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Kenneth S Kendler - One of the best experts on this subject based on the ideXlab platform.
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the development of kraepelin s mature diagnostic concept of catatonic dementia praecox a close reading of relevant texts
Schizophrenia Bulletin, 2020Co-Authors: Kenneth S KendlerAbstract:Through a close reading of texts, this essay traces the development of catatonia from its origination in Kahlbaum's 1874 monograph to Kraepelin's catatonic subtype of his new category of Dementia Praecox (DP) in 1899. In addition to Kraepelin's second to sixth textbook editions, I examine the six articles referenced by Kraepelin: Kahlbaum 1874, Brosius 1877, Neisser 1887, Behr 1891, Schule 1897, and Aschaffenburg 1897 (Behr and Aschaffenburg worked under Kraepelin). While Brosius and Neisser confirmed Kahlbaum's descriptions, Behr, Schule, and Aschaffenburg concluded that his catatonic syndrome was nonspecific and only more narrowly defined forms, especially those with deteriorating course, might be diagnostically valid. Catatonia is first described by Kraepelin as a subform of Verrucktheit (chronic nonaffective delusional insanity) in his second to fourth editions. In his third edition, he adds a catatonic form of Wahnsinn (acute delusional-affective insanity). His fourth and fifth editions contain, respectively, catatonic forms of his two proto-DP concepts: Psychischen Entartungsprocesse and Die Verblodungsprocesse. Kahlbaum's catatonia required a sequential phasic course. Positive psychotic symptoms were rarely noted, and outcome was frequently good. While agreeing on the importance of key catatonic signs (stupor, muteness, posturing, verbigeration, and excitement), Kraepelin narrowed Kahlbaum's concept, dropping the phasic course, emphasizing positive psychotic symptoms and poor outcome. In his fourth to sixth editions, as he tried to integrate his three DP subtypes, he stressed, as suggested by Aschaffenburg and Schule, the close clinical relationship between catatonia and Hebephrenia and emphasized the bizarre and passivity delusions seen in catatonia, typical of paranoid DP.
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the development of kraepelin s mature diagnostic concept of Hebephrenia a close reading of relevant texts of hecker daraszkiewicz and kraepelin
Molecular Psychiatry, 2020Co-Authors: Kenneth S KendlerAbstract:In developing his mature concept of hebephrenic dementia praecox (DP) in his 4th (1893) through 6th textbook editions (1899), Kraepelin worked from the hebephrenic syndrome first described by Hecker (1871) and then carefully studied by his student Daraszkiewicz (1892). Working under Kraepelin’s supervision, Daraszkiewicz followed Hecker in emphasizing several key features of Hebephrenia (distinctive deteriorative course, importance of silliness and minimal positive psychotic symptoms) but expanded the syndrome to include cases developing severe dementia, rejected the link to prodromal depressive and manic phases, and reduced the emphasis on thought disorder. Daraszkiewicz proposed a soft subtyping of Hebephrenia based on level of deterioration, which Kraepelin adopted in his 4th edition with an additional emphasis on severe positive psychotic symptoms. In his 5th edition, Kraepelin created a third subform with even more pronounced and bizarre delusions and hallucinations. In his 6th edition, which contained his first articulation of DP, Kraepelin eliminated his Hebephrenia subforms presenting a single syndrome, which, compared to Hecker, included more emphasis on positive psychotic and catatonic symptoms and severe dementia. Kraepelin’s paths to hebephrenic and paranoid DP differed in important ways. Paranoid DP was a de novo syndrome created by differentiation from paranoia. Hebephrenia, by contrast, evolved from a disorder created in the Kahlbaum/Hecker paradigm of the iterative study of clinical features, course and outcome. Kraepelin further implemented this approach in substantially reworking, over several drafts, the hebephrenic syndrome to fit into his emerging construct of dementia praecox.
