Edward Spitzka's 1883 Textbook

Abstract

Edward Spitzka, a prominent New York–based alienist, who spent 3 years in Germany studying psychiatry, published a textbook in 1883—the same year as the first edition of Kraepelin's textbook—that contained detailed descriptions of all the seven psychiatric syndromes that formed the basis of Kraepelin's nosologic synthesis: mania, melancholia, katatonia, secondary deteriorations, hebephrenia, circular insanity, and monomania. A study of this text provides us with a “before” picture—a view of the canvas of psychiatric diagnostic categories—from which Kraepelin worked. Studying what Spitzka's diagnostic categories contain and what they are missing highlights the key steps Kraepelin took in the development of his nosologic synthesis. For example, Spitzka does not describe a commonality in symptoms or outcome in katatonia, hebephrenia, and the move severely ill delusional monomaniacs, nor did he link together mania, melancholia, and circular insanity, but instead comments on wide differences in outcome among these three syndromes.

The Course Patterns and Diagnostic Shifts of Patients With Schizoaffective Disorder

“…This approach, which also marks the current diagnostic classifications, is thought to be simplistic for Kraepelin's period as well. For example, in terms of affective disorders, there is an extensive literature that includes Kahlbaum's “cyclothymia,” French psychiatrists' “circular insanity” concepts, different types of mania, and melancholia in the periods before Kraepelin (Harrington, 2019; Kendler, 2022). Although Kraepelin himself never saw it as a primary affective disorder, he argued that the concept of “manic depressive insanity” covers all these clinical conditions (Berrios, 1996).…”