Ewald Hecker’s description of cyclothymia as a cyclical mood disorder: its relevance to the modern concept of bipolar II

摘要: 1 . Historical note basis until they could be back on their feet. His work with outpatients and his intimate acquaintance Ewald Hecker (1843–1909) was a disciple of Karl them enabled him to make observations which Ludwig Kahlbaum closest assistant for many escaped hospital psychiatrists. incisive clinical years at the Sanitarium in Goerlitz, Silesia description sophisticated understanding (Germany). cousin Kahlbaum’s first wife. psychopathology made (1898) not only Their collaboration extremely fruitful proforerunner, but also one who anticipated today’s duced landmark works hebephrenia conceptions cyclothymia as bipolar II cyclothymia. Hecker’s progressive approach psydisorder (Dunner et al., 1976; Akiskal 1977; chiatry, he recommended Kahlbaum, comAkiskal 1979; Akiskal, 1981; Depue bated coercive methods time placed Cassano 1992; American Psychiatric accent public education eliminate Association, 1994; Brieger Marneros, 1997; stigma attached mental illness. Like Hantouche 1998; 2000; never attained university chair psychiatry, Pinto, 1999). Indeed, described perhaps because liberal ideas. Instead, brief depressions mild excitements short worked own private Wiesbaden, duration (measured days), well longer bought 1891. reputadepressions (lasting weeks months) followed tion hypnotherapist psychotherapist paby hypomanias. The latter course correspond tients cyclothymia, anxiety sleep disorders, concept II. He proceeded anticipating outpatient combination psyprovide superb picture chiatry psychotherapy. such imporbipolar we know it today. Even recomtance humane practices that even accommomendations tamper too much depresdated some patients into home temporary sive phase instead endeavour limit hypomanic phase, resonates contemporary advice (Akiskal 1999; Wehr Goodwin, 1987; *Tel.: 39-06-687-4415; fax: 39-06-6880-2345. Mallya, Koukopoulos 1990; E-mail address: a.koukopoulos@flashnet.it (A. Koukopoulos). 2001)—alas heeded often enough!