Paraphrenia: Evolution of the Concept

Abstract

Paraphrenia was identified as a psychopathological entity characterized by chronic delirium, described next to schizophrenia, but with rich and fanciful elaborations, without social and cognitive impairment associated. Despite having been extensively described, paraphrenia fell into disuse. With this work, the authors intend to carry out a literature review on the concept of paraphrenia, since its first report to the extinction from the current practice of psychiatry. The term paraphrenia (para “near” phrenia “pathological mental state”) was first noted by Kahlbaum in 1863, who identified dementia and subdivided it into three types: “neofrenia”, “paraphrenia hebetica” and “senilis paraphrenia”). Magnan and Manager suggested the concept of “chronic hallucinatory psychosis” in 1963, while Kraepelin started jobs with similar characteristics, defining the concept of paraphrenia. Kraepelin distinguished dementia praecox from the later onset dementia, despite considering them closer to one another than any of them to paranoia. Paraphrenia would be characterized by less formal disturbances of thought and greater preservation of affection. In 1911, with “schizophrenia” expression, Bleuler broke with Kraepelin concept, as Mayer, who reviewed Kraepelin patients, concluding that more than half had progressed to a diagnosis of schizophrenia. At this time, paraphrenia was virtually abolished from the practice of psychiatry. Despite the observations made over the years, the concept of paraphrenia have revealed that the description proposal does not correspond to an isolated and distinct psychiatric condition, several times, in clinical practice we have encountered with patients presenting diagnostic criteria for schizophrenia but with the evolution of the disease showing no significant deterioration in several areas.

Disclosure of interest

The authors have not supplied their declaration of competing interest.