Background of Study
February 14, 2013
Professor Eric Durbrow
Background of the Study
In a given year 2 million Americans and 25 million people worldwide suffer from one of the top ten most debilitating diseases. Schizophrenia is a long-term major mental disorder that affects several aspects of behavior, thinking, and emotion, which makes it difficult to tell between what is real and unreal; it is also characterized by positive and negative symptoms. Either being acute with a rapid beginning and good hopes of resurgence or a chronic longer term course that builds over time. Such variation in symptoms leads to observations of discord in patients.
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3). “In France Benedict Morel referred to such cases as démence précoce, while in Scotland, Clouston coined the term adolescent insanity” (Jablensky, 2010, para. 3). In Germany, Kahlbaum and his pupil Hecker had outlined and described catatonic syndrome and hebephrenia (today they are known as catatonic and disorganized schizophrenia).
However it was Emile Kraepelin and Eugene Bleuler that brought us closer to understanding the schizophrenic disorder. In 1893 Kraepelin a German physician, named the disorder dementia praecox which he had adopted from Morel’s term that described “a mental disorder which initially struck males when they were in their teens or were young adults” (Snowden, 2008, p. 444). Kraepelin also suggested integration of the various depictions into a single classification. “Kraepelin was the first to clarify objective descriptions and diagnostic criteria for the precursor to schizophrenia” (Snowden, 2008, p. 444). Kraepelin was trying to create a system of criteria to diagnose the disorder. This was because he noticed that major symptoms could be a part of different disorders, and they could not be diagnostic on their own. He believed schizophrenia was “a disease of the brain, identified by a common unique pattern of early onset (praecox) and inexorable decline (dementia)” (Snowden, 2008, p. 444).
Bleuler who was a Swiss Psychiatrist disagreed with Kraepelin’s solely biological construction and presented the term schizophrenia in 1911. Schizophrenia comes from Greek roots meaning split (schiz) mind (phren). Not to be confused with personality disorders, Bleuler “explained: I call dementia praecox “schizophrenia” because … the “splitting” of the different psychic functions is one of its most important characteristics” (Coleman, 2008). Through his work he also found that the disorder did not constantly end in dementia as Kraepelin had proposed, and presented a different set of diagnostic criteria. The four A’s: “flattened affect, ambivalence, autism (social relatedness deficit), and impaired association of ideas” (Snowden, 2008, p. 445).
However Kraepelin’s and Bleuler’s criteria were criticized for being too vague, although they were more customary in the U.S., and they formed the basis for schizophrenia in the DSM-I and DSM-II until 1980 when the DSM-III was published. This is when the DSM acquired new tactics to diagnosis because of the deficiency in uniformity that led to unclear diagnoses. The new approach was called neo-Kraepelinian and replaced old methods of diagnoses criteria “with specific inclusion and exclusion criteria” (Snowden, 2008, p.445). Kurt Schneider’s first rank symptoms and Feighner’s 6-month duration became the new set for diagnoses criteria.
With the combined efforts of researchers, five subtypes of schizophrenia are now recorded in the DSM-IV-TR: paranoid, disorganized, catatonic, residual, and undifferentiated. However, the first three put forward by Kraepelin haven’t proven to be...