Emil Kraepelin

While he proclaimed his own high clinical standards of gathering information "by means of expert analysis of individual cases", he also drew on reported observations of officials not trained in psychiatry.

[2][3] Kraepelin, whose father, Karl Wilhelm, was a former opera singer, music teacher, and later successful story teller,[4] was born in 1856 in Neustrelitz, in the Duchy of Mecklenburg-Strelitz in Germany.

Kraepelin proposed that by studying case histories and identifying specific disorders, the progression of mental illness could be predicted, after taking into account individual differences in personality and patient age at the onset of disease.

[6] In 1884, he became senior physician in the Prussian provincial town of Leubus, Silesia Province, and the following year he was appointed director of the Treatment and Nursing Institute in Dresden.

Following a large donation from the Jewish German-American banker James Loeb, who had at one time been a patient, and promises of support from "patrons of science", the German Institute for Psychiatric Research was founded in 1917 in Munich.

In 1918 he called for "educational discipline" such as those introduced by the Nazi party after 1933: severe punishments for the crime of 'corruption' (seduction), applicable to any act related to sexual gratification.

When he first introduced this concept as a diagnostic entity in the fourth German edition of his Lehrbuch der Psychiatrie in 1893, it was placed among the degenerative disorders alongside, but separate from, catatonia and dementia paranoides.

It later became clear that dementia praecox did not necessarily lead to mental decline and was thus renamed schizophrenia by Eugen Bleuler to correct Kraepelin's misnomer.

In addition, as Kraepelin accepted in 1920, "It is becoming increasingly obvious that we cannot satisfactorily distinguish these two diseases"; however, he maintained that "On the one hand we find those patients with irreversible dementia and severe cortical lesions.

[19] Nevertheless, overlap between the diagnoses and neurological abnormalities (when found) have continued, and in fact a diagnostic category of schizoaffective disorder would be brought in to cover the intermediate cases.

This has been described as a psychiatric redefinition of Cesare Lombroso's theories of the "born criminal", conceptualised as a "moral defect", though Kraepelin stressed it was not yet possible to recognise them by physical characteristics.

[21] In fact from 1904 Kraepelin changed the section heading to "The born criminal", moving it from under "Congenital feeble-mindedness" to a new chapter on "Psychopathic personalities".

The concept of "psychopathic inferiorities" had been recently popularised in Germany by Julius Ludwig August Koch, who proposed congenital and acquired types.

In the eighth edition from 1909 that category would include, in addition to a separate "dissocial" type, the excitable, the unstable, the Triebmenschen driven persons, eccentrics, the liars and swindlers, and the quarrelsome.

It has been described as remarkable that Kraepelin now considered mood disturbances to be not part of the same category, but only attenuated (more mild) phases of manic depressive illness; this corresponds to current classification schemes.

[citation needed] Upon moving to become Professor of Clinical Psychiatry at the University of Munich in 1903, Kraepelin increasingly wrote on social policy issues.

[2] Kraepelin was convinced that such institutions as the education system and the welfare state, because of their trend to break the processes of natural selection, undermined the Germans' biological "struggle for survival".

[2] Martin Brune has pointed out that Kraepelin and Rüdin also appear to have been ardent advocates of a self-domestication theory, a version of social Darwinism which held that modern culture was not allowing people to be weeded out, resulting in more mental disorder and deterioration of the gene pool.

Kraepelin saw a number of "symptoms" of this, such as "weakening of viability and resistance, decreasing fertility, proletarianisation, and moral damage due to "penning up people" [Zusammenpferchung].

He also wrote that "the number of idiots, epileptics, psychopaths, criminals, prostitutes, and tramps who descend from alcoholic and syphilitic parents, and who transfer their inferiority to their offspring, is incalculable".

He felt that "the well-known example of the Jews, with their strong disposition towards nervous and mental disorders, teaches us that their extraordinarily advanced domestication may eventually imprint clear marks on the race".

[24] Kraepelin's great contribution in classifying schizophrenia and manic depression remains relatively unknown to the general public, and his work, which had neither the literary quality nor paradigmatic power of Freud's, is little read outside scholarly circles.

His fundamental theories on the diagnosis of psychiatric disorders form the basis of the major diagnostic systems in use today, especially the American Psychiatric Association's DSM-IV and the World Health Organization's ICD system, based on the Research Diagnostic Criteria and earlier Feighner Criteria developed by espoused "neo-Kraepelinians", though Robert Spitzer and others in the DSM committees were keen not to include assumptions about causation as Kraepelin had.

Despite proclaiming high clinical standards for himself to gather information "by means of expert analysis of individual cases", he would also draw on the reported observations of officials not trained in psychiatry.

The various editions of his textbooks do not contain detailed case histories of individuals, however, but mosaiclike compilations of typical statements and behaviors from patients with a specific diagnosis.

Abridged and clumsy English translations of the sixth and seventh editions of his textbook in 1902 and 1907 (respectively) by Allan Ross Diefendorf (1871–1943), an assistant physician at the Connecticut Hospital for the Insane at Middletown, inadequately conveyed the literary quality of his writings that made them so valuable to practitioners.

Grave in Heidelberg (2008)