Thursday, January 10, 2008

Schizophrenia: A hundred years of a dubious concept

Eugen Bleuler
The idea of a split mind has been introduced 1908 by the Swiss psychiatrist Eugen Bleuler, replacing Kraepelin's idea of premature dementia, but modern science has found that Kraepelin got closer to the point.

The zeitgeist of the Freudian era in the early 20th century was in favour of the view that psychic diseases can be cured by cognitive interventions. Bleuler's new term schizophrenia (Greek for split mind) has opened such therapeutic perspectives whereas the older term dementia praecox, coined by Emil Kraepelin, implied a damage that cannot be cured in therapeutic sessions.

During most of the 20th century, both terms have been used at the same time and partially as synonyms. Schizophrenia tended to be more broadly defined, also including psychogenic causes. Dementia praecox, on the other hand, was defined in a more narrow sense, stating that the causes are organic and that the prognosis is bad.

With the new brain imaging techniques (fMRI), a number of deficits in the brain have been localized in schizophrenics. These findings support the concept of Kraepelin.

The split mind concept, on the other hand, has not been verified, and its diagnostic power is poor. In Japan, it has been replaced 2004 by the concept of integration disorder. In the Western world, despite some controversies, it is still being used. A new review of the current research findings on schizophrenia comes to the conclusion that this term should better be abandoned.

Photo credit: University of Zurich

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