Emil Kraepelin
Emil Kraepelin | |
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University of Heidelberg Ludwig Maximilian University of Munich | |
Thesis | The Place of Psychology in Psychiatry (1882) |
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Emil Wilhelm Georg Magnus Kraepelin (/ˈkrɛpəlɪn/; German: [ˈeːmiːl 'kʁɛːpəliːn]; 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 psychiatric genetics.
Kraepelin believed the chief origin of psychiatric
His textbooks do not contain detailed case histories of individuals but mosaic-like compilations of typical statements and behaviors from patients with a specific diagnosis. He has been described as "a scientific manager" and "a political operator", who developed "a large-scale, clinically oriented, epidemiological research programme".[2][3]
Family and early life
Kraepelin, whose father, Karl Wilhelm, was a former opera singer, music teacher, and later successful story teller,[4] was born in 1856 in Neustrelitz, in the Duchy of Mecklenburg-Strelitz in Germany. He was first introduced to biology by his brother Karl, 10 years older and, later, the director of the Zoological Museum of Hamburg.[5]
Education and career
Kraepelin began his medical studies in 1874 at the
At Würzburg he completed his Rigorosum (roughly equivalent to an
Returning to the University of Leipzig in February 1882,[1] he worked in Wilhelm Heinrich Erb's neurology clinic and in Wundt's psychopharmacology laboratory.[6] He completed his habilitation thesis at Leipzig;[1] it was entitled "The Place of Psychology in Psychiatry".[6] On 3 December 1883 he completed his umhabilitation ("rehabilitation" = habilitation recognition procedure) at Munich.[1]
Kraepelin's major work, Compendium der Psychiatrie: Zum Gebrauche für Studirende und Aerzte (Compendium of Psychiatry: For the Use of Students and Physicians), was first published in 1883 and was expanded in subsequent multivolume editions to Ein Lehrbuch der Psychiatrie (A Textbook: Foundations of Psychiatry and Neuroscience). In it, he argued that psychiatry was a branch of medical science and should be investigated by observation and experimentation like the other natural sciences. He called for research into the physical causes of mental illness, and started to establish the foundations of the modern classification system for mental disorders. Kraepelin proposed that by studying case histories and identifying specific disorders, the progression of mental illness could be predicted, after taking into account individual differences in personality and patient age at the onset of disease.[6]
In 1884, he became senior physician in the Prussian provincial town of
In 1903, Kraepelin moved to Munich to become Professor of Clinical Psychiatry at the
In 1908, he was elected a member of the Royal Swedish Academy of Sciences.[citation needed]
In 1912, at the request of the DVP (Deutscher Verein für Psychiatrie; German Association for Psychiatry),
Kraepelin spoke out against the barbarous treatment that was prevalent in the psychiatric asylums of the time, and crusaded against alcohol,
He also firmly rejected the assumption of natural difference in relation to homosexuality, which he regarded as a vice caused by masturbation. In 1918 he called for "educational discipline" such as those introduced by the Nazi party after 1933: severe punishments for the crime of 'corruption' (seduction), applicable to any act related to sexual gratification. This extended the anti-gay policy of the time, which only punished sexual intercourse between men. These ideas eventually went on to lend legitimacy to Nazi policies that persecuted gay people, allowing the Nazi party to do so under the guise of conforming to scientific opinions. His work legitimized the persecution and inhumane treatment of gay people in Nazi Germany.[12]
In the later period of his career, as a convinced champion of social Darwinism, he actively promoted a policy and research agenda in racial hygiene and eugenics.[13]
Kraepelin retired from teaching at the age of 66, spending his remaining years establishing the institute. The ninth and final edition of his Textbook was published in 1927, shortly after his death. It comprised four volumes and was ten times larger than the first edition of 1883.[6]
In the last years of his life, Kraepelin was preoccupied with
Theories and classification schemes
Kraepelin announced that he had found a new way of looking at mental illness, referring to the traditional view as "symptomatic" and to his view as "clinical". This turned out to be his paradigm-setting synthesis of the hundreds of mental disorders classified by the 19th century, grouping diseases together based on classification of syndrome—common patterns of symptoms over time—rather than by simple similarity of major symptoms in the manner of his predecessors.
