History of schizophrenia

The word schizophrenia was coined by the Swiss psychiatrist Eugen Bleuler in 1908, and was intended to describe the separation of function between personality, thinking, memory, and perception.

Accounts of a schizophrenia-like syndrome are thought to be rare in the historical record prior to the 19th century, although reports of irrational, unintelligible, or uncontrolled behavior were common.

[10] A review of ancient Greek and Roman literature indicated that although psychosis was described, there was no account of a condition meeting the criteria for schizophrenia.

[11] Bizarre psychotic beliefs and behaviors similar to some of the symptoms of schizophrenia were reported in Arabic medical and psychological literature during the Middle Ages.

[12] However, no condition resembling schizophrenia was reported in Şerafeddin Sabuncuoğlu's Imperial Surgery, a major Ottoman medical textbook of the 15th century.

Kraepelin believed that dementia praecox was caused by a lifelong, smoldering systemic or "whole body" process of a metabolic nature that would eventually affect the functioning of the brain in a final decisive cascade.

[19] In 1853 Bénédict Morel used the term démence précoce (precocious or early dementia) to describe a group of young patients who were affected by "stupor".

Finally, there is no evidence that Morel's démence précoce had any influence on the later development of the dementia praecox concept by either Arnold Pick or Emil Kraepelin.

[22] Paul Eugen Bleuler first used the term "schizophreniegruppe", on April 24, 1908, during a lecture at a meeting of the German Psychiatric Association in Berlin.

[24] Bleuler coined the term to more aptly describe the separation of function between personality, thinking, memory, and perception in his patients.

[25] Bleuler later published his treatise on the subject, Dementia Praecox oder Gruppe der Schizophrenien, in 1911,[26][27] which is recognised as his magnum opus.

Bleuler's treatise describes the fundamental symptoms of the disorder as being of four A's:[28] flattened Affect, Autism, impaired Association of ideas and Ambivalence.

[25] Bleuler sought to differentiate schizophrenia as not a form of dementia, but an entirely separate disorder since his subjects did not suffer from loss or distortion of their memories.

[29][28] Bleuler wrote in 1911 of his terminology:[23] I call dementia precox schizophrenia because, as I hope to show, the splitting of the different psychic functions is one of its most important features.

In each case there is a more or less clear splitting of the psychological functions: as the disease becomes distinct, the personality loses its unity.From the creation of the new term, at least two schools of thought arose after the acceptance of the idea.

[33] In the first half of the 20th century schizophrenia was considered to be a hereditary defect, and affected people were subject to eugenics in many countries.

[38] According to E. Fuller Toddy and Robert H. Yolken, it was in 1939 that Hitler asked his private physician and his officials to draft a law that would allow the systematic killing of individuals with mental disorders, sticking to a claim that he had made shortly after assuming office in 1933: "it is right that the worthless lives of such creatures should be ended, and that this would result in certain savings in terms of hospitals, doctors and nursing staff."

The prominent Soviet psychiatrist Andrei Snezhnevsky created and promoted an additional sub-classification of sluggishly progressing schizophrenia.

[41] Rather than defending his claim that a latent form of schizophrenia caused dissidents to oppose the regime, Snezhnevsky broke all contact with the West in 1980 by resigning his honorary positions abroad.

[45] Frontal lobotomies, a form of psychosurgery, were carried out from the 1930s until the 1970s in the United States, and until the 1980s in France, involving either the removal of brain tissue from different regions or the severing of pathways,[46] widely recognized as a grave human rights abuse.

Related criticisms of psychiatry were launched by philosophers such as Michel Foucault, Jacques Lacan, Gilles Deleuze, Thomas Szasz, and Félix Guattari.

David Rosenhan's 1972 study, published in the journal Science under the title "On being sane in insane places", concluded that the diagnosis of schizophrenia in the US was often subjective and unreliable.

[57] The DSM-IV of 1994 showed an increased focus on an evidence-based medical model, with the diagnostic criteria for schizophrenia slightly adjusted to require one month of positive symptoms instead of one week.

[62] Hong Kong uses the a similar phrase (思覺失調) to refer to psychosis since 2001,[63] keeping the original "split-psyche" name of schizophrenia.