초록 열기/닫기 버튼
본 연구는 사회구성주의 관점에서 20세기 전반 ‘갱년기 울병(involutional melancholia)’의 역사를 재구성한다. 에밀 크레펠린은 1896년 개별 정신질환으로서 갱년기 울병을 처음으로 정의하고 도입했지만, 1913년 이 진단명을 폐기하였다. 이후 출판된 전문가용 텍스트를 분석하면, 갱년기 울병 개념의 존폐를 둘러싼 토론이 지속되고 있는 동안에도 영국 정신의학계는 이 진단명을 유지했을 뿐만 아니라 오히려 활발하게 사용했음을 알 수 있다. 여러 정신병원에서 작성된 다양한 의료 기록들 역시 이 진단 개념이 전간기 동안 널리 활용되고 있었음을 보여주며, 심지어는 독립된 질병으로서 갱년기 울병의 존치에 반대하는 전문가들도 그 유용성을 인정하고 있었음을 증명한다. 그러나 정작 이 병을 진단받은 환자들은 갱년기 울병 개념에 전혀 익숙하지 않았는데, 이는 전문 지식의 생산과 대중화 사이의 시간차에서 비롯된 현상으로 이해될 수 있다.
This article traces the confusing history of ‘involutional melancholia’ against the backdrop of early-twentieth-century Britain by applying a social-constructionist approach. Emil Kraepelin introduced involutional melancholia as a discrete diagnosis term in 1896, but abandoned the concept in 1913, putting it under ‘manic-depressive insanity’ category. His change of mind caused immediate confusion and brought about a prolonged debate amongst psychiatrists. Consulting psychiatric expert literature, notably textbooks and major periodicals, it seems that involutional melancholia not only survived after Kraepelin’s abandonment but also even prospered during the interwar years. Also, medical records of mental hospitals illustrate that the concept was commonly applied, in various forms, in medical practice although the terminology was not frequently used as a formal diagnosis. Such practice, furthermore, was observed in some institutions where the psychiatrists were against the notion in an official manner. Meanwhile, close reading of the case notes of female patients who were deemed to suffer from involutional melancholia reveals that contemporary lay people were not familiarised with the psychiatric concept yet. However, it does not mean that the patients were ignorant about medical knowledge. Rather, it shows that there existed a time gap between production and popularisation of scientific knowledge and that the public, thus, needed time to get used to the new notion.
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involutional melancholia, manic-depressive insanity, depression, depressive disorder, Emil Kraepelin, classification of mental illness, lay understanding, British psychiatry, The Great British Debate
