Schizophrenia from Hippocrates to Kraepelin

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From one perspective, the literature of the 1990s abounds with controversies for the schizophrenia researcher. From another, the consensus that has emerged is astonishing, viewed relative to the history of conflicting thoughts about the disorder. Despite some dissension among the ranks, the subcommittees that formulated DSM-III, DSM-III-R, and the nascent DSM-IV have endorsed largely consistent diagnostic criteria for schizophrenia for the past 10 years. This is no small accomplishment, considering that many characteristics of schizophrenia were only clearly delineated within the past 200 years. Further, although debate continues about the relative importance of psychosocial versus somatic factors in the etiology of the illness, most would now agree that a genetic component is part of the diathesis for schizophrenia. That such consensus should exist is remarkable in light of two points of history. One is that in this country less than a half-century ago, prevailing beliefs about the primary causes of mental illness were solidly psychogenic, and indeed psychoanalytic. Moreover, only a little more than 200 years ago, viable candidate causes for the etiology of psychopathology included mystical forces: the last European execution of a witch occurred in Switzerland in 1782 (Zilboorg & Henry, 1941).