarily correctly or by agreement. See above. But I'm glad we're moving. Chiswick Chap (talk) 13:59, 23 May 2014 (UTC)[reply]
It's really NOT helpful to move things in the middle of an RM discussion, 5 mins after the title moved to was first proposed, in particular because that change cannot be reverted. I suggest we carry on, although all targets seem to be moving ones. Wiki CRUK John (talk) 14:08, 23 May 2014 (UTC)[reply]
sorry to be upsetting. thanks for your tolerance. Jytdog (talk) 14:55, 23 May 2014 (UTC)[reply]
Thank you Steel1943 for noting that I haven't moved anything, least of all at anytime before a day or so after this RM was posted. The only thing I've done is removing "(temperament)" from the list on the disambiguation page. walk victor falk talk 12:34, 24 May 2014 (UTC)[reply]
I apologize again for the pre-emptive move. Bad judgement on my part. Jytdog (talk) 14:22, 24 May 2014 (UTC)[reply]
I am horrified by my error--I apologize unreservedly to victor falk. Red Slash 04:22, 25 May 2014 (UTC)[reply]
no big deal. Cheers, walk victor falk talk 04:41, 25 May 2014 (UTC)[reply]

The above discussion is preserved as an archive of a requested move. Please do not modify it. Subsequent comments should be made in a new section on this talk page or in a move review. No further edits should be made to this section.
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trimmed/updated content

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Damnation! I knew this was going to end badly...

Trimmed/updated in lead [2]:

Despite there being a variety of mental and physical symptoms to this condition, clinicians in the 20th century came to attach the term "melancholia" almost exclusively to depression, before largely ceasing to use it at all. As such, "melancholia" is the historical predecessor of the modern mental-health diagnosis of "clinical depression",[1] and the term currently characterises a subtype of major depression known as melancholic depression.[2]

References

  1. ^ Berrios, G.E. (1988). "Melancholia and depression during the 19th century: A conceptual history". The British Journal of Psychiatry. 153 (3): 298–304. doi:10.1192/bjp.153.3.298. PMID 3074848.
  2. ^ Compare: "An Update on Melancholia: Page 3 of 5". Melancholia is variably positioned dimensionally (ie, a severe expression of clinical depression) or categorically (ie, a distinct type)

(rapid note: the trimmed PMID 3074848, Berrios 1988, appears to be a useful source, although not so recent and unfortunately paywalled). 86.169.96.127 (talk) 16:55, 17 March 2021 (UTC)[reply]

...changed to:

Between the late 18th and late 19th centuries, melancholia was a commonly used medical diagnosis, and modern concepts of depression as a mood disorder eventually grew out of this historical practice.[1] Although depression and melancholia are separate concepts,[1] the adjective "melancholic" is still used as a current diagnostic term to specify certain features that may be present in major depression.[2]

86.169.96.127 (talk) 20:55, 17 March 2021 (UTC)[reply]

Essentially fine with that, but can you reword to avoid the Easter egg link in "the adjective "melancholic" is still used as a current diagnostic term to specify certain features...". Maybe "the adjective "melancholic" is still used in melancholic depression, in American medicine a current diagnostic term with certain specific features...". I've also globalized - something you should probably be more attentive to. Johnbod (talk) 17:06, 17 March 2021 (UTC)[reply]
@Johnbod Hum, my (limited :) understanding is that while DSM is American, it has a rather wider - albeit not universal - reach. Personally, I felt that my inclusion of the word "adjective" was itself a bit clunky, though I did try to keep close to the sourcing. Given that Melancholic depression seemed to me a somewhat muddled/dated page, I'm not altogether sure how easter-eggy "...a [[DSM-5|current diagnostic]] term to [[Melancholic depression|specify]] certain features..." actually is. I wonder if it could be appropriate to call @Markworthen (or another experienced PSY editor) for an informed opinion/recommendation. 86.169.96.127 (talk) 20:35, 17 March 2021 (UTC)[reply]
Well, I wouldn't know, but my impression is that this is one of the areas where DSM & APA ideas are by no means universally accepted (domestically as well as globally). We might ask User:Casliber. "Melancholic depression|specify" looks pretty chocolatey to me. Johnbod (talk) 21:09, 17 March 2021 (UTC)[reply]
And I'm really *happy* to seek input from others. 86.169.96.127 (talk) 21:19, 17 March 2021 (UTC)[reply]
DSM 5 is very widely used and has become de facto lingua franca for diagnoses etc. Writing is ok - I should be able to get the Berrios paper. Also, Melancholic depression should be merged into this article as it doesn't exist as an entity any more - was a qualifier in DSM IV...actually not sure if even a qualifier anymore...hmmm Cas Liber (talk · contribs) 23:18, 17 March 2021 (UTC)[reply]
Thanks - happy to take your word for that. Johnbod (talk) 04:59, 18 March 2021 (UTC)[reply]

