[Aretaios concerning the relationship melancholy-mania and psychogenesis: a look backwards on a "forward" look]

This contribution to the study of the evolution of fundamental concepts in psychiatry, and in particular of the history of "atrabilious disease", focuses on Aretaios the Cappadocian, one of the most eminent medical authors of Greek antiquity. A rigorous reading, both philological and psychiatric, of Aretaios' text clearly illustrates his importance as a psychiatric nosologist, especially with regard to the articulation between melancholia and mania, which are nowadays considered to be antinomous mood disorders. Contrary to the assumption of most scholars, Aretaios cannot be considered the "inventor" of "manic-depressive psychosis", but rather a "precursor" of "unitary psychosis", a concept that emerged in German psychiatry in the middle of the 19th century. Het may also be regarded as the first author to focus on "premorbid characteristics" in patients with melancholia and mania. Moreover, he assumed a psychogenetic, not merely organogenetic etiology of these psychiatric disorders and, consequently, the possibility of psychotherapy for these conditions.