Reception of Kraepelin's ideas 1900–1960

Abstract

Kraepelin's system of mental diseases has contributed substantially to the foundation of modern psychiatric diagnosis in the DSM-IV and ICD-10. Considering Kraepelin's influence in the creation of these diagnostic tools, the question arises as to how Kraepelin's contemporaries and successors reacted to his nosology. Historical libraries and archives in Munich, Berlin and Paris were searched for European and American psychiatric literature using the keywords 'Kraepelin', 'dichotomy' and 'manic-depressive disorder'. Literature from 1900 to 1960 was examined and compared to the current literature regarding Kraepelin's impact on modern classification systems. The sixth edition of Kraepelin's 'Lehrbuch' (1899) presented the dichotomy in its entirety and led to three different periods of critical comment on dichotomy and methodology between 1900 and 1960. But on the whole, Kraepelin's system was quickly and completely adopted in clinical diagnosis. The publications appearing on and following Kraepelin's centenary in 1956 represent his work as generally being the foundation of modern psychiatry. The neo-Kraepelinian movement, beginning in the late 1960s, developed more differentiated views of Kraepelin's scientific background and methodology. Notwithstanding all the criticism of Kraepelin's dichotomy, it remains more than ever the basis of psychiatric diagnosis. The criticism today shows parallels to the statements made during Kraepelin's era, mainly concerning the issue of diagnostic overlapping of the two disease entities, manic-depressive disorder and schizophrenia, and includes the question of syndromatology.

På tide å tenke nytt om psykiatriske diagnoser

“…Diagnosene, slik de ble beskrevet i DSM-III, hadde godt etablerte røtter i vestlig medisinsk historie, men det var klarere bånd til psykiaterne Emil Kraepelin (1856-1926) og Kurt Schneider (1887-1967) enn til Sigmund Freud (1856-1939) (5,7,8). Definisjonen av mental sykdom ble dermed endret fra noe man gjorde eller kanskje var, som ledd i en utvikling, til noe man hadde.…”

“…Kraepelins hovedkategorier dementia praecox og manisk-depressiv lidelse dannet grunnlaget for nye sykdomskategorier. Det som var et viktig moment hos Kraepelin ble imidlertid mindre tydelig -nemlig behovet for å forstå symptomer som manifestasjoner av underliggende nevrofysiologiske årsaker og som et samspill mellom nevrofysiologiske og psykologiske mekanismer (7,8).…”

History of psychiatry and its institutions

“…Obviously, there are plenty of other innovative and very fruitful areas of scholarly research. Biographical studies of Bleuler [44 && ,45,46], Sullivan [47], Emil Kraepelin [48,49], and others [50][51][52] are serving as important touchstones and correctives to all too schematically constructed narratives of professional development. Richard Noll's history of dementia praecox in the United States is especially noteworthy as an example of how studying specific diagnoses can shift our understanding of an entire historical era [43 && ].…”

Centenary of schizophrenia: Should the term survive “togo shicchou sho” and “salience syndrome”?

“…Whereas Kraepelin conceived dementia praecox to be a disease entity, Bleuler used the plural form “schizophrenias” to specify a group of disorders and to take into account the differences in onset, course, and outcome. Overall, however, Bleuler accepted Kraepelin's description because of its homogeneity and clear delimitation (Palm and Möller, ).…”

“…Kraepelin's description of the basic character of the disorder implied “decay” and “dulling” (Palm and Möller, ). In European and American countries, scientific progress has caused this obsolete notion to change over recent decades.…”