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the structure of psychosis latent class analysis of probands from the roscommon family study
Archives of General Psychiatry, 1998Co-Authors: Kenneth S Kendler, Laura M Karkowski, Dermot WalshAbstract:Background The nosologic structure of psychotic illness, still influenced as much by historical as empirical perspectives, remains controversial. Methods Latent class analysis was applied to detailed symptomatic and outcome assessments of probands (n=343) with broadly defined schizophrenia and affective illness ascertained from a population-based psychiatric registry in Roscommon County, Ireland. First-degree relatives (n=942) were assessed by personal interview and/or review of hospital record. Results Six classes were found, all of which bore substantial resemblance to current or historical nosologic constructs. In order of decreasing frequency, they were (1) classic schizophrenia, (2) major depression, (3) schizophreniform disorder, (4) bipolar-schizomania, (5) schizodepression, and (6) Hebephrenia. These classes differed on many historical and clinical variables not used in the latent class analysis. Compared with relatives of controls, significantly increased rates of major depression were seen in relatives of depressed and schizodepressed probands. Significantly increased rates of bipolar illness were restricted to relatives of bipolar-schizomanic probands. The risks for schizophrenia and schizophrenia spectrum disorders were significantly increased in relatives of all proband classes except major depression. This increase was moderate for bipolar-schizomanic probands, substantial for schizophrenic, schizophreniform, and schizodepressed probands, and marked for hebephrenic probands. Conclusions These results suggest a relatively complex typology of psychotic syndromes consistent neither with a unitary model nor with a Kraepelinian dichotomy. The familial vulnerability to psychosis extends across several syndromes, being most pronounced in those with schizophrenialike symptoms. The familial vulnerability to depressive and manic affective illness is somewhat more specific.
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abstract and review of zur erbpathologie der schizophrenie contribution to the genetics of schizophrenia
American Journal of Medical Genetics, 1996Co-Authors: Kenneth S Kendler, Edith ZerbinrudinAbstract:Starting from the 722 probands originally studied by Rudin, Bruno Schulz re-examined them and their relatives confirming the diagnosis in 660. While Rudin sought for mendelian ratios in siblings, Schulz, anticipating modern methods, focused on the family study method as an approach to clarifying possible etiologic heterogeneity within the schizophrenia syndrome. Using a Kraepelian approach to diagnosis, Schulz reports a MR for narrowly and broadly defined schizophrenia of 6.7 and 8.2% in siblings and 2.6 and 3.7% in parents. He found no evidence for a difference in risk of illness in siblings as a function of either the gender or outcome of the proband. The risk for schizophrenia was significantly increased in siblings of hebephrenic probands. Compared to siblings of probands with no identified factor which precipitated their schizophrenia, the risk for schizophrenia was significantly decreased in probands with a physical etiologic factor but did not differ in siblings of probands with a psychological etiologic factor. The risk for schizophrenia was particularly low in siblings of probands whose onset of illness occurred within a year of major head trauma.
Athanasios Koukopoulos - One of the best experts on this subject based on the ideXlab platform.
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Ewald Hecker's description of cyclothymia as a cyclical mood disorder: its relevance to the modern concept of bipolar II.
Journal of Affective Disorders, 2003Co-Authors: Athanasios KoukopoulosAbstract:1 . Historical note basis until they could be back on their feet. His work with outpatients and his intimate acquaintance with Ewald Hecker (1843–1909) was a disciple of Karl them enabled him to make observations which Ludwig Kahlbaum and his closest assistant for many escaped hospital psychiatrists. His incisive clinical years at the Kahlbaum Sanitarium in Goerlitz, Silesia description and his sophisticated understanding of (Germany). His cousin was Kahlbaum’s first wife. psychopathology made Hecker (1898) not only a Their collaboration was extremely fruitful and proforerunner, but also one who anticipated today’s duced landmark works on Hebephrenia and conceptions of cyclothymia as the basis of bipolar II cyclothymia. Hecker’s progressive approach to psydisorder (Dunner et al., 1976; Akiskal et al., 1977; chiatry, which he recommended to Kahlbaum, comAkiskal et al., 1979; Akiskal, 1981; Depue et al., bated the coercive methods of his time and placed 1981; Cassano et al., 1992; American Psychiatric the accent on public education to eliminate the Association, 1994; Brieger and Marneros, 1997; stigma attached to mental illness. Like Kahlbaum, he Hantouche et al., 1998; Akiskal et al., 2000; Akiskal never attained a university chair in psychiatry, and Pinto, 1999). Indeed, he described cyclothymia perhaps because of his liberal ideas. Instead, he as brief depressions with mild excitements of short worked at his own private hospital in Wiesbaden, duration (measured in days), as well as longer which he bought in 1891. Hecker attained a reputadepressions (lasting weeks to months) and followed tion as hypnotherapist and psychotherapist for paby brief hypomanias. The latter of course correspond tients with cyclothymia, anxiety and sleep disorders, to today’s concept of bipolar II. He proceeded to anticipating today’s outpatient combination of psyprovide a superb description of the clinical picture of chiatry and psychotherapy. He attached such imporbipolar II as we know it today. Even his recomtance to humane practices that he even accommomendations not to tamper too much with the depresdated some patients into his home on a temporary sive phase and instead endeavour to limit the hypomanic phase, resonates with contemporary advice (Akiskal and Pinto, 1999; Wehr and Goodwin, 1987; *Tel.: 1 39-06-687-4415; fax: 1 39-06-6880-2345. Akiskal and Mallya, 1987; Koukopoulos et al., 1990; E-mail address: a.koukopoulos@flashnet.it (A. Koukopoulos). Akiskal, 2001)—alas not heeded often enough! The
Abdullah Kraam - One of the best experts on this subject based on the ideXlab platform.
