Dementia praecox

Murray RM, Lewis SW, Owen MJ and Foerster A (1988). The neurodevelopmental origins of dementia praecox. In P Bebbington and P McGuffin (eds), Schizophrenia The Major Issues (pp. 90-106). Heinemann, Oxford, UK. 

An interesting question comes up in connection with psychotic patients suffering from dementia praecox catatonia. The psychosis is due unquestionably to an over-dispersed state, and we must therefore conclude either that the sleep of such patients is theoretically quite different from ordinary sleep or that the centers of consciousness may be over-agglomerated while some centers of thinking are over-dispersed. So far as I can learn, these patients do sleep normally as a rule. Consequently one portion of the brain must be over-agglomerated at times, even though another portion of the brain is over-dispersed. 

Our understanding of the clinical cause of schizophrenia has evolved considerably in the last 20 years. Until the 1980s, Emil Kraepelin s notion that schizophrenia is a neurodegenerative disease basically went unquestioned. What we now call schizophrenia, Kraepelin called dementia praecox, literally precocious dementia. He believed that the illness followed a progressive downhill course and culminated in dementia. It later became clear that not all schizophrenia patients follow this deteriorating course, but the neurodegenerative concept of the illness continued for years to hold sway. 

The term schizophrenia was introduced by the Swiss physician Eugen Bleuter to replace the earlier term dementia praecox. It derives from the two Greek words schism, a split , and phren, the mind , to indicate the apparent splitting of the mind. One part remains in touch with reality whereas the other part is out of touch. It is, however, characterised by its symptoms rather than by biological markers. The current hypothesis to account for the most... 

Bleuler, E. (1911) Dementia praecox oder die Gruppe der Schizo-phrenien. In Aschaffenburg, G. ed. Handbuch der Psychiatrie, special part, section 4. Leipzig Deuticke, pp. 1 20. 

Schizophrenia designates a group of mental disorders rather than a uniform disease. Eugen Bleuler (1911), who coined the term schizophrenia, disputed the then current Kraepelinian concept of dementia praecox because he had recognized that the disorders in question could have very different courses and outcomes. Specifically, not all patients with schizophrenic psychoses ended up in dementia praecox, i.e. with a premature loss of their mind. Carpenter and Buchanan (1994) suggested that the clinical manifestations of schizophrenia could be grouped into three relatively separate core domains of psychopathology (the three-compartment model of schizophrenia) ... 

Bleuler, E. Dementia praecox oiler Gruppe tier Schizophrenia. Deuticke, Leipzig, 1911. 

The identification of this illness in modern psychiatry began with Kahibaum, who described catatonia Hecker, who described hebephrenia and Emil Kraepelin, who described dementia praecox (1,2, 3 and 4). 

Kraepelin E. Dementia praecox and paraphrenia. Barclay RM, trans. Huntington, NY Robert Krieger, 1971 (facsimile of 1919 edition). 

Bleuler E. Dementia praecox or the group of schizophrenias. Zinkin J, trans. New York International Universities Press, 1950. 

Kraepelin E. In Dementia Praecox and Paraphrenia. Edinburgh E S Livingstone, 1919 87. 

At the beginning of the 20th century, Emil Kraepelin, a German psychiatrist divided severe psychiatric disturbance into two conditions dementia praecox, which became known as schizophrenia, and manic depression. 

Malzberg, B. 1938, Outcome of insulin treatment of one thousand patients with Dementia Praecox., Psychiatr.Quarterly, vol. 12, pp. 528-553. 

Pollock, H. 1939, A statistical study of 1,140 Dementia Praecox patients treated with metrazol, Psychiatr.Q., vol. 13, pp. 558-568. 

In regard to neuroleptics, we found that pioneers in their use were most straightforward about its brain-disabling effects. We find the same phenomenon with lithium. Cade (1949) indicated that lithium, when used for other medicinal purposes, produced actual mental depression in a variety of patients, not just those suffering from mania or manic depression. The drug enforced a so-called quieting effect on persons he considered schizophrenic (dementia praecox, in his nosology) ... 

Johnstone, E., Crow, T., Frith, C., Stevens, M., Kreel, L., 6c Husband, J. (1978). The dementia of dementia praecox. Acta Psychiatrica Scandinavica, 57, 305-324. 

Bleuler E. 1911. Dementia Praecox oder Gruppen der Schizo-phrenien. Leipzig Franz Deutike. 

Abstract The family as a unit for support and care of chronically ill individuals with schizophrenia, as well as a source for valuable research information, needs emphasis. However, over the years, studies of families have been misinterpreted in a variety of political, social, and psychodynamic ways that have only hindered research progress. Currently, families are important resources for genetic research. Nevertheless, the new accumulated data on gene variation and expression in schizophrenia and families based on this research need to be better understood. The following is a review of the influence of the family on schizophrenia over the past century since Dementia Praecox was first defined as a separate entity by Kraepelin. 

Kraepelin E. 1971/1919. Dementia praecox and paraphrenia. New York Krieger. 

Kraepelin, E. (1971). Dementia praecox and paraphenia. Huntington, NY Krieger. (Original work published 1919)... 

The terni schizophrenia is used to denote a number of heterogeneous, but related, disorders usually characterized by withdrawal from the environment and preoccupation with interior processes, attended by a resultant disintegration of the personality. An early term for schizophrenia was Dementia Praecox, meaning an intense pathological state begirming early in... 

Since the 1950s, the psychiatric community has had the benefit of antimanic and antidepressant medications to treat manic-depressive illnesses. These medications were developed using the work of Emil Kraepelin, a German physician who wrote about mental illness in the late nineteenth century and early part of the twentieth century. Kraepelin had carefully noted distinguishing symptoms among mental patients and had followed the course of the various illnesses in many of them. He was the first to distinguish what he called dementia praecox, now called schizophrenia, and was able to differentiate this illness from manic depression. 

Traditionally, as mentioned above, schizophrenia was seen as being like dementia praecox—as having a chronic, progressive course. More recent research has called this into question, and suggests that a significant percentage of people with schizophrenia will eventually have a substantial recovery. Manfred Bleuler (1968) reviewed pooled data from many studies and found that almost half of schizophrenic patients substantially improved or recovered. It has been suggested that the view that schizophrenia has a poor outcome is based on experience in public mental health clinics, which serve the 40 to 50 percent of people with schizophrenia who do poorly. 

Both dispersion and coagulation states are apparently included under dementia praecox. Since the coagulation form of catatonic excitement apparently involves deterioration, it is included at present under dementia praecox. 

E. Bleuler, Dementia Praecox or the Group ofi Schizophrenias, pp. 279, 327, emphasis added. 

Emil Kraepelin publishes his Psychiatric, Ein Lehrbuch (A Textbook of Psychiatry). He systematizes psychiatry with a new diagnostic scheme defines two major psychoses— manic-depressive insanity, which tends to improve and recur spontaneously, and dementia praecox, whidi tends toward progressive deterioration. 

Kraepelin E. Dementia Praecox and Paraphrenia (Barclay RM, Roberston GM, trans.). Edinburgh Livingstone, 1919. 

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