Emil Kraepelin
Emil Kraepelin was a German
Germany , officially the Federal Republic of Germany , is a federal parliamentary republic in Europe. The country consists of 16 states while the capital and largest city is Berlin. Germany covers an area of 357,021 km2 and has a largely temperate seasonal climate...

A psychiatrist is a physician who specializes in the diagnosis and treatment of mental disorders. All psychiatrists are trained in diagnostic evaluation and in psychotherapy...

. H.J. Eysenck
Hans Eysenck
Hans Jürgen Eysenck was a German-British psychologist who spent most of his career in Britain, best remembered for his work on intelligence and personality, though he worked in a wide range of areas...

's Encyclopedia of Psychology identifies him as the founder of modern scientific psychiatry
Psychiatry is the medical specialty devoted to the study and treatment of mental disorders. These mental disorders include various affective, behavioural, cognitive and perceptual abnormalities...

, as well as of psychopharmacology
Psychopharmacology is the scientific study of the actions of drugs and their effects on mood, sensation, thinking, and behavior...

 and psychiatric genetics
Psychiatric genetics
Psychiatric genetics, a subfield of behavioral neurogenetics, studies the role of genetics in psychological conditions such as alcoholism, schizophrenia, bipolar disorder, and autism. The basic principle behind psychiatric genetics is that genetic polymorphisms, as indicated by linkage to e.g...

. Kraepelin believed the chief origin of psychiatric disease
A disease is an abnormal condition affecting the body of an organism. It is often construed to be a medical condition associated with specific symptoms and signs. It may be caused by external factors, such as infectious disease, or it may be caused by internal dysfunctions, such as autoimmune...

 to be biological
Biological process
A biological process is a process of a living organism. Biological processes are made up of any number of chemical reactions or other events that results in a transformation....

 and genetic
Genetics , a discipline of biology, is the science of genes, heredity, and variation in living organisms....

 malfunction. However, Kraepelin was criticized for considering schizophrenia as a biological illness in the absence of any detectable histologic or anatomic abnormalities. While Kraepelin tried to find organic causes of mental illness, he adopted many theses of positivist medicine, but the basis for understanding is not etiology
Etiology is the study of causation, or origination. The word is derived from the Greek , aitiologia, "giving a reason for" ....

, as the causes of madness cannot be established with any precision. His theories dominated psychiatry at the start of the twentieth century and, despite later psychodynamic incursions by Sigmund Freud
Sigmund Freud
Sigmund Freud , born Sigismund Schlomo Freud , was an Austrian neurologist who founded the discipline of psychoanalysis...

 and his disciples, appeared to enjoy a revival at century's end.

Family and early life

Kraepelin, the son of a civil servant, was born in 1856 in Neustrelitz
Neustrelitz is a town in the Mecklenburgische Seenplatte district in the state of Mecklenburg-Vorpommern, Germany. It is situated on the shore of the Zierker See in the Mecklenburg Lake District. From 1738 until 1918 it was the capital of the duchy of Mecklenburg-Strelitz...

, in the Mecklenburg district of Germany. He was first introduced to biology by his brother Karl, 10 years older and, later, the director of the Zoological Museum of Hamburg.

Early career

Kraepelin began his medical studies at 18, in Leipzig and Wurzburg, Germany. At Leipzig
Leipzig Leipzig has always been a trade city, situated during the time of the Holy Roman Empire at the intersection of the Via Regia and Via Imperii, two important trade routes. At one time, Leipzig was one of the major European centres of learning and culture in fields such as music and publishing...

, where he studied neuropathology under Paul Flechsig
Paul Flechsig
Paul Emil Flechsig was a German neuroanatomist, psychiatrist and neuropathologist. He is mainly remembered today for his research of myelinogenesis.-Biography:...

 and experimental psychology with Wilhelm Wundt
Wilhelm Wundt
Wilhelm Maximilian Wundt was a German physician, psychologist, physiologist, philosopher, and professor, known today as one of the founding figures of modern psychology. He is widely regarded as the "father of experimental psychology"...

, he wrote a prize-winning essay, "The Influence of Acute Illness in the Causation of Mental Disorders." He received his M.D. in 1878. In 1879, Kraepelin went to work with Bernhard von Gudden
Bernhard von Gudden
Johann Bernhard Aloys von Gudden was a German neuroanatomist and psychiatrist born in Kleve.In 1848 he earned his doctorate from the University of Halle, and became an intern at the asylum in Siegburg under Carl Wigand Maximilian Jacobi...

 at the University of Munich, where he completed his thesis, "The Place of Psychology in Psychiatry". Returning to the University of Leipzig in 1882, he worked in Wilhelm Heinrich Erb
Wilhelm Heinrich Erb
Wilhelm Heinrich Erb was a German neurologist who was a native of Winnweiler, Rhineland-Palatinate.- Academic career :...

's neurology clinic and in Wundt's psychopharmacology laboratory. His major work, "Compendium der Psychiatrie", was first published in 1883. In it, he argued that psychiatry was a branch of medical science and should be investigated by observation and experimentation like the other natural sciences. He called for research into the physical causes of mental illness and established the foundations of the modern classification system for mental disorders. Kraepelin proposed that by studying case histories and identifying specific disorders, the progression of mental illness could be predicted, after taking into account individual differences in personality and patient age at the onset of disease.

