Hostname: page-component-78c5997874-s2hrs Total loading time: 0 Render date: 2024-11-13T02:31:01.435Z Has data issue: false hasContentIssue false
  • English
  • Français

Kraepelin's concept of psychiatric illness

Published online by Cambridge University Press:  01 September 2010

K. S. Kendler  and
A. Jablensky
K. S. Kendler*
Affiliation:
Departments of Psychiatry, and Human and Molecular Genetics, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
A. Jablensky
Affiliation:
Centre for Clinical Research in Neuropsychiatry, University of Western Australia School of Psychiatry and Clinical Neurosciences, Perth, Australia
*
*Address for correspondence: K. S. Kendler, M.D., Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University Medical School, PO Box 980126, Richmond, VA 23298-0126, USA. (Email: kendler@vcu.edu)
Get access Rights & Permissions [Opens in a new window]

Abstract

Emil Kraepelin fundamentally shaped our current psychiatric nosology. Although much has been written about his diagnostic formulations, less is known about his views on the fundamental nature of psychiatric illness and the goals of psychiatric nosology. We focus on his writings from 1896 to 1903 but also review his inaugural lecture in Dorpat in 1887 and his last two papers, published in 1919–1920. Kraepelin hoped for a ‘natural’ classification of psychiatric illness but realized that the level of etiologic knowledge required to undergird this effort was not feasible in his own lifetime. This did not stop him, however, from developing a pragmatic approach based on his clinical method of careful description with detailed follow-up, coupled with the available fallible tools of pathological anatomy and, by 1919, genetics and biochemistry. Kraepelin saw psychiatric disorders as multifactorial, arising from the difficult to untangle action and interaction of internal and external causes. He was aware of the problem of defining the boundaries of illness and health but knew this was not unique to psychiatry. Contrary to his stereotype, he was sensitive to the importance of personality factors in psychiatric illness and advocated for their investigation. He also recognized the limitations of his ‘clinical method’ and was especially critical of classifications based on single prominent symptoms. Ultimately, Kraepelin was a skeptical realist when it came to psychiatric nosology. His goal of developing a consistent ‘natural’ classification of the major mental disorders has yet to be attained, but his ‘research agenda’ remains central to psychiatry to the present day.

