[On the nosological position of the obsessional-compulsive depressions (author's transl)].

Abstract

After the introduction of the term "Zwangsvorstellungen" (compulsive ideas) into german psychiatry in 1867, there were intensive psychopathological discussions concerning the role of the affective component of this disturbance. The conviction that an affective causation of compulsion has to be repudiated, that a primary compulsive idea is just followed by a secondary affect, contrasted with the belief that alterations of mood are a prerequisite of compulsive symptoms. The latter hypothesis led to the identification of a typical course of illness in the compulsive depressions. After a short review of Lauter's casuistry, some of our own cases are presented. A differentiation between two types of compulsive depression seems to fulfill the requirements of the clinic. The distinguishing criterion is the pattern of the premorbid personality. To the widespread therapeutic pessimism we oppose various psychotherapeutic techniques for the treatment of non-psychotic compulsive phenomenal; for the manifestations occurring in the course of psychotic illnesses, the appropriate psychotropic drugs will be used in the first place, although they are of limited importance in these types of illness which oppose serious difficulties to all methods of treatment.