Edits by Markworthen on 18 Mar 2021

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Thank you for the ping. :) I made some edits today (diff). Here is a brief description of the edit with my rationale.

  • Change "medical doctor" to "physician". The term "medical doctor" is relatively recent compared to "physician". Both historically (the definition that follows dates back to 1200) and currently, "physician" means "a person who is trained and qualified to practise medicine; esp. one who practises medicine as opposed to surgery."[1] At present (21st century), "doctor" often means "a doctor of medicine", but it also means "a person who, in any faculty or branch of learning, has attained to the highest degree conferred by a University"; "a person who is proficient in knowledge of theology: a learned divine"; or "a person who is proficient in knowledge of law".[2]
  • I deleted "Although depression and melancholia are separate concepts" because, as written, it is not accurate, particularly for an article about the historical concept of melancholia. For example, the American Heritage Dictionary provides this definition:

    melancholia, n. 1. Extreme, persistent sadness or hopelessness; depression. No longer in clinical use.

  • Finally, I rewrote the rest of the paragraph in question. It now reads:

At present (21st century), melancholia describes a depression subtype characterised by:

  • severely depressed mood, wherein the person often feels despondent, forlorn, disconsolate, or empty
  • pervasive anhedonia - loss of interest or pleasure in most activities that are normally enjoyable
  • lack of emotional responsiveness (mood does not brighten, even briefly) to normally pleasurable stimuli (such as food or entertainment) or situations (such as warm, affectionate interactions with friends or family)
  • terminal insomnia - unwanted early morning awakening (two or more hours earlier than normal)
  • marked psychomotor retardation or agitation
  • marked loss of appetite or weight loss

The American Psychiatric Association does not like anyone to copy their text verbatim, so I made sure I did not violate their copyright. Plus ICD-11's "Current depressive episode with melancholia" is quite similar. Thus, the list above is representative of current understanding in the two major nosological systems, which I referenced,[3][4] yet the list does not violate copyright and it is not original research.

Btw, I recognize that many people, including many Wikipedia editors, believe that DSM-5 predominates internationally and in English-speaking countries. DSM-5 is certainly very influential, but ICD is used to classify and understand medical (including mental) disorders at least as often, if not more so. I will eventually write something about that fact with citations, but it's still on my to do list. Mark D Worthen PsyD (talk) [he/his/him] 18:46, 18 March 2021 (UTC)[reply]

Thank you for that Mark. I'm happy to defer (and the DSM / ICD point is well taken). Your edits imply that melancholia does remain a *current* medical concept, and I've made a rapid copyedit [3] to avoid an internal contradiction in the lead. I leave it to you PSY guys to agree on the extent to which melancholia can (still) be considered a "subtype" of depression. My own very laylish understanding fitted more with Casliber's response above [4] that, in DSM at least, it's a "qualifier" (but maybe this is a semantic hair-splitter?).

More generally, I concur about the *historic* character of the article. While finding the many cultural aspects intriguing, I can't help feeling that it also poses particular editorial challenges that aren't altogether straightforward (for example how to weight its *current* med relevance as a somewhat marginal qualifier/subtype of the far broader diagnosis it historically spawned). But hey, that could be cool... 86.134.212.111 (talk) 20:46, 18 March 2021 (UTC) 86.186.155.219 (talk) 13:17, 19 March 2021 (UTC)[reply]

