Accounts that may relate to symptoms of Schizophrenia date back as far as 2000 BC
in the 'Book of Hearts', part of the ancient 'Ebers Papyrus'. However, a recent study
into the ancient Greek and Roman literature showed that whilst the general population
probably had an awareness of psychotic disorders, there was no recorded condition
that would meet the modern diagnostic criteria for Schizophrenia in these societies.
This
non-specific concept of madness has been around for many thousands of years and Schizophrenia
was only classified as a distinct mental disorder by Emil Kraepelin in 1887. He was
the first to make a distinction in the psychotic disorders between what he called
Dementia Praecox (a term first used by psychiatrist Benedict A Morel) and Manic Depression.
Kraepelin believed that Dementia Praecox was primarily a disease of the brain and
particularly a form of dementia. Kraepelin named the disorder 'Dementia Praecox'
(early dementia) to distinguish it from other forms of dementia (such as Alzheimer's
Disease) which typically occur late in life. He used this term because his studies
focused on young adults with dementia.
The term Schizophrenia is derived from the
Greek words 'schizo' (split) and 'phrene' (mind) and was coined by Eugene Bleuler
to refer to the lack of interaction between thought processes and perception. He
was also the first to describe the symptoms as 'positive' or 'negative'. Bleuler
changed the name to Schizophrenia as it was obvious that Krapelin's name was misleading.
The word 'praecox' implied precocious or early onset, hence premature dementia, as
opposed to senile dementia from old age. Bleuler realised the illness was not a dementia
- it did not always lead to mental deterioration - and could sometimes occur late
as well as early in life and was, therefore. misnamed.
With the term 'Schizophrenia'
Bleuler intended the name to capture the separation of function between personality,
thinking, memory, and perception, however it is commonly misunderstood to mean that
affected persons have a 'split personality' (something akin to the character in Robert
Louis Stevenson's The Strange Case of Dr Jekyll and Mr. Hyde'). Schizophrenia is
commonly, although incorrectly, confused with Multiple Personality Disorder (now
called 'Dissociative Identity Disorder' in DSM-IV-TR). Although people diagnosed
with Schizophrenia may 'hear voices' and may experience the voices as distinct personalities,
Schizophrenia does not involve a person changing between distinct multiple personalities.
The confusion perhaps arises in part due to the meaning of Bleuler's term 'schizophrenia'
(literally 'split mind'). Interestingly, the first known misuse of this word Schizophrenia
to mean 'split personality' (in the Jekyll and Hyde sense) was in an article by the
poet T S Eliot in 1933.
In the first half of the twentieth century, Schizophrenia
was considered by many as a ‘hereditary defect', and people with Schizophrenia became
the target of the eugenics programs of many countries. Hundreds of thousands were
forcibly sterilised, the majority in Germany, the United States, and various Scandinavian
countries.
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