- 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:
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