Becker K, Kluge M, Steinberg H
Archiv für Leipziger Psychiatriegeschichte, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universität Leipzig, Semmelweisstr. 10, 04103, Leipzig, Deutschland.
Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universität Leipzig, Leipzig, Deutschland.
Nervenarzt. 2015 Nov;86(11):1403-11. doi: 10.1007/s00115-015-4296-7.
While Emil Kraepelin's comprehensive psychiatric oeuvre has attracted researchers' attention, his studies on sleep disorders and their treatment as well as on the interconnections between sleep and mental disorders so far seem to have been neglected.This article identifies and analyzes Kraepelin's sporadic contributions on the pathology of sleep, the comorbidities and treatment made between 1883 and 1924 in textbooks and isolated papers as well as in a presentation that was also published and compares them with current opinions in sleep research.Kraepelin never published a dedicated work on sleep, apart from a summary of the different narcotics; however, his occasional statements reveal astonishing insights and in particular his clear etiologically oriented classification of sleep disorders is captivating. Similar to the current classification, Kraepelin conceptualized sleep disorders as symptoms or rather a complex of symptoms and also identified associated diseases which once again are very near to current opinion. Apart from this his recommendations on sleep hygiene and, in a second step, pharmacological treatment of pathological sleep patterns are still clinically relevant. As early as the end of the nineteenth century Kraepelin laid down an algorithm of treatment which is very similar to the current clinical guidelines. At Kraepelin's time it seemed impossible to reach an agreement on classification and treatment issues of sleep disturbances and even though there has been an ongoing discussion until the present day, an agreement at least about guidelines could be reached. Against this background Kraepelin's contributions can still be regarded as a proposal for best practice.
虽然埃米尔·克雷佩林全面的精神病学著作已引起研究人员的关注,但他对睡眠障碍及其治疗以及睡眠与精神障碍之间相互联系的研究,迄今为止似乎一直被忽视。本文识别并分析了克雷佩林在1883年至1924年间在教科书、单篇论文以及一篇已发表的演讲中对睡眠病理学、合并症和治疗方面的零星贡献,并将它们与睡眠研究的当前观点进行比较。除了对不同麻醉品的总结外,克雷佩林从未发表过关于睡眠的专门著作;然而,他偶尔的论述揭示了惊人的见解,尤其是他对睡眠障碍清晰的病因学分类很吸引人。与当前的分类相似,克雷佩林将睡眠障碍概念化为症状或更确切地说是一组症状,并识别出相关疾病,这些再次与当前观点非常接近。除此之外,他关于睡眠卫生的建议,以及第二步,对病理性睡眠模式的药物治疗,在临床上仍然具有相关性。早在19世纪末,克雷佩林就制定了一种治疗算法,与当前的临床指南非常相似。在克雷佩林那个时代,似乎不可能就睡眠障碍的分类和治疗问题达成一致,即使直到今天一直在进行讨论,但至少可以就指南达成一致。在此背景下,克雷佩林的贡献仍可被视为最佳实践的提议。