A brief history

The vague concept of psychosis and madness has been present for several thousands of years. The earliest account of symptoms related to schizophrenia can be dated as far back to the pre-classical period.

In the 19th century, Emil Kraepelin, a German psychiatrist was one of the first to categorise mental illnesses, in particular, psychosis. Kraepelin made the distinction between the psychotic disorders dementia praecox (or dementia of the young, now referred to as schizophrenia) and manic- depressive psychosis. Through this differentiation, Kraepelin highlighted

Emil Kraepelin

the importance of dementia praecox occurring in the young and having deteriorating cognitive impairment as opposed to manic depressive psychosis, which had a better prognosis. Furthermore, Kraepelin grouped together dementia praecox as a single illness which included the previously separate entities; hebephrenia, catatonia and paranoia.

Eugen Bleuler

In 1911, Eugen Bleuler, a Swiss psychiatrist, coined the term schizophrenia, having observed that the term dementia praecox was misleading as it did not necessarily have a deteriorating course and did not always have an early age of onset. The word schizophrenia was derived from the Greek roots schizo, which means to split or tear, and phren, which means “the mind” or “the intellect”. Furthermore, Bleuler, introduced the concept of fundamental and accessory symptoms of schizophrenia. The four fundamental symptoms, also referred to as the four A’s were: autism, ambivalence, abnormal associations and abnormal effect.

Currently, schizophrenia can be categorised into various different subtypes based on the symptoms presented. Advancement in imaging studies of the brain and in understanding the nature of the symptoms, genetics and underlying cognitive deficits have provided a greater consensus, however, substantial uncertainties remain.