schizophrenia and relationship to term dementia praecox
dementia praecox first used in 1891 by Arnold Pick, a professor of psychiatry at the German branch of Charles University in Prague
term dementia praecox was popularized by German psychiatrist Emil Kraepelin in 1896 in his first detailed description of a condition
Kraepelin broadened the notion of dementia praecox, leaving out the degenerative aetiology, and incorporated the notion of Griesinger and other authors of a predisposing diffuse cerebral pathology
Kraepelin noted that age of onset, family history and premorbid personality or temperament were useful in distinguishing between dementia praecox and manic-depressive insanity
he emphasized hereditary factors in dementia praecox and found evidence of a hereditary factor in a majority of his cases
raised the possibility that obstetric complications such as difficult labour, previous miscarriages, stillborn children, and premature births were significant factors in the aetiology of psychosis
emphasized that dementia praecox is a central nervous system disease involving very serious lesions of the cerebral cortex, the lesions are rather permanent or can only be regenerated in part, if at all
believed that many other biologic abnormalities, including endocrinologic, cause schizophrenia
the condition dementia praecox would be eventually reframed and relabeled as schizophrenia
Bleuler (1908), a Swiss psychiatrist, introduced the term schizophrenia
was influenced by Wundt, Freud and Jung in his understanding of mental illness
Bleuler criticized the term ‘dementia praecox’ because schizophrenia did not always first appear in adolescence and did not invariably end in deterioration
Bleuler wrote that this disease lacked an adjective, called for a new name because he felt the name dementia praecox was awkward - he stated that the naem dementia praecox name only designated the disease, not the diseased
term ‘schizophrenia’ (splitting of mind) implies a psychological aetiology
some suggest that, because current data supports a central nervous system aetiology for schizophrenia, the concept of dementia praecox warrants resurrection (1)
authors suggest abandoning the term schizophrenia in favour of the more broad and generic term dementia praecox
suggested that 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.
neuroimaging findings including enlargement of the lateral ventricles, undersized superior temporal gyrus, and prefrontal abnormalities, are seen in patients with schizophrenia
additionally, these findings are correlated with the clinical symptoms of schizophrenia (3)
Notes:
originally the term dementia was synonymous with insanity unrelated to age, cognitive status, or reversibility
Reference:
(1) Howells JG (ed.) The Concept of Schizophrenia: Historical Perspectives. American Psychiatric Press, Washington DC, 1991.
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