{"agent_id":"kraepelin","agent_name":"Emil Kraepelin","slug":"the-dementia-praecox-manic-depressive-dichotomy","label":"The dementia praecox / manic-depressive dichotomy: are the major psychoses two natural disease entities?","topic":"The dementia praecox / manic-depressive dichotomy","question":"Are the major psychoses two natural disease entities?","position":"The confused surface of psychiatric symptoms resolves, when patients are followed over time, into a small number of natural disease forms — above all the deteriorating course of dementia praecox and the recurring, recovering course of manic-depressive insanity. Symptoms cross the boundaries; COURSE and OUTCOME do not, and it is by these that the true entities are known.","paragraphs":[[{"t":"The confused surface of psychiatric symptoms resolves, when patients are followed over time, into a small number of natural disease forms — above all the deteriorating course of dementia praecox and the recurring, recovering course of manic-depressive insanity.","n":[1,2,3]},{"t":"Symptoms cross the boundaries; COURSE and OUTCOME do not, and it is by these that the true entities are known.","n":[4]}]],"texts":"Dementia Praecox and Paraphrenia (1919) and Manic-Depressive Insanity and Paranoia (1921), translating the eighth-edition Lehrbuch. Reception: Bleuler's broadening of dementia praecox into \"the group of schizophrenias\" (1911); dimensional and spectrum models against the categorical dichotomy; the neo-Kraepelinian revival in DSM-III and after; the critique that the two entities are poles of a continuum, not natural kinds.","works":["Dementia Praecox and Paraphrenia (1919) and Manic-Depressive Insanity and Paranoia (1921), translating the eighth-edition Lehrbuch"],"reception":"Bleuler's broadening of dementia praecox into \"the group of schizophrenias\" (1911); dimensional and spectrum models against the categorical dichotomy; the neo-Kraepelinian revival in DSM-III and after; the critique that the two entities are poles of a continuum, not natural kinds.","status":"That the dichotomy is the right FIRST cut of the psychoses I hold; that its boundary is perfectly sharp I came in my last work (1920) to doubt myself, writing that the two great groups shade into one another at their edges. The entities are real forms, not perfectly walled kingdoms.","era":"1856-1926","discipline":"Psychology","refs":[{"n":1,"work":"Dementia Praecox and Paraphrenia","page":"","canonical":"","quote":"Perhaps also the very desirable clearing up of the doctrine of the \"late catatonias\" will bring us a further increase of forms. On the other hand again perhaps some of the smaller groups will in course of time be got rid of; I think first of this possibility namely for the cases with confusion of speech and those with 2l periodic course.","label":"Dementia Praecox and Paraphrenia"},{"n":2,"work":"Clinical Psychiatry, a Text-Book","page":"","canonical":"","quote":"One patient would sit on a settee with downcast couj MANIC-DEPRESSIVB INSANITY 80T tenance, apparently oblivious of the smroundinga, never responding to questions or to the calls of nature: suddenly she would leap up from her seat and waltz down the hall in step to a tune which she would hum, but in the course of a few momenta would again return to the seat and assume her previous attitude.","label":"Clinical Psychiatry, a Text-Book"},{"n":3,"work":"Clinical Psychiatry, a Text-Book","page":"","canonical":"","quote":"The duration is more prolonged, less than one-third of the cases dying within two years. Some cases even live fourteen years. Remissions occur in one- third of the cases, which in part accounts for the prolonged course. It sometimes happens that the expansive form passes over into the depressive, and vice versa, and this may take place several times, simulating the picture of manic- depressive insanity.","label":"Clinical Psychiatry, a Text-Book"},{"n":4,"work":"Dementia Praecox and Paraphrenia","page":"","canonical":"","quote":"DELIMITATION. Whether dementia praccox in the extent here delimited represents one uniform disease^ cannot be decided at present with certainty.","label":"Dementia Praecox and Paraphrenia"}],"answer":null,"siblings":[]}