31
See also: Wilhelm Wundt 32–37 ■ R.D. Laing 150–51G
erman physician Emil
Kraepelin believed that
the origins of most mental
illnesses are biological, and he is
often regarded as the founder of
modern medical psychiatry. In his
Textbook of Psychiatry, published
in 1883, Kraepelin offered a detailed
classification of mental illnesses,
including “dementia praecox,”
meaning “early dementia,” to
distinguish it from late-onset
dementia, such as Alzheimer’s.Schizophrenia
In 1893, Kraepelin described
dementia praecox, now called
schizophrenia, as consisting
“of a series of clinical states
which hold as their common a
peculiar destruction of the internal
connections of the psychic
personality.” He observed that the
illness, characterized by confusion
and antisocial behavior, often starts
in the late teens or early adulthood.
Kraepelin later divided it into four
subcategories. The first, “simple”
dementia, is marked by slow
decline and withdrawal. Thesecond, paranoia, manifests in
patients as a state of fear and
persecution; they report being
“spied upon” or “talked about.” The
third, hebephrenia, is marked by
incoherent speech, and often by
inappropriate emotional reactions
and behavior, such as laughing
loudly at a sad situation. The fourth
category, catatonia, is marked by
extremely limited movement and
expression, often in the form of
either rigidness, such as sitting in
the same position for hours, or
excessive activity, such as rocking
backward and forward repeatedly.
Kraepelin’s classification still
forms the basis of schizophrenia
diagnosis. In addition, postmortem
investigations have shown that
there are biochemical and structural
brain abnormalities, as well as
impairments of brain function, in
schizophrenia sufferers. Kraepelin’s
belief that a great number of mental
illnesses are strictly biological in
origin exerted a lasting influence
on the field of psychiatry, and many
mental disorders are still managed
with medication today. ■PHILOSOPHICAL ROOTS
A P E C U L I A R
DESTRUCTION OF THE
INTERNAL CONNECTIONS
O F T H E P S Y C H E
EMIL KRAEPELIN (1856 –1926)
IN CONTEXT
APPROACH
Medical psychiatry
BEFORE
C.50 BCE Roman poet and
philosopher Lucretius uses
the term “dementia” to mean
“being out of one’s mind.”
1874 Wilhelm Wundt,
Kraepelin’s tutor, publishes
Principles of Physiological
Psychology.
AFTER
1908 Swiss psychiatrist
Eugen Bleuler coins the term
“schizophrenia,” from the
Greek words skhizein (to split)
and phren (the mind).
1948 The World Health
Authority (WHO) includes
Kraepelin’s classifications
of mental illnesses in its
International Classification
of Diseases (ICD).
1950s Chlorpromazine, the
first antipsychotic drug, is
used to treat schizophrenia.