DEVELOPMENT OF THE DIAGNOSTIC CONCEPT OF MANIC-DEPRESSIVE PSYCHOSIS IN EMIL KRAEPELIN’S CLASSIFICATIONS

Thomas A. Ban          

In 44 years, from 1883 to 1927, Emil Kraepelin’s 400 pages Compendium of Psychiatry, grew into a 1425 pages Textbook of Psychiatry and his syndromic classifications in the first three editions (1883, 1886 and 1889) were replaced by his disease oriented classification. The shift from syndromic to disease oriented classification was completed by 1899 with the introduction of the diagnostic concept of manic-depressive psychosis (insanity), in the sixth edition (Pichot 1983).

Tracking the development that lead to the diagnostic concept of manic-depressive psychosis (MDP), an episodic disease with full remission between episodes, one finds the following chain of events (Menninger, Mayman and Pruyser 1968):

1^st edition, 1883: Depression (simple melancholia and melancholia with delirium); excitement (melancholia active and mania); and periodic psychoses (periodic mania, periodic melancholia and circular states).

2^nd edition, 1886: Melancholia (activa, simplex, attonita); mania; periodical insanity (mania, melancholiay) and circular insanity.

3^rd edition, 1889:  Mania; melancholia; periodical mental disease (delirious form, manic form, circular form and depressive form).

4^th edition, 1893: Mania; melancholia; periodical mental disease (delirious form, manic form, circular form and depressive form).

5^th edition, 1896: Involutional melancholia; periodic psychosis (mania, circular psychosis and depression).

6^th edition, 1899: Involutional melancholia; manic-depressive psychosis (manic states, depressive sates and mixed states).

 7^th edition, 1903-4: Involutional melancholia; manic - depressive psychosis.

8^th edition, 1909 -15: Manic-depressive psychosis.

9^th edition, 1927:  Manic-depressive psychosis.

Kraepelin’s  all-embracing diagnosic concept of “manic-depressive psychosis” was first fully presented,  in 1913, in the third volume of the 8^th edition of his textbook, in which on the basis of his own comprehensive observations with consideration of earlier German and French research, he united in this diagnosis “the entire realm  of periodic and circular insanity, uncomplicated mania, the majority of illness entities taken for ‘melancholia’, and  a non-negligible  quantity of ‘amentia cases’, as well as “certain mild, partly periodic, partly chronic  morbid mood modifications, which,  on the one hand  are to be considered as preliminary stages  of more severe disorders, on the other as blending into the realm of individual nature” (Berner, Gabriel, Katschnig, Kieffer, Koehler, Lenz and Simhandl 1983).

References

Berner P,  Gabriel E, Katschnig H, Kieffer W, Koehler K, Lenz G, Simhandl CH. Diagnostic Criteria for Schizophrenia and Affective Psychoses. World Psyhiatric Association; 1983.

Kraepelin E: Compendium der Psychiatrie. Leipzig: Barth; 1883.

Kraepelin E: Compendium der Psychiatrie. 2 Aufl. Leipzig: Barth; 1886.

Kraepelin E: Compendium der Psychiatrie. Leipzig: Barth; 1889.

Kraepelin E. Psychiatrie. Ein Lehrbuch für Studierende und Ärzte. 4 Aufl. Leipzig: Barth; 1893.

Kraepelin E. Psychiatrie. Ein Lehrbuch für Studierende und Ärzte. 5 Aufl. Leipzig: Barth; 1896.

Kraepelin E. Psychiatrie. Ein Lehrbuch für Studierende und Ärzte. 6 Aufl. Leipzig: Barth; 1899.

Kraepelin E. Psychiatrie. Ein Lehrbuch für Studierende und Ärzte. 7 Aufl. Leipzig: Barth; 1903-1904.

Kraepelin E. Psychiatrie. Ein Lehrbuch fuer Studierende und Ärzte. 8 Aufl. Leipzig: Barth; 1908-1915.

Kraepelin E. Psychiatrie. Ein Lehrbuch fuer Studierende und Ärzte. 9 Aufl. Leipzig: Barth; 1927.

Menninger K, Mayman M, Pruyser P. The Vitla Balance. New York: Viking Press; 1969. 

Pichot P. A Century of Psychiatry. Paris: Roger Dacosta; 1983.

Thomas A. Ban
November 5, 2015