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Hebephrenia: a conceptual history
History of Psychiatry, 2012Co-Authors: Abdullah Kraam, Paula PhillipsAbstract:This paper traces the conceptual history of Hebephrenia from the late nineteenth century until it became firmly embedded into modern psychiatric classification systems. During this examination of t...
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Hebephrenia a contribution to clinical psychiatry
History of Psychiatry, 2009Co-Authors: Ewald Hecker, Abdullah KraamAbstract:When Kahlbaum reluctantly allowed his disciple Hecker to write the paper on Hebephrenia no one could foresee that it would be one of the few psychiatric concepts that would still be relevant today, for three reasons. First, it is still included in major current psychiatric classification systems. Second, some authors believe that it signifies a particularly malignant form of schizophrenia with an early onset and poor prognosis. Third, its introduction coincided with increased interest in age of onset of psychiatric disorders and proved to be a sensitive marker for the emergence of child psychiatry as a specialty. Until now, only excerpts of Hecker’s seminal paper have been available in English; this is the first complete translation including all case reports and letters. The seven cases and accompanying letters formed a crucial part of Hecker’s paper. Readers can now, for the first time, judge for themselves why it had such a tremendous impact beyond nineteenth-century German psychiatry.
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classic text no 77 Hebephrenia a contribution to clinical psychiatry by dr ewald hecker in gorlitz 1871
History of Psychiatry, 2009Co-Authors: Abdullah KraamAbstract:When Kahlbaum reluctantly allowed his disciple Hecker to write the paper on Hebephrenia no one could foresee that it would be one of the few psychiatric concepts that would still be relevant today,...
Peter F Liddle - One of the best experts on this subject based on the ideXlab platform.
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inner connections within domain of dementia praecox role of supervisory mental processes in schizophrenia
European Archives of Psychiatry and Clinical Neuroscience, 1995Co-Authors: Peter F LiddleAbstract:Kraepelin's conclusion that there were underlying common features justifying the amalgamation of catatonia, Hebephrenia and paranoia hallucinatoria to form a single illness is confirmed by factor analytic studies delineating the various dimensions of schizophrenic psychopathlogy. Neuropsychological studies reveal that the three cardinal demensions reflect disorder of the supervisory mental processes responsible for initiation, selection and monitoring of self-generated mental activity. Brain-imaging studies indicate that the underlying neuropathology entails disordered functional connectivity within the neural networks in multimodal association cortex that are the substrate of the supervisory mental processes, consistent with Kraepelin's own speculation about the essential nature of the condition.
Bernhard Bogerts - One of the best experts on this subject based on the ideXlab platform.
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Cortical sulcal enlargement in catatonic schizophrenia: a planimetric CT study
Psychiatry research, 1999Co-Authors: Georg Northoff, Hagen Waters, Ingeborg Mooren, Uwe Schlüter, Silvia Diekmann, Peter Falkai, Bernhard BogertsAbstract:Abstract To determine whether patients with catatonic schizophrenia have specific alterations in brain morphology, internal (ventricles) and external (frontal, temporal, parieto-occipital) components of the cerebrospinal fluid (CSF) spaces were examined morphometrically. Planimetric measurements of computed tomographic (CT) scans from 37 patients with catatonic schizophrenia, 28 patients with hebephrenic schizophrenia, and 39 patients with paranoid schizophrenia, all diagnosed according to DSM-III-R criteria, were compared with separate age- and sex-matched non-psychiatric control groups, respectively. The areas of the frontal sulci, the parieto-occipital sulci, the inter-hemispheric fissure, and the lateral and third ventricles were measured separately for the right and left hemispheres. Catatonic patients showed significant enlargements in almost all CSF spaces, especially in the left fronto-temporal area which, in addition, correlated significantly with illness duraton. Hebephrenic patients showed selective enlargements in left temporal and left/right lower frontal cortical sulci, whereas paranoid schizophrenic patients showed no enlargements but significant correlations between left temporal cortical sulcal volume and illness duration. Alterations in temporal cortical areas were present in all three sub-types of schizophrenia. In addition to temporal alterations, hebephrenic schizophrenia was characterised by lower frontal (i.e. orbitofrontal) enlargement. Catatonic schizophrenia, the most severe sub-type with regard to clinical symptomatology and brain pathology, showed fronto-parietal cortical alterations.