History and work of Emil Kraeplin

History and Work of Emil Kraepelin
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Abstract
Emil Kraepelin, a German psychiatrist, is renowned for his contributions he made in the field of psychiatric nosology. He is particularly known for his demarcation of manic-depressive insanity, a bipolar disorder and dementia praecox or schizophrenia (Decker, 2004, p.248). Apart from developing the classification system for mental disorders, Kraepelin was instrumental in developing the field of psychiatry into a solid science standing the meticulous test of empiricism (Hippius & Muller, 2008, p.3). Important figures behind Kraepelin’s nosology include Ewald Hecker and Karl Ludwig Kahlbaum who first described catatonia and hebephrenia thus suggesting the existence of two discrete types of mental diseases. Kraepelin’s ideas and philosophy were also influenced by a number of Greek philosophers such as Plato, Aristotle and Socrates who employed theatrical techniques to explore philosophical and psychiatric themes (Wallace & Gach, 2008, p.201). Other individuals who inspired Kraepelin include Wilhelm Wundt and Charles Darwin. Inspired by the ideas of great thinkers, Kraepelin became an essential cornerstone in the world of psychology making significant contributions of ideas that underpin modern psychopharmacology and clinical psychology (Ebert & Bar, 2010, p.191). Born in 1856 his work in psychiatric nosology still remains to be an important reference for psychologists and clinicians today. This paper goes beyond covering the history and work of Emil Kraepelin to exploring his particular impact on modern psychiatry.
Labeling the Mind: History and Work of Emil Kraepelin
Introduction
Emil Kraepelin was one of the most influential psychiatrists of the 20th century. His contributions in developing a system for psychiatric classification in made an enormous impact in the field of psychiatry. Kraepelin’s work not only made fruitful contributions in the field of psychiatry but also in psychopharmacology and natural sciences (Hippius & Muller, 2008, p.3). Kraepelin was born in a small town in Northern Germany known as Neustrelitz in 1856. He ranked as one of the great forerunners in clinical medicine following the footsteps of Kahlbaum. Kraepelin was interested in circumscribing the pathological entities as one of the most crucial tasks in expanding the field of scientific psychiatry (Geraud, 2007, p.561). He developed the field of psychiatry into a solid science standing the meticulous test of empiricism (Hippius & Muller, 2008, p.3). As Geraud (2007, p.561) writes, scientific psychiatry inspired by Kraepelin was aimed at clinical rather than symptomatic study of diseases. His work set a paradigm shift from the symptomatic study of mental diseases to the empirical disease investigation based on the conditions of occurrence, emergence and the outcomes. Two important results were achieved using this new approach. First, manic-depressive insanity was unified and recognized for the first time. Secondly, the early-onset dementia also known as dementia praecox was defined (Geraud, 2007, p.561).
Kraepelin’s comprehensive work in systematic nosography is described in the Treatise of Psychiatry which by the time of his death in 1915, eight editions had been published. The Treatise of Psychiatry contains the descriptions of mental diseases thus making the work of Kraepelin to be an important tool in the practice of modern psychiatrists. This innovative method in science apparently required specialized tools and team work with like mindset. Kraepelin therefore created a systematic technique for conducting psychiatric experiments and founded a research center which had topographic histology, histopathology, genealogy and serology in place. Among the individuals who were closely associated to Kraepelin during this establishment included Franz Nissl and Alois Alzheimer (Geraud. 2007, p.561). Apart from scientific psychiatry, Kraepelin also founded social psychiatry, comparative psychiatry and experimental psychology. It is in the area of experimental psychology where he investigated certain drug agents which elicited psychic effects thus founding the science of psychopharmacology. This paper aims to discuss Emil Kraepelin’s ideas in psychiatry, his historical background that led to the channeling of his ideas and the impacts his work has had on modern psychiatry
Emil Kraepelin and His Ideas in Psychiatry
One of the most notable achievements of Kraepelin was deciphering the correlation between psychiatric disorders and the pathological process of mental diseases (Ebert & Bar, 2010, p.191). Going contrary to the ruling theories of his time, Kraepelin detached from believing that certain symptoms signaled the disease process of particular diseases. His own clinical investigations made him come with the hypothesis that some combinations of some symptoms during the course of mental diseases usually make it easy to identify a given mental disease. In modern texts, the concept of endogenous psychosis is perhaps the most outstanding achievements Kraepelin is credited for. He defined differences between manic depression and dementia praecox as two different forms of psychosis. According to his definitions, Kraepelin considered dementia praecox or schizophrenia as a biological disease which is caused by toxic or anatomical processes. According to Kraepelin, dementia praecox (schizophrenia) presented as a neurodegenerative disease which often resulted in permanent loss of cognitive processes. Contrary, he defined manic depressions as rather episodic which did not always lead to irreversible impairment of brain functions. It was only in 1911 when Eugene Bleuler, a Swiss psychiatric renamed dementia praecox earlier described by Kraepelin to schizophrenia (Ebert & Bar, 2010, p.192). Nevertheless, Kraepelin’s separation of schizophrenic psychosis and affective disorders as two different disease classes formed the foundation for understanding mental diseases for over a century. While over the last decades both entities have rather been conceptualized as a continuum instead of two different entities, the International Classification of Diseases of WHO and DSM-Classification of APA still employ Kraepelin’s ideas in psychiatric nosology (Ebert & Bar, 2010, p.192).
The dichotomic concept of mental illness is perhaps the best known contribution of Kraepelin but not the only achievement he made in the field of psychiatry. He made several other achievements which earned him credit. For instance, he was a pioneering figure in the area of psychopharmacology which had not been conceptualized during his time. In his investigations, Kraepelin used substances such as caffeine, alcohol and chloroform together with other psychological tests to study abnormal behavior (Ebert & Bar, 2010, p.192).
Kraepelin is however critiqued in his ideas in psychiatry on the basis of his overreliance on generalization of his findings in psychiatry to political and social contexts. He for instance used his generalization to judge opponents of the First World War and socialists as mentally ill He always avoided alcohol as he had already experienced a deterioration of his relationship with his father who abused alcohol and suffered from alcoholism (Ebert & Bar, 2010, p.192). In addition, contrary to expectations of how psychiatrists should handle their patients, Kraepelin did not believe in listening to the patients but to largely rely on observation. He entirely struggled for objective observation and the reliance of evidence-based psychiatric practice.
Historical Background of the Ideas that Influenced Emil Kraepelin
The famous Kraepelin’s nosology became conceptualized in the context of two critical developments in psychiatry between the 1860s and 1870s in Germany (Engstrom, Weber & Burgmair, 2006, p.1710). Kraepelin’s concept is also thought to have been a counteraction to the collapse of the ideologies of unitary psychosis which was premised that all symptoms of mental illnesses were manifestations of only a single ...