Keywords

DiagnosishistoryKraepelinpsychiatric illness
Type
Review Article
Information
Psychological Medicine , Volume 41 , Issue 6 , June 2011 , pp. 1119 - 1126
Copyright
Copyright © Cambridge University Press 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Berrios, GE, Hauser, R (1988). The early development of Kraepelin's ideas on classification: a conceptual history. Psychological Medicine 12, 813–821.CrossRefGoogle Scholar
Birnbaum, K (1923). Der Aufbau der Psychose. Springer: Berlin [trans. H. Marshall: The making of a psychosis: the principles of structural analysis in psychiatry. In Themes and Variations in European Psychiatry: An Anthology (ed. Hirsch, S. R. and Shepherd, M.), pp. 199–238. University Press of Virginia: Charlottesville, 1974].Google Scholar
Bleuler, E (1920). Lehrbuch der Psychiatrie, Dritte Auflage [Textbook of psychiatry, 3rd edn]. Springer: Berlin.CrossRefGoogle Scholar
Falret, JP (1854). Memorandum on circular insanity [in French]. Bulletin de l'Academie impériale de médecine 19, 382–400.Google Scholar
Griesinger, W (1861). Die Pathologie und Therapie der psychischen Krankheiten. Krabbe: Stuttgart [trans. C. L. Robertson and J. Rutherford: Mental Pathology and Therapeutics. William Wood & Company: New York, 1882].Google Scholar
Hecker, E (1871). Hebephrenia: a contribution to clinical psychiatry [in German]. Archiv für pathologische Anatomie und für klinische Medizin 52, 394–429.Google Scholar
Hughlings Jackson, J (1887). Remarks on evolution and dissolution of the nervous system. Journal of Mental Science 33, 25–48.Google Scholar
Jablensky, A, Hugler, H, von Cranach, M, Kalinov, K (1993). Kraepelin revisited: a reassessment and statistical analysis of dementia praecox and manic-depressive insanity in 1908. Psychological Medicine 23, 843–858.Google Scholar
Kahlbaum, KL (1863). Die Gruppierung der psychischen Krankheiten und die Einteilung der Seelenstörungen [The grouping of psychiatric diseases and the classification of mental disturbances]. Kafemann: Danzig.Google Scholar
Kraepelin, E (1887). Die Richtungen der psychiatrischen Forschung. Vogel: Leipzig [trans. E. J. Engstrom and M. M. Weber: The directions of psychiatric research by Emil Kraepelin. History of Psychiatry 2005, 16, 350–364].Google Scholar
Kraepelin, E (1896). Der psychologische Versuch in der Psychiatrie [The psychological experiment in psychiatry – excerpts translated by A. Jablensky]. In Psychologische Arbeiten (ed. Kraepelin, E.), pp. 1–91. Engelmann: Leipzig.Google Scholar
Kraepelin, E (1899 a). Psychiatrie. Ein Lehrbuch für Studierende und Ärzte, 6. Auflage, 1. Band. Barth: Leipzig [trans. H. Metoui: Psychiatry, A Textbook for Students and Physicians, 6th edn, Vol. 1. Science History Publications: Canton, MA, 1990].Google Scholar
Kraepelin, E (1899 b). Psychiatrie. Ein Lehrbuch für Studierende und Ärzte, 6. Auflage, 2. Band. Barth: Leipzig [trans. S. Ayed: Psychiatry, A Textbook for Students and Physicians, 6th edn, Vol. 2. Science History Publications: Canton, MA, 1990].Google Scholar
Kraepelin, E (1903–04). Psychiatrie: Ein Lehrbuch fur Studierende und Aerzte, 7. Auflage, 2 Bände. Barth: Leipzig [trans. A. Ross Diefendorf: Clinical Psychiatry: a Text-book for Students and Physicians, 2 vols. Macmillan: New York, 1907].Google Scholar
Kraepelin, E (1909–13). Psychiatrie: Ein Lehrbuch für Studierende und Aerzte, 8. Auflage. Barth: Leipzig [trans. R. M. Barclay and G. M. Robertson: Dementia Praecox and Paraphrenia. Krieger: Huntington, NY, 1919. Reprinted 1971].Google Scholar
Kraepelin, E (1919). Die Erforschung psychischer Krankheitsformen [The investigation of the forms of psychiatric illness – excerpts translated by A. Jablensky]. Zeitschrift fur die gesamte Neurologie und Psychiatrie 51, 224–246.CrossRefGoogle Scholar
Kraepelin, E (1920). Die Erscheinungsformen des Irreseins. Zeitschrift für die gesammte Neurologie und Psychiatrie 62, 1–29 [trans. (i) H. Marshall: Patterns of mental disorder. In Themes and Variation in European Psychiatry: An Anthology (ed. S. R. Hirsch and M. Shepherd), pp. 7–30. John Wright & Sons: Bristol, 1974; (ii) D. Beer: The manifestations of insanity. History of Psychiatry 1992, 3, 509–529].Google Scholar
Kraepelin, E (1987). Lebenserinnerungen. Herausgegeben von H. Hippius, G. Peters and D. Ploog, unter Mitarbeit von P. Hoff und A. Kreuter [trans. C. Wooding-Deane: Memoirs (ed. H. Hippius, G. Peters and D. Ploog, in cooperation with P. Hoff and A. Kreuter). Springer: Berlin].Google Scholar
Kraepelin, E (2002). Lifetime Editions of Kraepelin in English: Foundations of Psychiatry and Neuroscience (ed. J. Gach). Thoemmes Press Continuum: Bristol.Google Scholar
Morel, BA (1860). Traité des maladies mentales [Treatise on mental diseases]. Masson: Paris.Google Scholar
Trede, K, Salvatore, P, Baethge, C, Gerhard, A, Maggini, C, Baldessarini, RJ (2005). Manic-depressive illness: evolution in Kraepelin's Textbook, 1883–1926. Harvard Review of Psychiatry 13, 155–178.CrossRefGoogle ScholarPubMed
Wundt, W (1874). Grundzüge der physiologischen Psychologie. Engelmann: Leipzig [trans. E. B. Titchener: Principles of Physiological Psychology. Harvard University Press: Cambridge, MA, 1904].Google Scholar