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Constructing Schizophrenia as a Category of Mental Illness

  • Sander L. Gilman
Chapter

Abstract

How can we define the illness we label schizophrenia? As there seems to be no clear and definite answer to this question, I will assume the existence of a nosological category called “schizophrenia” and will also assume that this category was constructed historically.1 Thus our present diagnostic criteria for schizophrenia evolve out of a constant analysis and restructuring of other concepts, which are formed to create the category of schizophrenia. Unlike most other disease entities in psychiatry, schizophrenia is still a label in search of a structure; it is a category applied to a rather large group of symptoms with an almost equal number of etiologies proposed for it.

Keywords

Mental Illness Nineteenth Century Disease Entity Late Nineteenth Century Eighth Edition 
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Notes and References

  1. 1.
    There have been many attempts to sketch the history of the concept of schizophrenia, either independently or within broader contexts, all of which are helpful, but only one of which provides any synthetic history of the concept: John G. Howells, ed., The Concept of Schizophrenia: Historical Perspectives (Washington DC: American Psychiatric Press, 1991), the essays in which are a useful adjunct to this paper. From 1928 to 1941 see Adolf Meyer, “The Evolution of the Dementia Praecox Concept,” in Charles L. Dana et. al., eds., Schizophrenia [Dementia Praecox] (New York: Paul Hoeber, 1928), 3–15; H. W. Gruhle, “Die Schizophrenie. Geschichtliches,” in O. Bumke, ed., Handbuch der Geisteskranken, IX, Spezieller Teil V (Berlin: Springer, 1932), 1–30; Gregory Zilboorg, A History of Medical Psychology (New York: Norton, 1941; revised edition, 1954). From 1956 to 1970 see J. Wyrsch, Zur Geschichte und Deutung der endogenen Psychosen (Stuttgart: Thieme, 1956); Erwin Ackerknecht, Kurze Geschichte der Psychiatrie (Stuttgart: Enke, 1957); Manfred Bleuler, “The Conception of Schizophrenia Within the Last Fifty Years and Today,” International Journal of Psychiatry 1 (1965), 501–523; Franz Alexander and Sheldon Selesnick, The History of Psychiatry (New York: Harper & Row, 1966); Dieter Wyss, Depth Psychology: A Critical History, Development, Problems (New York: W.W. Norton, 1966); N. D. Lewis, “The History of the Nosology and the Evolution of the Concepts of Schizophrenia,” Proceedings of the American Psychopathological Association 54 (1966),1–18; G. Tourney, “A History of Therapeutic Fashions in Psychiatry, 1800–1966,” American Journal of Psychiatry 124 (1967), 784–796. From 1970 to 1975 see Robert Cancro and Paul W. Pruyser, “A Historical Review of the Development of the Concept of Schizophrenia,” in Robert Cancro, ed., The Schizophrenic Reactions (New York: Brunner/Mazel, 1970), 3–12; Henri F. Ellenberger, The Discovery of the Unconscious: The History and Evolution of Dynamic Psychiatry (New York: Basic Books, 1970); Silvano Arieti, Interpretation of Schizophrenia (New York: Basic Books, 1974), 9–29; Werner Janzarik, Themen und Tendenzen der deutschsprachigen Psychiatrie (Berlin: Springer, 1974); A. D. Forrest, “Concepts of Schizophrenia: Historical Review,” in A. D. Forrest and J. Affleck, eds., New Perspectives in Schizophrenia (Edinburgh: Churchill Livingstone, 1975), 1–15. From 1976 to 1979 see M. D. Altschule, “Historical Perspective—Evolution of the Concept of Schizophrenia,” in Stewart Wolf and Beatrice Bishop Berle, eds., The Biology of the Schizophrenic Process (New York: Plenum Press, 1976), 1–13; J. Ramano, “On the Nature of Schizophrenia: Changes in the Observer as Well as the Observed,” Schizophrenia Bulletin 3 (1977), 532–559; Henry Werlinder, Psychopathy: A History of the Concepts/Analysis of the Origin and Development of a Family of Concepts in Psychopathology (Stockholm: Almqvist & Wiksell, 1978), 100–127; Hannah S. Decker, “The Historical Evolution of Dementia Praecox,” in William E. Fann et al., eds., Phenomenology and Treatment of Schizophrenia (New York: Spectrum, 1978), 301–309; Manfred Bleuler, “On Schizophrenic Psychoses,” American Journal of Psychiatry 136 (1979), 1403–1409. From 1980 to 1983 see Peter Berner, “Schizophrenie: Oberblick und Geschichte,” in U. H. Peters, ed., Psychiatrie 1 (Zurich: Kindler, 1980), 353–370; John M. Neale and Thomas F. Oltmanns, Schizophrenia (New York: John Wiley & Sons, 1980), 2–16; Seymour S. Kety, “The Syndrome of Schizophrenia: Unresolved Questions and Opportunities for Research,” British Journal of Psychiatry 136 (1980), 421–436; Sue A. Shapiro, Contemporary Theories of Schizophrenia: Review and Synthesis (New York: McGraw-Hill, 1981), 7–23; Kenneth Kendler and Ming T. Tsuang, “The Nosology of Paranoid Schizophrenia and Other Paranoid Psychoses,” Schizophrenia Bulletin 7 (1981), 594–610; S. P. Fullinwider, Technicians of the Finite: The Rise and Decline of the Schizophrenic in American Thought, 1840–1960 (Westport, CT: Greenwood Press, 1982); Ph. Van Meerbeck, “D’ou nous viennent la demence précoce et la schizophrénie?” Acta Psychiatrica Belgica 82 (1982), 243–276; R. D. Chandresna, “Phenomenology and Nosology of Schizophrenia: Historical Review,” Psychiatric Journal of the University of Ottawa 8 (1983), 17–24; William N. Goldstein, “DSM-III and the Diagnosis of Schizophrenia,” American Journal of Psychotherapy 37 (1983), 168–181.Google Scholar
  2. 2.
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    On historical changes in the appearance of schizophrenia see B. Mahendra, “Where Have All the Catatonics Gone?” Psychological Medicine 1 (1981), 669–671. Compare J. R. Morrison, “Changes in Sub-Type Diagnosis in Schizophrenia: 1920–1966,” American Journal of Psychiatry 131 (1974), 674–677. I am relying in this study on the accepted distinction between an “illness” as a social state created by human evaluation of problematic experiences and a “disease” as a variety of biological events existing independently of human knowledge and evaluation; see D. Locker, Symptoms and Illness: The Cognitive Organization of Disorder (London: Tavistock, 1981). The research in the area of schizophrenia is, in general, operating without a specific definition of the concept of schizophrenia. The standard American periodical dealing with this area, the Schizophrenia Bulletin (funded by the National Institutes of Mental Health), ran a series of guest columns under the title “What is Schizophrenia?” Such openness about the difficulty of definition is rare in any medical subspecialty. See John S. Strauss and Thomas E. Gift, “Choosing an Approach for Diagnosing Schizophrenia,” Archives of General Psychiatry 34 (1977), 1248–1253.CrossRefGoogle Scholar
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Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Sander L. Gilman
    • 1
  1. 1.Liberal Arts and SciencesEmory UniversityUSA

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