Kraepelin described his work in the 5th edition of his textbook as a "decisive step from a symptomatic to a clinical view of insanity. . . . The importance of external clinical signs has . . . been subordinated to consideration of the conditions of origin, the course, and the terminus which result from individual disorders. Thus, all purely symptomatic categories have disappeared from the nosology".[15]
Psychosis and mood
Kraepelin is specifically credited with the classification of what was previously considered to be a unitary concept of psychosis, into two distinct forms (known as the Kraepelinian dichotomy):
- recurrent major depression,[16]and
- dementia praecox.
Drawing on his long-term research, and using the criteria of course, outcome and
One of the cardinal principles of his method was the recognition that any given symptom may appear in virtually any one of these disorders; e.g., there is almost no single symptom occurring in dementia praecox which cannot sometimes be found in manic depression. What distinguishes each disease symptomatically (as opposed to the underlying pathology) is not any particular (pathognomonic) symptom or symptoms, but a specific pattern of symptoms. In the absence of a direct physiological or genetic test or marker for each disease, it is only possible to distinguish them by their specific pattern of symptoms. Thus, Kraepelin's system is a method for pattern recognition, not grouping by common symptoms.
It has been claimed that Kraepelin also demonstrated specific patterns in the genetics of these disorders and patterns in their course and outcome,
He also reported a pattern to the course and outcome of these conditions. Kraepelin believed that schizophrenia had a deteriorating course in which mental function continuously (although perhaps erratically) declines, while manic-depressive patients experienced a course of illness which was intermittent, where patients were relatively symptom-free during the intervals which separate acute episodes. This led Kraepelin to name what we now know as schizophrenia, dementia praecox (the dementia part signifying the irreversible mental decline). It later became clear that dementia praecox did not necessarily lead to mental decline and was thus renamed schizophrenia by Eugen Bleuler to correct Kraepelin's misnomer.
In addition, as Kraepelin accepted in 1920, "It is becoming increasingly obvious that we cannot satisfactorily distinguish these two diseases"; however, he maintained that "On the one hand we find those patients with irreversible dementia and severe cortical lesions. On the other are those patients whose personality remains intact".[19] Nevertheless, overlap between the diagnoses and neurological abnormalities (when found) have continued, and in fact a diagnostic category of schizoaffective disorder would be brought in to cover the intermediate cases.
Kraepelin devoted very few pages to his speculations about the etiology of his two major insanities, dementia praecox and manic-depressive insanity. However, from 1896 to his death in 1926 he held to the speculation that these insanities (particularly dementia praecox) would one day probably be found to be caused by a gradual systemic or "whole body" disease process, probably
Psychopathic personalities
In the first through sixth edition of Kraepelin's influential psychiatry textbook, there was a section on moral insanity, which meant then a disorder of the emotions or moral sense without apparent delusions or hallucinations, and which Kraepelin defined as "lack or weakness of those sentiments which counter the ruthless satisfaction of egotism". He attributed this mainly to degeneration. This has been described as a psychiatric redefinition of Cesare Lombroso's theories of the "born criminal", conceptualised as a "moral defect", though Kraepelin stressed it was not yet possible to recognise them by physical characteristics.[21]
In fact from 1904 Kraepelin changed the section heading to "The born criminal", moving it from under "Congenital feeble-mindedness" to a new chapter on "Psychopathic personalities". They were treated under a theory of degeneration. Four types were distinguished: born criminals (inborn delinquents),
The concept of "
Kraepelin had referred to psychopathic conditions (or "states") in his 1896 edition, including compulsive insanity, impulsive insanity, homosexuality, and mood disturbances. From 1904, however, he instead termed those "original disease conditions, and introduced the new alternative category of psychopathic personalities. In the eighth edition from 1909 that category would include, in addition to a separate "dissocial" type, the excitable, the unstable, the Triebmenschen driven persons, eccentrics, the liars and swindlers, and the quarrelsome. It has been described as remarkable that Kraepelin now considered mood disturbances to be not part of the same category, but only attenuated (more mild) phases of manic depressive illness; this corresponds to current classification schemes.[22]
