Kraepelin's views on obsessive neurosis: a comparison with DSM-5 criteria for obsessive-compulsive disorder

Emil Kraepelin (1856-1926) is considered one of the founders of modern psychiatric nosology. However, his conceptualization of obsessive-compulsive phenomena is relatively understudied. In this article, we compare and contrast excerpts from the eighth edition (1909-1915) of Kraepelin's Textbook of Clinical Psychiatry focusing on what Kraepelin called "obsessive neurosis" and related "original pathological conditions" with the current DSM-5 criteria for obsessive-compulsive disorder (OCD). Consistently with DSM-5 OCD, Kraepelin described obsessive neurosis as characterized by obsessive ideas, compulsive acts, or both together. His detailed descriptions of these symptoms are broadly coherent with their characterization in DSM-5, which is also true for the differential diagnoses he provided. He also mentioned cases illustrating decreased insight into symptoms and association with tic disorders. In conclusion, Kraepelin's experience, which reflects decades of consistent clinical work, may help validate current ideas and explain how the current conceptualization has emerged and developed. Even though one can hardly say that the classification laid out in DSM-5 goes back to Kraepelin's views directly, it still is true that Kraepelin played an outstanding role in systematizing psychiatric diagnostic criteria in general, and provided a major contribution to the conceptual history of OCD.

Kraepelin's views on obsessive neurosis: a comparison with DSM-5 criteria for obsessive-compulsive disorder.

Emil Kraepelin (1856-1926) is considered one of the founders of modern psychiatric nosology. However, his conceptualization of obsessive-compulsive phenomena is relatively understudied. In this article, we compare and contrast excerpts from the eighth edition (1909-1915) of Kraepelin's Textbook of Clinical Psychiatry focusing on what Kraepelin called "obsessive neurosis" and related "original pathological conditions" with the current DSM-5 criteria for obsessive-compulsive disorder (OCD). Consistently with DSM-5 OCD, Kraepelin described obsessive neurosis as characterized by obsessive ideas, compulsive acts, or both together. His detailed descriptions of these symptoms are broadly coherent with their characterization in DSM-5, which is also true for the differential diagnoses he provided. He also mentioned cases illustrating decreased insight into symptoms and association with tic disorders. In conclusion, Kraepelin's experience, which reflects decades of consistent clinical work, may help validate current ideas and explain how the current conceptualization has emerged and developed. Even though one can hardly say that the classification laid out in DSM-5 goes back to Kraepelin's views directly, it still is true that Kraepelin played an outstanding role in systematizing psychiatric diagnostic criteria in general, and provided a major contribution to the conceptual history of OCD.

Richard Arwed Pfeifer - a pioneer of 'medical pedagogy' and an opponent of Paul Schroder.

Richard Arwed Pfeifer (1877-1957) was one of the initiators and foster fathers of the renowned child-psychiatric and special needs education workgroup at Leipzig University under Paul Schröder (1873-1941) in the 1920s and 1930s. This paper is an account of their dispute concerning the interrelations between child and adolescent psychiatry and special needs education, as well as their disagreement about whether adolescent psychopaths should be admitted to specialized child psychiatric wards or elsewhere. Moreover, Pfeifer questioned the practical relevance of the separation of constitutional and environmentally-based psychopathy and fought eugenic research, which he found incompatible with the ethics of his profession as a remedial teacher and child psychiatrist.

[Department of Psychiatry, Centre for Psychiatry, Psychatrium--trends and changes in the names for mental health care institutions in Germany in the 20th century]. / Psychiatrisches Krankenhaus, Klinik, Zentrum für Psychiatrie, Psychatrium--Trends und Wandlungen in den Bezeichnungen psychiatrischer Kliniken in Deutschland im 20. Jahrhundert.

This paper investigates trends in the history of names for psychiatric institutions in Germany in the 20 (th) century. Professional lobbyism as well as efforts to fight stigmatisation of mentally ill patients form the background for name changes. The replacement of the term "Heil- Und Pflegeanstalt" ("Institution for the Cure and Care") by "Krankenhaus" ("hospital") in the 1950s/1960s, when through the introduction of modern psychopharmaceuticals psychiatry finally got acknowledged as an equal medical discipline and at the same time broke with the dreadful heritage of Nazi psychiatry, was a major step. The unity of the hospital itself and complimentary mental health care institutions is often expressed by "Zentrum" ("centre") as is the preservation of the patients' ties and their reintegration into the community by "Soziale Psychiatrie".

[Madhouse, asylum, retreat, specialist hospital - on the genesis and history of names for psychiatric institutions in Germany until the beginning of the 20th century]. / Narrenhaus, Irrenanstalt, Heil- und Pflegeanstalt, Fachkrankenhaus - Zur Entwicklung der Bezeichnungen für psychiatrische Kliniken in Deutschland bis zum Anfang des 20. Jahrhunderts.

This paper analyses the history of names for psychiatric institutions in the German language. When scientific, medical psychiatry came into being in the late 18 (th) century, names with negative connotations such as "Narrenhaus" or "Tollhaus" (approximating to the English word "madhouse") were substituted by the then neutral "Irrenhaus" and later in the 19 (th) century by "Irrenanstalt". Soon, however, this new term became associated with negative connotations, making it unsuitable as a reflection of the many improvements made both in the treatment and the public image of psychiatric service users. Changes in word form such as "Heilanstalt", "Pflegeanstalt" and "Heil- und Pflegeanstalt" better reflect the character of the institutions. Objections to the word "Anstalt" (institution) were not acknowledged until the 20 (th) century when the term "Fachkrankenhaus" ("specialist hospital") was introduced. Before then the German word "Klinik" was reserved for university hospitals, the first of which was founded in 1878. The history of names for psychiatric institutions reflects both changes in the treatment of the mentally ill and the attempts made above all by psychiatrists to face and overcome stigmatisation of their clients.