The Kraepelinian dichotomy is the division of the major
endogenous
Endogenous substances and processes are those that originate from within a living system such as an organism, tissue, or cell.
In contrast, exogenous substances and processes are those that originate from outside of an organism.
For example, es ...
psychoses
Psychosis is a condition of the mind that results in difficulties determining what is real and what is not real. Symptoms may include delusions and hallucinations, among other features. Additional symptoms are incoherent speech and behavior t ...
into the disease concepts of
dementia praecox
Dementia praecox (meaning a "premature dementia" or "precocious madness") is a disused psychiatric diagnosis that originally designated a chronic, deteriorating psychotic disorder characterized by rapid cognitive disintegration, usually beginnin ...
, which was reformulated as
schizophrenia
Schizophrenia is a mental disorder characterized by continuous or relapsing episodes of psychosis. Major symptoms include hallucinations (typically hearing voices), delusions, and disorganized thinking. Other symptoms include social withdra ...
by
Eugen Bleuler
Paul Eugen Bleuler (; ; 30 April 1857 – 15 July 1939) was a Swiss psychiatrist and humanist most notable for his contributions to the understanding of mental illness. He coined several psychiatric terms including "schizophrenia", "schizoid", " ...
by 1908, and manic-depressive psychosis, which has now been reconceived as
bipolar disorder
Bipolar disorder, previously known as manic depression, is a mental disorder characterized by periods of depression and periods of abnormally elevated mood that last from days to weeks each. If the elevated mood is severe or associated with ...
. This division was formally introduced in the sixth edition of
Emil Kraepelin
Emil Wilhelm Georg Magnus Kraepelin (; ; 15 February 1856 – 7 October 1926) was a German psychiatrist.
H. J. Eysenck's ''Encyclopedia of Psychology'' identifies him as the founder of modern scientific psychiatry, psychopharmacology and psychi ...
's psychiatric textbook ''Psychiatrie. Ein Lehrbuch für Studirende und Aerzte'', published in 1899. It has been highly influential on modern psychiatric classification systems, the
DSM-IV-TR
The ''Diagnostic and Statistical Manual of Mental Disorders'' (DSM; latest edition: DSM-5-TR, published in March 2022) is a publication by the American Psychiatric Association (APA) for the classification of mental disorders using a common langua ...
and
ICD-10
ICD-10 is the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD), a medical classification list by the World Health Organization (WHO). It contains codes for diseases, signs and symptoms, ...
, and is reflected in the
taxonomic
Taxonomy is the practice and science of categorization or classification.
A taxonomy (or taxonomical classification) is a scheme of classification, especially a hierarchical classification, in which things are organized into groups or types. ...
separation of schizophrenia from
affective psychosis. However, there is also a diagnosis of
schizoaffective disorder
Schizoaffective disorder (SZA, SZD or SAD) is a mental disorder characterized by abnormal thought processes and an unstable mood. This diagnosis is made when the person has symptoms of both schizophrenia (usually psychosis) and a mood disorder: ...
to cover cases that seem to show symptoms of both.
History
The Kraepelinian system and the modern classification of psychoses are ultimately derived from the insights of
Karl Kahlbaum
Karl Ludwig Kahlbaum (28 December 1828 – 15 April 1899) was a German psychiatrist.
Life and career
In 1855 he received his medical doctorate at Berlin, and subsequently worked as a physician at the mental asylum in Wehlau. For a period he w ...
. In 1863 the Prussian psychiatrist published his
habilitation
Habilitation is the highest university degree, or the procedure by which it is achieved, in many European countries. The candidate fulfills a university's set criteria of excellence in research, teaching and further education, usually including a ...
which was entitled, ''Die Gruppierung der psychischen Krankheiten (The Classification of Psychiatric Diseases).'' In this text he reviewed the then heterogeneous state of medical taxonomies of mental illness and enumerated the existence of some thirty such nosologies from the early seventeenth-century until the mid-nineteenth-century. The major contribution of his published dissertation, which is still the foundation of modern psychiatric nosology, was to first formulate the clinical method for the classification of psychosis by symptom, course and outcome.
[; ]
Kahlbaum also differentiated between two major groups of mental illnesses which he termed ''vecordia'' and ''vesania''.
Emil Kraepelin first introduced his proposed dichotomy between the endogenous psychoses of manic-depressive illness and dementia praecox during a public lecture in Heidelberg, Germany on 27 November 1898.
See also
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Comparison of bipolar disorder and schizophrenia Schizophrenia is a primary psychotic disorder, whereas, bipolar disorder is a primary mood disorder which can also involve psychosis. Both schizophrenia and bipolar disorder are characterized as critical psychiatric disorders in the Diagnostic and ...
*
History of bipolar disorder
Cyclical variations in moods and energy levels have been recorded at least as far back as several thousand years. The words "melancholia" (an old word for depression) and "mania" have their etymologies in Ancient Greek. The word melancholia is der ...
*
History of schizophrenia The word ''schizophrenia'' was coined by the Swiss psychiatrist Eugen Bleuler in 1908, and was intended to describe the separation of function between personality, thinking, memory, and perception. He introduced the term on 24 April 1908 in a lectu ...
Notes
Bibliography
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*Briole, G. (2012). "Emil Kraepelin: The Fragility of a Colossal Oeuvre". ''
Hurly-Burly'' 8: 125-147.
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{{refend
Classification of mental disorders
Psychosis
History of mental disorders
Psychiatry controversies