The Schizophrenias
1908
Paul Eugen Bleuler (1857–1939)
What we now refer to as schizophrenia has almost certainly existed throughout human history, but it was not until 1908 that it was given its current label by psychiatrist Eugen Bleuler. At the time, Bleuler was the director of the leading psychiatric hospital in Europe, the Burghölzli, in Switzerland. He became its director in 1898, and during his tenure, many of the leading figures in psychiatry worked with him, including Carl Jung and Hermann Rorschach. Bleuler disagreed with the existing term for the condition, dementia praecox, because his clinical experience showed him that patients did not typically become demented, nor was the onset always in youth (the meaning of the word praecox).
The schizophrenias are characterized by delusions, hallucinations, and disordered thought. The subtypes of the disorder are catatonic, disorganized, paranoid, and undifferentiated. Each subtype has its own characteristic patterns. The paranoid type, for example, may have delusions of persecution or grandeur, as one patient explained in the following passage from Bleuler’s Dementia Praecox: “Inside it is as if I were Christ or the Apostles. Twenty-six Apostles are on the Mount of Olives in my arms.” It is not uncommon for multiple patients in the same hospital to have identical delusions, as in the famous case of the “three Christs of Ypsilianti”; in a hospital in the Washington, D.C., area, two patients, similar in age, both believed they were the legitimate sons of John F. Kennedy. It also is common for those suffering from one of the schizophrenias to invent neologisms, or to coin new meaningless words and phrases: for example, one person might spit “cage-weather juice,” while others have been “botanized” or “blued-off.”
Despite more than a hundred years of research, there is no known cause for schizophrenia; it is likely that there are multiple causes. The study of identical twins indicates a strong genetic component. A 2012 report indicated that at least five disorders share a common genetic link: schizophrenia, bipolar disorder, Autism, major depression, and attention deficit hyperactivity disorder.
SEE ALSO Bedlam (1357), American Classification of Mental Disorders (1918), Antipsychotic Medications (1952)
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Eugen Bleuler, c. 1900.
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Self-Portrait with Straw Hat (Winter 1887/88) by Dutch post-Impressionist Vincent van Gogh, who is thought to have suffered from schizophrenia or manic depression. He died at the age of 37 from a self-inflicted gunshot wound.