Right, think about it like this - historically melancholia was a syndrome of low mood, lack of energy and psychomotor retardation (not moving much), DSM comes along with endogenous (i.e. biological) depression and reactive depression - these then shift in DSM IV to broaden to "major depressive disorder" and narrow to "adjustment disorder with depressed mood". The criteria of major depressive disorder are much broader than original melancholia and include people who are pervasively depressed, many of whom do not have psychomotor retardation. "with melancholic features" is preserved as a qualifier in DSM IV and has some use as some medications work better in those people (TCAs and venlafaxine) than usual first line agents. Anyway I need to check but I suspect this qualifier has been kyboshed in DSM 5. NB: not thrilled about "physician" as in Australia it means non-surgical specialist in internal medicine (i.e. specifcially excludes surgeons, psychiatrists, radiologists, pathologists etc.). But not really fussed about this. I see "doctor" as unequivocally plainer English. No-one is going to presume we mean Doctor of Philosophy or other non-medical doctor in this sense here. Cas Liber (talk · contribs) 21:17, 18 March 2021 (UTC)[reply]
Excellent points.
  • 86.134.212.111 - Thank you for your rapid copy edit. :) ¶ There probably is a unique type of depression with some of the current descriptors/symptoms listed in DSM-5 & ICD-11, but the current list will likely be refined over the next several years as research continues. ¶ I agree that this article poses editorial challenges, and maybe it would be best merged with melancholic depression, but I haven't looked into that possibility at all (it may have been argued and decided previously).
Hum, imo, the bullet-point list might be better located in a dedicated section of the main text (titled something along the lines of == Current medical/psychiatric xxxxxxxxx == [?]). At the moment, I think there's a real issue of undue weighting in the lead, potentially making it seem as if centuries of conceptual history have somehow culminated in this particular qualifier of depression. Whereas, consensus in the reliable sourcing (of which PMID 31995137 is a recent example) seems to be that the centuries-long traditions of Melancholia ultimately culminated in the birth of the new major diagnostic entity of clinical depression, within which the *term* melancholic is currently used as a descriptor for certain cases. (Fwiw, I think that other notable *psychological* traditions that may remain of current non-psychiatric/non-medical pertinence should also find space in the page.) My 2c, 86.186.155.219 (talk) 19:02, 19 March 2021 (UTC)[reply]
Another excellent point, i.e., it is too much detail for the lede. Thank you. Mark D Worthen PsyD (talk) [he/his/him] 00:26, 20 March 2021 (UTC)[reply]

Hehehe - I looked in a DSM 5 in clinic today at saw page 185. Is only a qualifier "with melancholic features" - which can be applied to a depressive episode. So "melancholic depression" not an entity labelled or described as such. I'm gonna post a merge template soon - this should be the target page as the simpler title and longer-lasting concept Cas Liber (talk · contribs) 10:34, 20 March 2021 (UTC)[reply]
Well, as they say, the devil is in the detail (...just a couple of small changes [5]).

A bit unclear to me exactly how the various bullet points relate to each of the two cited sources, but hopefully that will emerge in the proposed merger. 86.172.165.171 (talk) 15:20, 20 March 2021 (UTC)[reply]

@86.172.165.171 - I wrote above: "Thus, the list above is representative of current understanding in the two major nosological systems, which I referenced,[3][4] yet the list does not violate copyright and it is not original research." I think that explains how the various bullet points relate to each of the two cited sources, but if not, please let me know. Mark D Worthen PsyD (talk) [he/his/him] 16:50, 21 March 2021 (UTC)[reply]
@Markworthen: on reflection, a straightforward copyedit [6] seemed to me all that's needed (doh :). 86.134.212.117 (talk) 19:21, 21 March 2021 (UTC)[reply]
Nice. I like it. :O) Mark D Worthen PsyD (talk) [he/his/him] 19:26, 21 March 2021 (UTC)[reply]
(edit conflict) Btw, I definitely agree with your downgrading [7]: the page needs work. Imo, the main focus should be on the history of the idea and its broad cultural reach (including the arts, natural philosophy, etc, etc). If done appropriately I think it could be a really valid and genuinely *encyclopedic* page. My 2c, 86.134.212.117 (talk) 19:39, 21 March 2021 (UTC)[reply]
@Cas Liber - We are on the same page. :0) Mark D Worthen PsyD (talk) [he/his/him] 16:52, 21 March 2021 (UTC)[reply]

