Emil Kraepelin’s classification system for Mental Illness

Emil Kraepelin

Emil Kraepelin

On October 7, 1926German psychologist Emil Kraepelin passed away. Kraepelin is considered the founder of modern scientific psychiatry, psychopharmacology and psychiatric genetics. He developed a classification system for mental illness that influenced subsequent classifications. Kraepelin made distinctions between schizophrenia and manic-depressive psychosis that remain valid today.

Emil Kraepelin studied medicine at the University of Leipzig and the University of Würzburg. At the former university, he studied studied neuropathology under Paul Flechsig and experimental psychology with Wilhelm Wundt. During that period, he wrote his influential essay The Influence of Acute Illness in the Causation of Mental Disorders. From 1878 to 1882, Kraepelin worked with Bernhard von Gudden at the University of Munich and returned to Leipzig after where he completed his Habilitation thesis entitled The Place of Psychology in Psychiatry.

In 1883, Emil Kraepelin’s succesful work Compendium der Psychiatrie: Zum Gebrauche für Studirende und Aertze was published and it was expanded in subsequent multivolume editions to Ein Lehrbuch der Psychiatrie (A Textbook: Foundations of Psychiatry and Neuroscience). Kraepelin discussed that psychiatry was a branch of medical science and should be investigated by observation and experimentation like the other natural sciences. He established the foundations of the modern classification system for mental disorders and promoted the research into the physical causes of mental illness. 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.

Emil Kraepelin is credited with the classification of what was previously considered to be a unitary concept of psychosis, into two distinct forms which became known as the Kraepelinian dichotomy. Manic depression and dementia praecox. Kraepelin developed the concept of dementia praecox, which he defined as the “sub-acute development of a peculiar simple condition of mental weakness occurring at a youthful age”. Kraepelin recognized that any given symptom may appear in virtually any one of these disorders, however what distinguishes each disease symptomatically is not a particular symptom itself, but a specific pattern of symptoms. Thus, Kraepelin’s system is a method for pattern recognition, not grouping by common symptoms. Kraepelin also demonstrated specific patterns in the genetics of these disorders and specific and characteristic patterns in their course and outcome.

Even though Emil Kraepelin only deoted few pages to his speculations about the etiology of his two major insanities he speculated that these insanities would one day probably be found to be caused by a gradual systemic or ‘whole body’ disease process, probably metabolic, which affected many of the organs and nerves in the body but affected the brain in a final, decisive cascade.

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