Virginia Institute of Psychiatric and Behavioral Genetics and Department of Psychiatry, Medical College of Virginia/Virginia Commonwealth University, Richmond, VA.
Schizophr Bull. 2021 Apr 29;47(3):635-643. doi: 10.1093/schbul/sbaa177.
In 1921, at the age of 65, 6 years after completing the final edition of his textbook, 22 years after first proposing the concept of dementia praecox (DP), and 1 year before retiring from clinical work, Emil Kraepelin completed the last edition of his "Introduction to Clinical Psychiatry," which contained a mini-textbook for students, 10 pages of which were devoted to DP. This work also included a series of new detailed case histories, 3 of which examined DP. This neglected text represents a distillation of what Kraepelin judged, near the end of his long career, to be the essential features of DP. The relevant text and case histories are translated into English for the first time. Kraepelin did not define DP solely by its chronic course and poor prognosis, acknowledging that remissions and even full recovery might be possible. His clinical description emphasized the frequency of bizarre delusions and passivity symptoms. He recognized the heterogeneity of the clinical presentations, outlining 6 subtypes of DP, including dementia simplex, depressive and stuporous dementia, and an agitated and circular DP. Kraepelin's original concept of DP was not impervious to change and expanded somewhat, especially with the inclusion of Diem's concept of simple DP. He also reviews several contributions of Bleuler, including his concept "latent schizophrenia." He writes poignantly of the psychological consequences of DP. His 3 DP cases, for advanced students, included simple DP, "periodic catatonic," and "speech confusion."
1921 年，65 岁的埃米尔·克雷佩林（Emil Kraepelin）完成了他的教科书的最后一版，这是他首次提出早发性痴呆（DP）概念的 22 年后，也是他从临床工作退休前的一年。他完成了他的《临床精神病学导论》的最后一版，其中包含一本学生用的迷你教科书，其中 10 页专门用于 DP。这部著作还包括一系列新的详细病史，其中 3 个检查了 DP。这部被忽视的著作代表了克雷佩林在漫长职业生涯接近尾声时对 DP 的基本特征的判断。相关的文本和病史被首次翻译成英文。克雷佩林并没有仅仅通过其慢性病程和预后不良来定义 DP，他承认缓解甚至完全康复是可能的。他的临床描述强调了奇异妄想和被动症状的频率。他认识到临床表现的异质性，概述了 DP 的 6 种亚型，包括单纯性痴呆、抑郁性和昏睡性痴呆，以及激越性和循环性 DP。克雷佩林最初的 DP 概念并非一成不变，而是有所扩展，尤其是包括了迪姆的简单 DP 概念。他还回顾了布洛伊勒的几个贡献，包括他的“潜在精神分裂症”概念。他对 DP 的心理后果进行了深刻的描述。他的 3 个 DP 病例是为高级学生准备的，包括单纯性 DP、“周期性紧张症”和“言语混乱”。