In 1884 he became senior physician in Leubus and the following year he was appointed director of the Treatment and Nursing Institute in Dresden. In 1886, at the age of 30, Kraepelin was named professor of psychiatry at the University of Dorpat (later the University of Tartu
University of Tartu
The University of Tartu is a classical university in the city of Tartu, Estonia. University of Tartu is the national university of Estonia; it is the biggest and highest-ranked university in Estonia...

) in what is today Estonia
Estonia , officially the Republic of Estonia , is a state in the Baltic region of Northern Europe. It is bordered to the north by the Gulf of Finland, to the west by the Baltic Sea, to the south by Latvia , and to the east by Lake Peipsi and the Russian Federation . Across the Baltic Sea lies...

 (see Burgmair Vol IV). Four years later, he became department head at the University of Heidelberg, where he remained until 1904. Whilst at Dorpat he became the director of the eighty-bed University Clinic
Tartu University Clinic
The Tartu University Clinic is a healthcare and medical teaching service in Tartu, Estonia, and a subsidiary of the Tartu University. Its administrative services are located in two buildings on the Puusepa Street; its buildings are located throughout the city of Tartu...

. There he began to study and record many clinical histories in detail and "was led to consider the importance of the course of the illness with regard to the classification of mental disorders." Ten years later he announced that he had found a new way of looking at mental illness. He referred to the traditional view as "symptomatic" and to his view as "clinical". This turned out to be his paradigm-setting synthesis of the hundreds of mental disorders classified by the 19th century, grouping diseases together based on classification of syndrome
In medicine and psychology, a syndrome is the association of several clinically recognizable features, signs , symptoms , phenomena or characteristics that often occur together, so that the presence of one or more features alerts the physician to the possible presence of the others...

s — common patterns of symptoms — rather than by simple similarity of major symptoms in the manner of his predecessors. In fact, it was precisely because of the demonstrated inadequacy of such methods that Kraepelin developed his new diagnostic system.

Theories and influence

Kraepelin is specifically credited with the classification of what was previously considered to be a unitary concept of psychosis
Unitary psychosis
Unitary psychosis refers to the 19th-century belief prevalent in German psychiatry until the era of Emil Kraepelin that all forms of psychosis were surface variations of a single underlying disease process...

, into two distinct forms:
  • manic depression
    Bipolar disorder
    Bipolar disorder or bipolar affective disorder, historically known as manic–depressive disorder, is a psychiatric diagnosis that describes a category of mood disorders defined by the presence of one or more episodes of abnormally elevated energy levels, cognition, and mood with or without one or...

     (now seen as comprising a range of mood disorders such as recurrent major depression
    Clinical depression
    Major depressive disorder is a mental disorder characterized by an all-encompassing low mood accompanied by low self-esteem, and by loss of interest or pleasure in normally enjoyable activities...

     and bipolar disorder
    Bipolar disorder
    Bipolar disorder or bipolar affective disorder, historically known as manic–depressive disorder, is a psychiatric diagnosis that describes a category of mood disorders defined by the presence of one or more episodes of abnormally elevated energy levels, cognition, and mood with or without one or...

    ), and
  • dementia praecox
    Dementia praecox
    Dementia praecox refers to a chronic, deteriorating psychotic disorder characterized by rapid cognitive disintegration, usually beginning in the late teens or early adulthood. It is a term first used in 1891 in this Latin form by Arnold Pick , a professor of psychiatry at the German branch of...


Drawing on his long-term research, and using the criteria of course, outcome and prognosis, he developed the concept of dementia praecox
Dementia praecox
Dementia praecox refers to a chronic, deteriorating psychotic disorder characterized by rapid cognitive disintegration, usually beginning in the late teens or early adulthood. It is a term first used in 1891 in this Latin form by Arnold Pick , a professor of psychiatry at the German branch of...

, which he defined as the "sub-acute development of a peculiar simple condition of mental weakness occurring at a youthful age." When he first introduced this concept as a diagnostic entity in the fourth German edition of his Lehrbuch der Psychiatrie in 1893, it was placed among the degenerative disorders alongside, but separate from, catatonia
Catatonia is a state of neurogenic motor immobility, and behavioral abnormality manifested by stupor. It was first described in 1874: Die Katatonie oder das Spannungsirresein ....

 and dementia paranoides. At that time, the concept corresponded by and large with Ewald Hecker
Ewald Hecker
Ewald Hecker was a German psychiatrist who was an important figure in the early days of modern psychiatry. He is known for research done with his mentor, psychiatrist Karl Ludwig Kahlbaum ....

's hebephrenia. In the sixth edition of the Lehrbuch in 1899 all three of these clinical types are treated as different expressions of one disease, dementia praecox.

