Dementia praecox was a term previously used to describe the disease now known as schizophrenia. The term is no longer commonly used in diagnosis. The word schizophrenia was coined by the Swiss psychiatrist Eugen Bleuler in 1908, describing the separation of function between personality, thinking, memory, and function. By the 1970’s when the first Diagnostic Statistical Manuel was compiled, the dementia praecox was formally listed as schizophrenia.
The disease now known as schizophrenia existed long before the name, even before this grouping of symptoms was coined dementia praecox by German psychiatrist Emil Kraepelin in the late 1800’s. The disease has gone through “a series of labels, from different variations of the French word ‘demence’ or loss of mind in the 1800s, to dementia praecox, and its current description, the mental disorder schizophrenia (Plumptre, 2022).
The term démence précoce (premature dementia) was first used in 1860 by Vienna psychiatrist Bénédict Augustin Morel to describe the symptoms of a fourteen year old boy suffering from mental deterioration and loss of memory (2014).
Karl Kahlbaum (1828–1899) and his protégé Ewald Hecker (1843–1909) became key figures in the development of formal diagnosis criteria for mental disorders. In 1863, Kahlbaum described what eventually would be called dementia praecox as a mental disease that did not appear until the time of puberty and rapidly terminated into dementia, he called this disease ‘hebephrenia.’
In 1871 Heckler, one of Kahlbaum’s pupils, published the first detailed symptoms of the disease, creating a clinical framework for hebephrenia. He wrote that “hebephrenia is a mental affection which makes its appearance at the age of puberty, manifesting itself by alternate or successive fits of mania and both melancholia, and progressing rapidly towards dementia (Christian, et al. 1901).
Since dementia praecox is an outdated term, there is no precise list of symptoms. Professionals recorded common threads of the disease. Once some commonality was recognized and categorized, researchers and doctors began to formulate a more detailed and generally accepted symptomology. However, doctors and medical institutions debated over the criteria and treatments, not agreeing over which cases should be included and or excluded from the diagnosis. Slowly, overtime more practitioners agreed upon some general symptoms of the disease.
Today, many of the debated symptoms of dementia praecox may be found in DSM symptomology for schizophrenia.
In 1901, Dr. Justin Christian encapsulated dementia praecox with these four elements:
- A constant appearance at the age of puberty
- Various delirious symptoms at beginning
- Constant sudden impulses
- A rapid termination in a dementia which is more or less complete (p. 218).
A common theme to dementia praecox was the development of dementia during adolescence. Most doctors making early references to the disease believed that the condition was biologically tied to heredity.
Most early diagnosis were made because some form of hallucinations or paranoid ideations were present.
Dr. Pompeo Milici suggested that although early symptoms of dementia praecox were often overlooked, he believed that those to later develop the disorder in adolescents exhibited a certain type of personality. Milici wrote that “almost from the start, such personalities are seen to be odd, peculiar, queer, ‘different.’ As a rule,” he continued, ” they are uncommonly seclusive, shy, retiring, docile in the extreme.”
Swiss Psychiatrist Adolf Meyer (1866-1950) believed that the disorder developed from “a special constitution and personality likely to break down in specific manners” (Milici, 1931). Meyer explained a process similar to what is now known as the diathesis stress model was instrumental in the development of the disease. In the diathesis stress model “predispositions interact with stressful experiences. When life stresses disrupt our psychological equilibrium (or homeostasis), the stressful event may catalyze development of predispositioned disorders” (Murphy, 2021).
Meyer stated that “the general principle is that many individuals cannot afford to count on unlimited elasticity in the habitual use of certain habits of adjustment.” Meyer concluded that “the types of adolescent deterioration can very largely be traced to disharmonies of thoughts, of habits and of interests, which bring about a stunting in one direction or another” (Milici, 1931).
Highly Moral and Sexual Conflict
Dr. L. S. London wrote that from his twenty years of experience that two conditions always accompanied dementia praecox. One the individuals were “highly moral and sensitive, and second, they were subject to sexual conflict.” London explains further that an event creates a “conflict with the instinctive impulses which are unconscious.” He explains that as a result of the repressed and conscious forces, the mind makes a a compromise, leading to the symptoms of dementia.
Emphatically, London proclaimed that any investigation into the disorder will reveal that a “moral shock” has taken place (1930). Dr. London, obviously, has built his opinions around Sigmund Freud’s theoretical framework.
In the end, time has disproven many of these early theories of the development of dementia praecox. Data strongly supports a biological cause (heredity) for later development of schizophrenia. Although, there is more at play than DNA since in studies of identical twins one twin may contract the disease while the other does not.
Today, professionals no longer diagnose patients with this disorder. Doctors today would likely diagnose many of the early cases of dementia praecox as schizophrenia today.
A complete list of schizophrenic symptoms.
A Few Final Thoughts
While schizophrenia diagnoses recently development within the last hundred years, the disease has been around much longer. Science is making headway in understanding and treating schizophrenia. While treatments have been to alleviate some of the symptoms, a cure still evades the reaches of science.
Christian, Justin, Wm. Rush Dunton, Clarence B. Farrar (1901). DEMENTIA PRAECOX. American Journal of Psychiatry.
Katzenelbogen, Solomon (2014). Dementia Praecox. Psychiatric Quarterly 16.3: 439-453. Originally published in 1942.
London, L.S. (1930) Treatment of dementia praecox. Psychiatric Quarterly 4, 631–641.
Milici, Pompeo (1931). Dementia praecox: Preventable. Psychiatric Quarterly, 11(4), 552-560.
Milici, Pompeo (1943). Psychology of dementia praecox. Psychiatric Quarterly 17, 87–111.
Pumptre, Elizabeth, (2022) What is Dementia Praecox? Verywellmind. Published 2-13-2022. Accessed 6-23-2022
Whitehead, Duncan (1937). Prognosis in dementia praecox. Psychiatric Quarterly 11, 383–390.