Review of the book «Melancholia – Clinical and generational Transmission» by Carlos Fernández Atiénzar

Melancolía – clínica y transmisión generacional
Carlos Fernández Atiénzar
Xoroi Edicions, Barcelona, 2019

[Automatic translation from Spanish]:
«The presence of a book on melancholy is not surprising… It is rarer, on the other hand, to find a book on psychiatry that deals with melancholy. It is pleasant but curious news at this time».

With these words, José María Álvarez and Fernando Colina begin the prologue of the book – magnificent – Melancholy, clinical and generational transmission, by psychiatrist Carlos Fernández Atiénzar. Indeed, it is not surprising that someone should write a book on melancholy, but it is surprising that the author should be a psychiatrist, since, as has been pointed out, the term melancholy has been practically abandoned by academic psychiatry, which is subjected -unfortunately- to the supposedly scientific mandate of the saga of the DSM (Diagnostic and Statistical Manual of Mental Disorders), invented by the American Psychiatric Association (APA). The fifth edition of the DSM-5 only considers the term melancholia as an adjective, in the section of specifiers for depressive disorders. «With melancholic features» is the syntagm coined by the DSM-5 to refer to those depressive states that present with loss of pleasure in all or almost all activities, lack of reactivity to generally pleasant stimuli, and three or more of a set of six characteristics among which «excessive or inappropriate guilt» stands out. In this way, with half a page, the US-produced Manual liquidates the issue of melancholia; half a page out of a total of thirty-three pages devoted to depression. The consequence of all this is easy to understand: the almost non-existence of the diagnosis of melancholy in all those environments that follow the mandates of the American manual to the letter.

In this context, marked by an explicit disregard for psychopathology, it is to be welcomed that a mental health professional, more specifically, from the public mental health network, has had the courage to undertake a task that is not at all easy, to sail against the tide and ask questions and, at the same time, propose hypotheses that help to understand a little more about the complex intricacies of the melancholic phenomenon. But to undertake an undertaking of such magnitude […]

Josep Moya
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