One of the cardinal principles of his method was the recognition that any given symptom may appear in virtually any one of these disorders; e.g., there is almost no single symptom occurring in dementia praecox which cannot sometimes be found in manic-depression. What distinguishes each disease symptomatically (as opposed to the underlying pathology) is not any particular (pathognomonic) symptom or symptoms, but a specific pattern of symptoms. In the absence of a direct physiological or genetic test or marker for each disease, it is only possible to distinguish them by their specific pattern of symptoms. Thus, Kraepelin's system is a method for pattern recognition, not grouping by common symptoms.

Kraepelin also demonstrated specific patterns in the genetics of these disorders and specific and characteristic patterns in their course and outcome. Generally speaking, there tend to be more schizophrenics among the relatives of schizophrenic patients than in the general population, while manic-depression is more frequent in the relatives of manic-depressives. Though, of course, this does not demonstrate genetic linkage, as this might be a socio-environmental factor as well.

He also reported a pattern to the course and outcome of these conditions. Kraepelin believed that schizophrenia had a deteriorating course in which mental function continuously (although perhaps erratically) declines, while manic-depressive patients experienced a course of illness which was intermittent, where patients were relatively symptom-free during the intervals which separate acute episodes. This led Kraepelin to name what we now know as schizophrenia, dementia praecox (the dementia
Dementia is a serious loss of cognitive ability in a previously unimpaired person, beyond what might be expected from normal aging...

 part signifying the irreversible mental decline). It later became clear that dementia praecox did not necessarily lead to mental decline and was thus renamed schizophrenia
Schizophrenia is a mental disorder characterized by a disintegration of thought processes and of emotional responsiveness. It most commonly manifests itself as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, and it is accompanied by significant social...

 by Eugen Bleuler
Eugen Bleuler
Paul Eugen Bleuler was a Swiss psychiatrist most notable for his contributions to the understanding of mental illness and for coining the term "schizophrenia."-Biography:...

 to correct Kraepelin's misnomer.


Kraepelin postulated that there is a specific brain or other biological pathology underlying each of the major psychiatric disorders. As a colleague of Alois Alzheimer
Alois Alzheimer
Aloysius "Alois" Alzheimer, was a German psychiatrist and neuropathologist and a colleague of Emil Kraepelin. Alzheimer is credited with identifying the first published case of "presenile dementia", which Kraepelin would later identify as Alzheimer's disease....

, and co-discoverer of Alzheimer's disease
Alzheimer's disease
Alzheimer's disease also known in medical literature as Alzheimer disease is the most common form of dementia. There is no cure for the disease, which worsens as it progresses, and eventually leads to death...

, it was his laboratory which discovered its pathologic basis. Kraepelin was confident that it would someday be possible to identify the pathologic basis of each of the major psychiatric disorders.


Kraepelin's great contribution in classifying schizophrenia and manic-depression remains relatively unknown to the general public, and his work, which had neither the literary quality nor paradigmatic power of Freud's, is little read outside scholarly circles. Kraepelin's contributions were to a large extent marginalized throughout a good part of the twentieth century, during the success of Freudian etiological theories. However, his views now dominate psychiatric research and academic psychiatry, and today the published literature in the field of psychiatry is overwhelmingly biological in its orientation. His fundamental theories on the etiology and diagnosis of psychiatric disorders form the basis of all major diagnostic systems in use today, especially the American Psychiatric Association
American Psychiatric Association
The American Psychiatric Association is the main professional organization of psychiatrists and trainee psychiatrists in the United States, and the most influential worldwide. Its some 38,000 members are mainly American but some are international...

's DSM-IV and the World Health Organization
World Health Organization
The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...

's ICD
The International Statistical Classification of Diseases and Related Health Problems is a medical classification that provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or disease...

 system. In that sense, not only is Kraepelin's significance historical, but contemporary psychiatric research is also heavily influenced by his work.


Kraepelin, being a disciple of Wilhem Wundt, had a life long interest in experimental psychology
Experimental psychology
Experimental psychology is a methodological approach, rather than a subject, and encompasses varied fields within psychology. Experimental psychologists have traditionally conducted research, published articles, and taught classes on neuroscience, developmental psychology, sensation, perception,...

. In the Heidelberg and early Munich years he edited Psychologische Arbeiten, a journal on experimental psychology. One of his own famous contributions to this journal also appeared in the form of a monograph (105 p.) entitled Über Sprachstörungen im Traume (on language disturbances in dreams). Kraepelin, on the basis on the dream-psychosis
Psychosis means abnormal condition of the mind, and is a generic psychiatric term for a mental state often described as involving a "loss of contact with reality"...

 analogy, studied for more than 20 years language disorder in dreams
Dream speech
In 1906 the famous German psychiatrist Emil Kraepelin published a monograph titled Über Sprachstörungen im Traume . In his psychiatry textbook Kraepelin used the shortcut Traumsprache to denote language disturbances occurring in dreams...

 in order to study indirectly schizophasia.

The dreams Kraepelin collected are mainly his own. They lack extensive comment by the dreamer. In order to study them the full range of biographical knowledge available today on Kraepelin is necessary (see e.g. Burgmair et al., I-VII).

External links

For biographies of Kraepelin see:
For English translations of Kraepelin's work see:
The source of this article is wikipedia, the free encyclopedia.  The text of this article is licensed under the GFDL.