Classics in ECT: "Reactive and endogenous depressions--response to E.C.T.", Br J Psychiatry, 1963
"Classics in ECT" brings you this study from 1963:
Reactive and endogenous depressions--response to E.C.T.
Br J Psychiatry. 1963 Mar;109:213-7. doi: 10.1192/bjp.109.459.213.PMID: 13974791
And from the text:
Summary
Twenty men and thirty women with severe depression were investigated with regard to the type of depression and response to a course of E.C.T. The patients were classified into endogenous, doubtful endogenous, doubtful reactive and reactive depressions, and were assessed on an appropriate rating scale before and twice after receiving E.C.T. The results indicated that all types of depression were of equal severity, and provided evidence that reactive and endogenous depressions respond differently to E.C.T., the latter group having a more favourable outcome. These findings are taken to support the hypothesis that these two types of depression are qualitatively different, and not to support the hypothesis that they differ only in a quantitative manner.This is a thoughtful, well-written paper that is a fairly early investigation of prediction of ECT response. Note that the HAM-D 17 scores are doubled in the above table. Family history of mood disorder was more common in the endogenous group.
PubMed shows13 publications between 1962 and 1969 for JT Rose. This article was written when Dr. Rose was a senior registrar (resident) at St. James's Hospital in Leeds. He acknowledges the statistical assistance of Dr. Max Hamilton at the end of the paper. According to a Google search, Dr. Rose was later a member of the "Northern and Midland Division" of the Royal Medico-Psychological Association (see below) and worked at High Royds Hospital in Menston, West Yorkshire, England, which closed in 2003.
This classic is worth a full read, ~15 minutes.
The below comment is from Dr. Max Fink:
ReplyDeleteEndogenous and reactive depression May 30, 2021
Behind this report is the teaching by Max Hamilton that two depressions are identified, one endogenous and often psychotic and suicidal and one reactive, labelled neurotic. In the 1970s Bernhard Carroll identified disturbances in cortisol metabolism distinguishing the endogenous depressed. Despite such reports DSM-III commissioners rejected the two form theory and amalgamated all depressive illnesses as MDD.
By the 1990s, Parker distinguished melancholia followed by Taylor and Fink in 2006. These efforts to separate a biologic, ECT responsive form of depression from an exogenous neurotic, characterological illness failed to attract interest. Melancholia is identifiable (by HAMD), verifiable (by DST), and treatable (by ECT and TCA) depression that is not recognized in DSM-IV or DSM-5.
By lumping "depression" as one entity, the DSM led to the cornucopia of placebo-effective medications and psychotherapies and guarantees failure of genetic, brain imaging, and clinical trial studies. A major tragedy in brain science.
Parker G, Hadzi-Pavlovic D: Melancholia: A Disorder of Movement and Mood. Cambridge UK: Cambridge University Press, 1996.
Taylor MA, Fink M. Melancholia: The Diagnosis, Pathophysiology, and Treatment of Depressive Disorders. Cambridge UK: Cambridge University Press, 2006.
Shorter E, Fink M. Endocrine Psychiatry: Solving the Riddle of Melancholia. Oxford University Press, 2010.