Emil Kraepelin

Emil Kraepelin (born Feb. 15, 1856, Neustrelitz, Mecklenburg-Strelitz [Germany]—died Oct. 7, 1926, Munich, Ger.) was a German psychiatrist, one of the most influential of his time, who developed a classification system for mental illness that influenced subsequent classifications. Kraepelin made distinctions between schizophrenia and manic-depressive psychosis that remain valid today.

After receiving his M.D. from the University of Würzburg (1878), Kraepelin continued his studies under several German neuroanatomists as well as with the experimental psychologist Wilhelm Wundt. Kraepelin employed Wundt’s experimental techniques to study the effects of drugs, alcohol, and fatigue on psychological functioning and in 1881 published a study of the influence of infectious diseases on the onset of mental illness. He then began his Compendium der Psychiatrie (1883), in which he first presented his nosology, or classification of disorders. Kraepelin divided mental illnesses into exogenous disorders, which he felt were caused by external conditions and were treatable, and endogenous disorders, which had such biological causes as organic brain damage, metabolic dysfunctions, or hereditary factors and were thus regarded as incurable.

Appointed professor at the University of Dorpat (now Tartu, Estonia) in 1885 and then at the University of Heidelberg six years later, Kraepelin continued to refine his classification, issuing several revisions of his psychiatry textbook, which has grown to several volumes. In the sixth edition (1899), he first made the distinction between manic-depressive psychosis and dementia praecox, now called schizophrenia. He believed that manic-depressive disorders and melancholia (depression) were exogenous and thus were treatable, while dementia praecox fell among the endogenous, incurable illnesses. Kraepelin attributed dementia praecox to organic changes in the brain. He further distinguished at least three clinical varieties of the disease: catatonia, in which motor activities are disrupted (either excessively active or inhibited); hebephrenia, characterized by inappropriate emotional reactions and behaviour; and paranoia, characterized by delusions of grandeur and of persecution.

Kraepelin became professor of clinical psychiatry at the University of Munich in 1903 and remained there until 1922, when he became director of the Research Institute of Psychiatry in the same city. Throughout his career, he continued to refine his classification and was working on the ninth edition of his textbook when he died.

The concepts embodied in Kraepelin’s classification system did not originate with him, but he was the first to synthesize them into a workable model that could be used to diagnose and treat mental patients. His classification was particularly influential during the early 20th century.