Logo image
Back
Concept of Schizophrenia: Past, Present, and Future
Book chapter

Concept of Schizophrenia: Past, Present, and Future

Nancy C Andreasen
Schizophrenia, pp.1-8
Wiley‐Blackwell
12/10/2010
DOI: 10.1002/9781444327298.ch1

View Online

Abstract

Schizophrenia is one of the world's most important public health problems. Although the name “schizophrenia” is relatively new, psychotic illnesses with its characteristic symptoms have been described for at least three millennia. Its modern concept emerged when Emil Kraepelin divided the broad group of psychotic disorders into two subtypes, based on their differences in course and outcome. He recognized these as distinct disorders and called them dementia praecox and manic depression. Bleuler later suggested that the name should be changed to schizophrenia (schiz = fragmenting, splitting; phren = mind, Gk) to emphasize the essential characteristic of the illness: a fragmenting of mental processes, or thought disorder. Bleuler's name was eventually adopted. Both Kraepelin and Bleuler emphasized that a fragmenting of thinking, emotion, and personality were the most important symptomatic features of the illness; these features are very similar to the concept of negative symptoms that was initially formulated by Hughlings‐Jackson. Jackson contrasted negative symptoms with positive symptoms, which represent the psychotic features of schizophrenia, such as delusions and hallucinations. In the 1960s and 1970s some investigators began to argue that positive symptoms should be considered the fundamental features of the illness. Their thinking was heavily influenced by the writings of Kurt Schneider, who described “first‐rank symptoms”, such as though insertion or delusions of control. The essence of these symptoms is the individual's sense of a loss of autonomy. They became a popular way to define schizophrenia because they were potentially more objective and clearly discontinuous from normality. Therefore they were included in early structured interviews, such as the Present State Examination, and they also contributed heavily to the diagnostic criteria for schizophrenia in DSM‐III. During more recent years, however, an interest in negative symptoms and cognitive impairments has re‐emerged. This complex history reflects the fact that the definition of the phenotype of schizophrenia continues to be a major challenge, particularly in an era when powerful research tools such as genomics are available.
 positive symptoms diagnostic criteria Kraepelin Bleuler Schneider negative symptoms Present State Examination schizophrenia psychosis Hughlings‐Jackson

Details

Metrics

35 Record Views
Logo image