Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich, Germany.
Psychiatry Clin Neurosci. 2011 Jun;65(4):318-25. doi: 10.1111/j.1440-1819.2011.02226.x.
Kraepelin's system of mental diseases has contributed substantially to the foundation of modern psychiatric diagnosis in the DSM-IV and ICD-10. Considering Kraepelin's influence in the creation of these diagnostic tools, the question arises as to how Kraepelin's contemporaries and successors reacted to his nosology. Historical libraries and archives in Munich, Berlin and Paris were searched for European and American psychiatric literature using the keywords 'Kraepelin', 'dichotomy' and 'manic-depressive disorder'. Literature from 1900 to 1960 was examined and compared to the current literature regarding Kraepelin's impact on modern classification systems. The sixth edition of Kraepelin's 'Lehrbuch' (1899) presented the dichotomy in its entirety and led to three different periods of critical comment on dichotomy and methodology between 1900 and 1960. But on the whole, Kraepelin's system was quickly and completely adopted in clinical diagnosis. The publications appearing on and following Kraepelin's centenary in 1956 represent his work as generally being the foundation of modern psychiatry. The neo-Kraepelinian movement, beginning in the late 1960s, developed more differentiated views of Kraepelin's scientific background and methodology. Notwithstanding all the criticism of Kraepelin's dichotomy, it remains more than ever the basis of psychiatric diagnosis. The criticism today shows parallels to the statements made during Kraepelin's era, mainly concerning the issue of diagnostic overlapping of the two disease entities, manic-depressive disorder and schizophrenia, and includes the question of syndromatology.
克雷丕林的精神疾病分类系统为《精神疾病诊断与统计手册》（DSM-IV）和《国际疾病分类》（ICD-10）这两个现代精神科诊断工具的建立做出了重大贡献。鉴于克雷丕林在这些诊断工具的创制中产生的影响，人们不禁要问，他同时代的人和继任者对他的疾病分类学有何反应。我们在慕尼黑、柏林和巴黎的历史图书馆和档案馆中，使用“克雷丕林”“二分法”和“躁狂抑郁障碍”等关键词，搜索了欧洲和美国的精神科文献。我们查阅了 1900 年至 1960 年的文献，并将其与当前关于克雷丕林对现代分类系统影响的文献进行了比较。克雷丕林的《教科书》（1899 年）第六版完整地呈现了二分法，并在 1900 年至 1960 年间引发了对二分法和方法论的三个不同阶段的批判性评论。但总的来说，克雷丕林的系统在临床诊断中很快被全面采用。1956 年克雷丕林诞辰一百周年之际及之后发表的出版物代表了他的工作，普遍被视为现代精神病学的基础。20 世纪 60 年代末开始的新克雷丕林主义运动，对克雷丕林的科学背景和方法论有了更为细致的看法。尽管对克雷丕林二分法的批评不绝于耳，但它仍然是精神科诊断的基础。今天的批评与克雷丕林时代的观点相似，主要涉及躁狂抑郁障碍和精神分裂症这两种疾病实体的诊断重叠问题，包括综合征学问题。
