Dementia praecox to schizophrenia: The first 100 years

Abstract

The historical roots of dementia praecox and schizophrenia are described in the context of current nosology and continuing controversies surrounding this nosology. Relevant books and journal articles were reviewed. The information was obtained through computer searches and cross‐references from previously published papers. If English translations of foreign language articles were available, they were used; if not, the cross‐references were consulted. The psychoses have existed as diagnostic categories from ancient times although their names have changed. Initially, these disorders were considered diseases of the brain, a concept that was swept aside in the United States, influenced by European‐derived psychodynamic theories. American clinicians and investigators simply accepted these theories, showing little interest in testing their underlying principles. In contrast, a narrower Kraepelinian approach was adopted outside the United States, and attempts were made to refine its nosology. Because current data supports a central nervous system aetiology for schizophrenia, the concept of dementia praecox warrants resurrection. The authors suggest abandoning the term schizophrenia in favour of the more broad and generic term dementia praecox. Replacing ‘schizophrenia’ with ‘dementia praecox’ in the 21st century will facilitate further research and help clarify the nosology of various brain disorders currently included in the schizophrenias.

Toward defining schizophrenia as a more useful clinical concept

“…The Japanese term for schizophrenia was changed to integration disorder in 2002 [ 50 ]. Others have suggested a return to Kraepelin's initial term, dementia praecox [ 51 ]. Whether the benefi t in renaming schizophrenia is believed to outweigh the disadvantages, the effort to delineate the underlying core construct will remain a challenge.…”

Cognitive Impairment in Bipolar Disorder and Schizophrenia: A Systematic Review

“…In his landmark paper “The Diagnosis and Prognosis of Dementia Praecox” presented in Heidelberg in 1898 (1), German psychiatrist Emil Kraepelin discussed the results of his methodical observation of patients by stating that in dementia praecox “ The prognosis, however, is really by no means simple. Whether dementia praecox is susceptible of a complete and permanent recovery … is still very doubtful, if not impossible.…”

Being Bleuler: The Second Century of Schizophrenia

“…13 In the book, Kraepelin announced that he intended to classify illnesses on the basis of aetiology Á meaning somatic causes Á derived from the principles of experimental psychology and bacteriology. 5 What had started as an exercise to improve his income soon expanded into an encyclopaedic activity with regular and ever-expanding editions of the textbook (growing from 385 pages in the first edition to 2425 in the ninth 14 ), announcing the latest developments in his classification.…”