Dementia praecox revisited

Abstract

Richard Noll (2012) usefully noted in this journal that Heinrich Schüle (1840-1916) appears to have been the first alienist to use the Latin term dementia praecox in the third edition of his textbook, Klinische Psychiatrie: Specielle Pathology und Therapie der Geisteskrankheiten (1886). Noll (2012) also wondered if the French alienist Bénédict-Augustin Morel (1809-73) influenced Schüle. Readers of this journal may be interested in a number of further developments on this subject. To begin with, it is worth observing that Schüle also used the term dementia praecox in the second edition of his Handbuch der Geisteskrankheiten (1880). Here we find clear evidence for the influence of Morel on Schüle. Schüle's fifteenth chapter has a single paragraph discussing him; the opening line notes how Morel had shown the various transformations of hereditary insanity as a progressive development to more severe and finally incurable conditions ('Morel hat die verschiedenen Umbildungen des hereditären Irreseins als eine fortschreitende Entwicklung zu immer schwereren und schliesslich unheilbaren Zuständen dargestellt'; Schüle 1880: 237). Accompanying this sentence is a footnote citing Morel's Traité (1860: 513ff.); this is a chapter on 'Aliénations ou Folies Héréditaires', and the term démence précoce appears on p. 516. Schüle (1880: 237-8), in the same paragraph, observes that Morel distinguished four stages; in the fourth stage, Schüle uses the Latin term dementia praecox: '4. Generation: mutism, congenital mental weakness and Dementia praecox [Generation: Taubstummheit, angeborene Geistesschwäche, Dementia praecox]' (Schüle, 1880: 238). In the following line, Schüle declares Morel to be an ingenious author. Thus, we have Morel lauded, his work summarized and cited, and the Latin dementia praecox all linked in one paragraph. Later we also find the statement that dementia praecox is one of the most common sequelae of hereditary degeneration ('Die Dementia praecox, einer der häufigsten Folgezustände der erblichen Entartung…'; Schüle, 1880: 345). Additionally, Morel is heavily referenced throughout Schüle's textbook. Therefore there seems to be clear evidence that Morel influenced Schüle at least as early as 1880. Second, when Schüle's 1886 edition of Klinische Psychiatrie was translated into French two years later by Dagonet and Duhamel, the term dementia praecox is repeatedly translated back into French as démence précoce. For example, the following line discusses the tendency to

Kahlbaum, Hecker, and Kraepelin and the Transition From Psychiatric Symptom Complexes to Empirical Disease Forms

“…We still do not know whether this "Kahlbaum-Hecker-Kraepelin paradigm"-defining disorders on the basis of distinctive symptoms and course-will produce psychiatric syndromes that are sufficiently homogeneous to yield up their etiologic secrets. Indeed, Kraepelin's nosology met with vigorous opposition by some psychiatric contemporaries (30,50,54). He was particularly criticized for his idiosyncratic use of prognosis as a key to diagnosis….…”

“…At the same time, however, he believed that Hecker's category was too narrowly focused on pubescence and needed to be expanded to include Daraszkiewicz's findings. It was precisely to accommodate this expanded understanding of hebephrenia that Kraepelin proposed the term "dementia praecox" (27, p. 1016), a term used previously by German and French psychiatrists, such as Heinrich Schüle and Bénédict Morel (28)(29)(30).…”

A historical account of schizophrenia proneness categories from DSM-I to DSM-5 (1952-2013)

“…3 For a discussion on the appropriation of the concepts of dementia praecox and schizophrenia see McNally (2013). Venancio (2010) discusses the same in the Brazilian context.…”

“…In the last three decades, the history of diagnostic classifications in psychiatry has been recognized as a privileged means of access to the vicissitudes, tensions, conflicts and negotiations inherent to the configuration of a scientific and professional field, also bringing significant contributions to conceptual history (Berrios, 1999;Berrios & Porter, 1995;Engstrom & Weber, 2007;McNally, 2012McNally, , 2013Venancio, 2010). 1 In this paper, we begin by briefly describing the history of the concept of schizophrenia, especially in the US.…”