Thomas A. Ban
Neuropsychopharmacology in Historical Perspective
Education in the Field in the Post-Neuropsychopharmacology Era

Background to An Oral History of the First Fifty Years
Special Areas (Volume Seven): 3. Psychiatric diagnosis
(Bulletin 61)


            The origin of most current diagnostic end-points in neuropsychopharmacological research is in the clinically distinct sub-populations separated from “unitary psychosis” (Einheitpsychose) during the second part of the 19th century (Ban 2011; Griesinger 1845; Guislain 1833; Neumann 1859). In order of chronology they are as follows: Lasègue’s délire de persecution (1852);  Falret’s folie circulaire (1854); Briquet’s   hysteria (1859), Morel’s  démence precoce (1860);  Morel’s délire emotiff (1867); Beard’s  neurasthenia (1869); Benedict’s Platztschwindel (agoraphobia) (1870); Lasègue’s l’anorexie hystérique (1873), Hecker’s  Hebephrenie (1871) and Westphal’s Agoraphobie (1871 & 1872); Lasègue’s l’anorexie hystérique (1873), and Gull’s “anorexia nervosa – apepsia hysterca” (1873); Kahlbaum’s Katatonie (1874); and Westphal’s Zwangsvorstellungen (obsessive-compulsive disorder) (1878) (Beard 1869; Benedict 1870; Briquet 1859; Falret 1845; Gull 1871; Hecker 1871; Kahlbaum   1871; Lasegue 1852, 1871; Menninger, Mayman and Pruysel  1968; Morel 1860, 1866; Shorter, 1871, 2005; Westphal 1871, 1872, 1878).

            At present, hysteria (referred to as “somatization disorder” in some of the   classifications), neurasthenia, agoraphobia, anorexia nervosa and obsessive-compulsive states have remained valid diagnostic concepts; délire de persecution developed in the early 1890s into Magnan and Sérieux’s diagnostic concept of “chronic delusional state of systematic evolution”; folie circulaire provided the core for Kraepelin’s diagnostic concept of manic-depressive insanity; and démence precoce served as the starting point for Kraepelin to develop his diagnostic concept of dementia praecox  (Goodwin and Guze 1989;  Magnan and Sérieux 1893).

            The origin of some of the other current diagnostic end-points are in Karl Kahlbaum’s classification which distinguishes five classes of disease, i.e., neophrenias, paraphrenias, vecordia, vesanias and dysphrenias, and in Emil Kraepelin’s different classifications presented in nine editions of his textbook, the first published in 1883 and the last in 1927 (Kahlbaum 1863; Kraepelin 1883, 1888, 1889, 1893, 1896, 1899, 1903-4, 1908-15, 1927). 

            Diagnostic concepts, like presbyophrenia, dysthymia and cyclothymia, were first introduced in Kahlbaum’s classification, and the unifying diagnostic concepts of dementia praecox and manic depressive insanity first appeared in the sixth edition of Kraepelin’s classification. (Kahlbaum 1863; Kraepelin 1899).

            In the seventh edition, published in 1903 and 1904, Kraepelin recognized 15 categories of mental illness: (1) infectious mental conditions, (2) exhaustion states, (3) intoxications, (4) thyrogenic conditions, (5) dementia praecox, (6) dementia paralytica, (7) mental disorders in brain diseases, (8) involutional diseases, (9) manic–depressive insanity, (10) paranoia (Verrűctheit), (11) epilepsy, (12) psychogenic neuroses, (13) diseases of constitutional origin, (14) psychopathic personalities and (16) developmental inhibitions (Kraepelin 1903-4).

            By the time of the eighth edition (1908-1914) of Kraepelin’s text appeared, Eugen Bleuler replaced the name dementia praecox with schizophrenia (1908) (Bleuler 1908, 1911; Dreyfus 1905; Hamilton 1976; Kraepelin 1908-14; Shorter 2005).

            Adoption of Kraepelin’s classification in the 1950s by the St. Louis School of Psychiatry in the United States was instrumental to the development of the third edition of the diagnostic and statistical manual of mental disorders of the American Psychiatric Association, published in 1980. (American Psychiatric Association 1980). The DSM-III and its successors were to provide, to date (2018), the diagnostic end-points of neuropsychopharmacological research.




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March 14, 2019