The Psychology of Dementia Praecox

To KraepelinEmil Kraepelin, a foundational figure in modern psychiatric classification. belongs the credit of having introduced new life into psychiatry by his indefatigable study of his patients over many years, his keen clinical insight, and especially by an independence of thought which led him to fearlessly shatter the traditions of centuries regarding the classification of mental diseases. As a pupil of Wundt, he was able to apply new methods of clinical investigation drawn from psychology. As is well known, he has brought together mania and melancholia as a single disorder under the title "manic-depressive insanity." This conception, vigorously attacked at first, has probably come to stay. It is otherwise with his creation of "dementia praecox," which is still strongly objected to in many quarters, chiefly because it seems to be a kind of wastebasket into which are thrown all forms of mental disease that cannot be tagged with another name. This disorder appears in so many guises that it is already divided into hebephrenic, catatonic, and paranoid groups, and Kraepelin himself has intimated that in time it will be broken up into even further groups or types. It is his merit, however, to have placed this psychological species before us, even if the outlines are coarse and the details more or less obscure.

In following Kraepelin, we find that he only offers us a general and superficial view of the disease. From his description, we learn that the patients are peculiar in speech and actions, that they utter numerous senseless remarks, repeat meaningless words or syllables, and that now and then they commit foolish and impulsive acts. However, no attempt is made to examine the nature and origin of these peculiar utterances and actions. When we review the cases described in Kraepelin's works, we find that while most of them show hallucinations and delusions, these are not at all of the same content or nature; the "verbigerations"incessant, meaningless repetition of words or phrases and mannerisms also differ in different cases. The same similarities and divergences are to be noticed in every hospital. We recall a patient whose auditory hallucinations were attributed to a child,