Medicine

The First Formal Description of Schizophrenia | by David Rovnyi | Jan, 2024

A Deep Dive into the Psychological Roots of Humanity

Considered the father of modern psychiatry, German physician Emil Kraepelin (1856–1926) believed that most mental illnesses have a biological origin.

Emil Kraepelin (Psychiatrist in Dubai)

In his Psychiatry Treatise, published in 1883, he presents a detailed classification of various diseases, including “premature dementia,” which he distinguishes from age-related forms such as Alzheimer’s disease.

Schizophrenia

In 1893, Kraepelin described premature dementia, now called schizophrenia, as a “series of clinical states sharing a particular destruction of internal connections within the psyche.”

A psychiatric hospital in Munich, around 1900 (Sage Journals)

He noted that the disease, characterized by mental confusion and antisocial behavior, often begins between adolescence and adulthood.

Kraepelin later divided it into four subcategories: the first, “simple dementia,” is marked by a slow decline. The second, paranoia, takes the form of delusions of persecution: the patient believes they are being spied on or are the center of conversations.

The third, hebephrenia, is characterized by incoherent speech and behavior disconnected from reality — laughing loudly in a sad situation, for example.

The fourth, catatonia, is marked by extremely reduced movements and expressions or by the alternation of rigidity — the patient remains seated in the same position for hours — and excessive activity — the patient constantly swings back and forth.

A schizophrenic patient who is experiencing catatonia (Wikipedia)

Kraepelin’s classification still forms the basis of schizophrenia diagnosis. Moreover, autopsies have shown that schizophrenics have biochemical and structural abnormalities in the brain, as well as insufficient brain function.

Kraepelin’s belief that most mental illnesses had a biological origin had a lasting impact on psychiatry, and many mental disorders are still treated with medication today.

Psychiatry Treatise, the book written by Emil Kraepelin (AbeBooks)

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