Varia

Ein offener Brief.

Dear Sir,

Herr Dr. Maeder, in a review of an analysis I published of a case of hypomania (see Zentralbl. S. 344), points out that the case was really one of Schizophrenia. With this criticism I quite agree, especially on going again over my notes of this case. But with this reservation, that it was a case of Schizophrenia only in the Bleuler-Jung sense, not in the Kraepelinian. Bleuler and Jung have not followed Kraepelin's latter tendencies to restriet the dementia praecox group in favour of the manic-depressive; I think it probable, and Dr. Jung has expressed to me a similar opinion, that Kraepelin would have made the diagnosis of manic-depressive insanity with my patient. I might say that the patient has remained well ever since the analysis (over two years). The interesting question however is, how many other cases labelled chronic mania, or hypomania, show the action of complexes similar to those present in dementia praecox. I must say that I have found evidences of such complexes in all the cases of the kind I have examined (to be sure, not a large number). On the other hand, Brill has pointed out (Zentralbl. S. 158) that many cases labelled melancholia, of which he relates an interesting example, are really cases of Angsthysterie. Psycho-analytic investigation would therefore seem to to restrict to a considerable extent the number of cases of „causeless“ affective psychoses (manic-depressive insanity), and the question arises whether there actually are any such cases that show no psychogenic mechanism. I believe that further experiences in this direction would prove of great interest, and would suggest that other observers communicate theirs.

Yours sincerely

Ernest Jones.