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Psychiatry's contribution to the public stereotype of schizophrenia : Historical considerations
Verfasser / VerfasserinKatschnig, Heinz
Erschienen in
Journal of Evaluation in Clinical Practice, 2018, Jg. 24, H. 5, S. 1093-1100
ErschienenWiley-Blackwell, 2018
DokumenttypAufsatz in einer Zeitschrift
Schlagwörter (EN)dementia praecox / DSM / first rank symptoms / ICD / public stereotype / schizophrenia
URNurn:nbn:at:at-ubmuw:3-345 Persistent Identifier (URN)
 Das Werk ist frei verfügbar
Psychiatry's contribution to the public stereotype of schizophrenia [0.25 mb]
Zusammenfassung (Englisch)

The public stereotype of schizophrenia is characterized by craziness, a split personality, unpredictable and dangerous behaviour, and by the idea of a chronic brain disease. It is responsible for delays in helpseeking, encourages social distance and discrimination, and furthers selfstigmatization. This paper discusses the circumstances of the origins of the idea of a chronic brain disease (Emil Kraepelin, 18561926), of the split personality concept derived from the term “schizophrenia” (Eugen Bleuler, 18571939), and the craziness idea reflected in the “first rank symptoms”, which are all hallucinations and delusions (Kurt Schneider, 18871967). It shows how Emil Kraepelin's scientific search for homogenous groups of patients with a common aetiology, symptom pattern, and prognosis materialized in the definition of “dementia praecox” as a progressing brain disease; how Eugen Bleuler's life and professional circumstances facilitated an “empathic” approach to his patients and prompted him to put in the foreground incoherence of cognitive and affective functioning, and not the course of the disease; finally, how Kurt Schneider in his didactic attempt to teach general practitioners how to reliably diagnose schizophrenia, neglected what Emil Kraepelin and Eugen Bleuler had emphasized decades earlier and devised his own criteria, consisting exclusively of hallucinations and delusions. In a strange conglomerate, the modern operational diagnostic criteria reflect all three approaches, by claiming to be NeoKraepelinean in terms of defining a categorical disease entity with a suggestion of chronicity, by keeping Bleuler's ambiguous term schizophrenia, and by relying heavily on Kurt Schneider's hallucinations and delusions. While interrater reliability may have improved with operational diagnostic criteria, the definition of schizophrenia is still arbitrary and has no empirical validitybut induces stigma.

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