Alzheimer's disease
Kraepelin postulated that there is a specific brain or other biological pathology underlying each of the major psychiatric disorders.[citation needed] As a colleague of Alois Alzheimer, he was a co-discoverer of Alzheimer's disease, and his laboratory discovered its pathological basis. Kraepelin was confident that it would someday be possible to identify the pathological basis of each of the major psychiatric disorders.[citation needed]
Eugenics
Upon moving to become Professor of Clinical Psychiatry at the
Kraepelin was convinced that such institutions as the
Martin Brune has pointed out that Kraepelin and Rüdin also appear to have been ardent advocates of a
Influence
Kraepelin's great contribution in classifying schizophrenia and manic depression remains relatively unknown to the general public, and his work, which had neither the literary quality nor paradigmatic power of Freud's, is little read outside scholarly circles. Kraepelin's contributions were also to a large extent marginalized throughout a good part of the 20th century during the success of Freudian etiological theories. However, his views now dominate many quarters of psychiatric research and academic psychiatry. His fundamental theories on the diagnosis of psychiatric disorders form the basis of the major diagnostic systems in use today, especially the
Kraepelin has been described as a "scientific manager"[25][26] and political operator, who developed a large-scale, clinically oriented, epidemiological research programme. In this role he took in clinical information from a wide range of sources and networks. Despite proclaiming high clinical standards for himself to gather information "by means of expert analysis of individual cases", he would also draw on the reported observations of officials not trained in psychiatry. The various editions of his textbooks do not contain detailed case histories of individuals, however, but mosaiclike compilations of typical statements and behaviors from patients with a specific diagnosis.
Kraepelin wrote in a knapp und klar (concise and clear) style that made his books useful tools for physicians. Abridged and clumsy English translations of the sixth and seventh editions of his textbook in 1902 and 1907 (respectively) by Allan Ross Diefendorf (1871–1943), an assistant physician at the Connecticut Hospital for the Insane at Middletown, inadequately conveyed the literary quality of his writings that made them so valuable to practitioners.[27]
Among the doctors trained by Alois Alzheimer and Emil Kraepelin at Munich at the beginning of the 20th century were the Spanish neuropathologists and neuropsychiatrists Nicolás Achúcarro and Gonzalo Rodríguez Lafora, two distinguished disciples of Santiago Ramón y Cajal and members of the Spanish Neurological School.
Dreaming for psychiatry's sake
In the Heidelberg and early Munich years he edited Psychologische Arbeiten, a journal on experimental psychology. One of his own famous contributions to this journal also appeared in the form of a monograph (105 pp.) entitled Über Sprachstörungen im Traume (On Language Disturbances in Dreams).
Bibliography
- Kraepelin, E. (1906). Über Sprachstörungen im Traume. Leipzig: Engelmann. ([1] Online.)
- Kraepelin, E. (1987). Memoirs. Berlin, Heidelberg, New York: Springer-Verlag. ISBN 978-3-642-71926-4.
Collected works
- Burgmair, Wolfgang & Eric J. Engstrom & Matthias Weber et al., eds. Emil Kraepelin. 9 vols. Munich: belleville, 2000–2019.
- Vol. I: Persönliches, Selbstzeugnisse (2000), ISBN 3-933510-90-2
- Vol. II: Kriminologische und forensische Schriften: Werke und Briefe (2001), ISBN 3-933510-91-0
- Vol. III: Briefe I, 1868–1886 (2002), ISBN 3-933510-92-9
- Vol. IV: Kraepelin in Dorpat, 1886–1891 (2003), ISBN 3-933510-93-7
- Vol. V: Kraepelin in Heidelberg, 1891–1903 (2005), ISBN 3-933510-94-5
- Vol. VI: Kraepelin in München I: 1903–1914 (2006), ISBN 3-933510-95-3
- Vol. VII: Kraepelin in München II: 1914–1920 (2009), ISBN 978-3-933510-96-9
- Vol. VIII: Kraepelin in München III: 1921–1926 (2013), ISBN 978-3-943157-22-2
- Vol. IX: Briefe und Dokumente II: 1876-1926 (2019), ISBN 978-3-946875-28-4
- Vol. I: Persönliches, Selbstzeugnisse (2000),
See also
- Kraepelinian dichotomy
- Comparison of bipolar disorder and schizophrenia
- History of bipolar disorder
- History of schizophrenia
- Lunatic asylum
- Psychiatric hospital
References
- ^ a b c d e f g h i j Dagmar Drüll, Heidelberger Gelehrtenlexikon: 1803–1932, Springer-Verlag, 2013, p. 149.