References

  1. ^ Oxford English Dictionary, 3rd ed. (Oxford, England: Oxford University Press, 2006, rev. December 2020), s.v. "physician".
  2. ^ Oxford English Dictionary, 2nd ed. (Oxford, England: Oxford University Press, 1989, rev. July 2020), s.v. "doctor".
  3. ^ World Health Organization, "6A80.3 Current depressive episode with melancholia", International Statistical Classification of Diseases and Related Health Problems, 11th rev. (September 2020).
  4. ^ American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-5®). United States: American Psychiatric Publishing. p. 185. ISBN 978-0-89042-557-2

Merge proposal

[edit]
The following discussion is closed. Please do not modify it. Subsequent comments should be made in a new section. A summary of the conclusions reached follows.
To 'merge Melancholic depression into Melancholia for overlap and context. Klbrain (talk) 16:54, 27 August 2024 (UTC)[reply]

I propose merging Melancholic depression into Melancholia. The two are in essence the same concept - one through a historical and lay-lens, the other in DSM classification. A unified page discussing them in a holistic manner with context would make for a more informative read than two separate articles. I tentatively support the destination page being "Melancholia" as broader more common term, though could easily settle on "Melancholic depression" as more exacting/defined term I guess. Cas Liber (talk · contribs) 23:52, 20 February 2024 (UTC)[reply]

I'm broadly supportive, but the difficulty would be keeping ancient and modern clearly distinct. Johnbod (talk) 01:52, 21 February 2024 (UTC)[reply]
I think this is feasible. The current pages combined would be about 2,500–3,000 words long, which is reasonable. I feel like Melancholic depression is missing some information (e.g., sex ratio?), but there would be room for some expansion.
I prefer Melancholia as the resulting title. WhatamIdoing (talk) 02:32, 21 February 2024 (UTC)[reply]
@WAID: Imo, appropriately weighted content on an historical diagnosis (in this case, 'melancholic depression') would not require the same level of clinical/epidemiological detail as a currently recognised clinical entity. 86.177.202.213 (talk) 21:08, 21 February 2024 (UTC)[reply]
@Johnbod: Fwiw, I think the key question is how to distinguish between historical and current (the Melancholia page already tries to distinguish somewhat between "ancient" and "modern" history). 86.177.202.213 (talk) 20:57, 21 February 2024 (UTC)[reply]
That's what I meant; too fanciful language. Johnbod (talk) 04:36, 22 February 2024 (UTC)[reply]
I support. I agree with WhatamIdoing, and if I understand correctly, "merging Melancholic depression into Melancholia" means that Melancholia would remain after the merge, whereas Melancholic depression would not. Mark D Worthen PsyD (talk) [he/him] 19:18, 21 February 2024 (UTC)[reply]
"Melancholic depression" would become a redirect to this page. WhatamIdoing (talk) 21:26, 21 February 2024 (UTC)[reply]
comment: Here, for example, is an RS (from an 'encyclopedic' publication) that recounts and critiques the long and overlapping histories of the concepts of melancholia and depression (including melancholic depression). In arguing for "the reinstatement of melancholia as a separate and distinct mood disorder", the author expresses a POV that diverges from the currently valid versions of the internationally accepted classifications (ICD and DSM) that are adhered to by Wikipedia Medicine as a basis for the provision of reliable medical information. Nevertheless, per WP:RS, I think the ideas expressed in this sort of book chapter – including its controversial and challenging POV – might be suitably (wp:weight) acknowledged within a page like Melancholia which is set up to provide readers with a wide-ranging cultural history (ancient and modern) of an influential concept. Of course, a page such as Melancholic depression could in theory also be set up in a similar way, in which case it would presumably be providing more detailed information on content contained in Melancholia and Depression (mood)#History / History of depression (and conceivably, I suppose, [[Mood disorder#History]]). At present, however, Melancholic depression describes a *current* diagnosis (i.e. a currently accepted clinical entity), which appears to be at odds with the currently valid versions of ICD (i.e. ICD-10 and ICD-11) and – assuming I've understood Cas Liber correctly – DSM (i.e. DSM-IV and DSM-5). This seems to me problematic, which is why I have argued to merge Melancholic depression into Melancholia. 86.177.202.227 (talk) 18:19, 23 February 2024 (UTC)[reply]
The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.
  checkY Merger complete. Klbrain (talk) 16:54, 27 August 2024 (UTC)[reply]