- ^ S2CID 46482747. Archived from the original(PDF) on 26 May 2013..
- S2CID 37204909.
- ^ Peter Barham (2004), Forgotten Lunatics of the Great War (New Haven: Yale), p. 163 n. 47.
- ^ On Kraepelin's early life and family, see Burgmair et al., vol. I, as well as his Memoirs (Berlin: Springer, 1987).
- ^ a b c d e f g h "Kraepelin, Emil (1856–1926)" by Margaret Alic, Gale Encyclopedia of Psychology, 2001.
- ^ "Klinik für Psychiatrie und Psychotherapie, Historie". LMU Klinikum München. Retrieved 10 June 2021.
- ^ See (1) German Society for Psychiatry, Psychotherapy, Psychosomatics and Neurology and (2) History of the DGPPN
- ^ Burgmair, Wolfgang, and Matthias M. Weber. "'Das Geld ist gut angelegt, und du brauchst keine Reue zu haben': James Loeb, ein deutsch-amerikanischer Wissenschaftsmäzen zwischen Kaiserreich und Weimarer Republik." Historische Zeitschrift 277 (2003): 343–378.
- ^ James Loeb Harvard University Press.
- ISBN 3-927408-82-4
- ISBN 978-0-304-32956-4.
- ^ PMID 17012678..
- ISBN 978-0415165303.
- ^ S2CID 19754009. Archived from the original(PDF) on 29 October 2013.
- S2CID 252779392.
- ^ Yuhas, Daisy (March 2013). "Throughout History, Defining Schizophrenia Has Remained a Challenge (Timeline)". Scientific American Mind (March 2013). Retrieved 2 March 2013..
- PMID 20838510.
- ^ Berrios GE, Luque R, Villagran JM (2003). "Schizophrenia: a conceptual history" (PDF). International Journal of Psychology and Psychological Therapy. 3 (2): 111–140.
- ^ Noll, Richard. "Whole Body Madness". Psychiatric Times. Retrieved 26 September 2012..
- ^ a b Richard Wetzell (2000) Inventing the criminal: a history of German criminology, 1880–1945 from p 59 & 146, misc.
- ^ Henning Sass & Alan Felthous (2008) Chapter 1: History and Conceptual Development of Psychopathic Disorders in International Handbook on Psychopathic Disorders and the Law. Edited by Alan Felthous, Henning Sass.
- PMID 17919321.
- S2CID 144482013. Archived from the original(PDF) on 29 October 2013.
- ^ Engstrom, Eric J. "Organizing Psychiatric Research in Munich (1903–1925): A Psychiatric Zoon Politicon between State Bureaucracy and American Philanthropy." In International Relations in Psychiatry: Britain, Germany, and the United States through World War II, edited by Volker Roelcke, Paul J. Weindling, and Louise Westwood, 48–66. Rochester: University of Rochester Press, 2010.
- S2CID 21375412.
- ^ Noll, Richard. "The Bed Makes Gestures". Psychiatric times. Retrieved 8 February 2013..
- ^ Über Sprachstörungen im Traume (1906).
Sources
- Noll, Richard (2011) American Madness: The Rise and Fall of Dementia Praecox. Cambridge and London: Harvard University Press.
- Briole G (2012). "Emil Kraepelin: The Fragility of a Colossal Oeuvre". Hurly-Burly. 8: 125–147.
External links
- Extensive bibliography of English translations of Kraepelin's works
- Extensive bibliography of works by and about Kraepelin's including those in the original German @ psych.mpg.de
- International Kraepelin Society contact
- Kraepelin's monograph Über Sprachstörungen im Traume
- Octavian Buda, The late works of Emil Kraepelin. Goethe Institute Riga, Latvia, 7th May 2009 at the Wayback Machine (archived 23 December 2019)
- Newspaper clippings about Emil Kraepelin in the 20th Century Press Archives of the ZBW
For biographies of Kraepelin see:
- engstrom.de/KRAEPELINBIOGRAPHY.pdf
- uni-leipzig.de/~psy/eng/kraep-e.html
- Burkhart Brückner, Julian Schwarz: Biography of Emil Wilhelm Georg Magnus Kraepelin in: Biographical Archive of Psychiatry (BIAPSY).
For English translations of Kraepelin's work see: