The word "schizophrenia" is less than 100 years old. However the disease was first identified as a discrete mental illness by Dr. Emile Kraepelin in the 1887 and the illness itself is generally believed to have accompanied mankind through its history.

Written documents that identify Schizophrenia can be traced to the old Pharaonic Egypt, as far back as the second millennium before Christ. Depression, dementia, as well as thought disturbances that are typical in schizophrenia are described in detail in the Book of Hearts. The Heart and the mind seem to have been synonymous in ancient Egypt. The physical illnesses were regarded as symptoms of the heart and the uterus and originating from the blood vessels or from purulence, fecal matter, a poison or demons.

A recent study into the ancient Greek and Roman literature showed that although the general population probably had an awareness of psychotic disorders, there was no condition that would meet the modern diagnostic criteria for schizophrenia in these societies.

At one point, all people who were considered "abnormal," whether due to mental illness, mental retardation, or physical deformities, were largely treated the same. Early theories supposed that mental disorders were caused by evil possession of the body, and the appropriate treatment was then exorcising these demons, through various means, ranging from innocuous treatments, such as exposing the patient to certain types of music, to dangerous and sometimes deadly means, such as releasing the evil spirits by drilling holes in the patient's skull.

One of the first to classify the mental disorders into different categories was the German physician, Emile Kraepelin. Dr. Kraepelin used the term "dementia praecox" for individuals who had symptoms that we now associate with schizophrenia.

The nonspecific concept of madness has been around for many thousands of years and schizophrenia was only classified as a distinct mental disorder by Kraepelin in 1887. He was the first to make a distinction in the psychotic disorders between what he called dementia praecox and manic depression. Kraepelin believed that dementia praecox was primarily a disease of the brain, and particularly a form of dementia. Kraepelin named the disorder 'dementia praecox' (early dementia) to distinguish it from other forms of dementia (such as Alzheimer's disease) which typically occur late in life. He used this term because his studies focused on young adults with dementia.

The Swiss psychiatrist, Eugen Bleuler, coined the term, "schizophrenia" in 1911. He was also the first to describe the symptoms as "positive" or "negative." Bleuler changed the name to schizophrenia as it was obvious that Krapelin's name was misleading as the illness was not a dementia (it did not always lead to mental deterioration) and could sometimes occur late as well as early in life.

The word "schizophrenia" comes from the Greek roots schizo (split) and phrene (mind) to describe the fragmented thinking of people with the disorder. His term was not meant to convey the idea of split or multiple personality, a common misunderstanding by the public at large. Since Bleuler's time, the definition of schizophrenia has continued to change, as scientists attempt to more accurately delineate the different types of mental diseases. Without knowing the exact causes of these diseases, scientists can only base their classifications on the observation that some symptoms tend to occur together.

Both Bleuler and Kraepelin subdivided schizophrenia into categories, based on prominent symptoms and prognoses. Over the years, those working in this field have continued to attempt to classify types of schizophrenia. Five types were delineated in the DSM-III: disorganized, catatonic, paranoid, residual, and undifferentiated. The first three categories were originally proposed by Kraepelin.

These classifications, while still employed in DSM-IV, have not shown to be helpful in predicting outcome of the disorder, and the types are not reliably diagnosed. Many researchers are using other systems to classify types of the disorder, based on the preponderance of "positive" vs "negative" symptoms, the progression of the disorder in terms of type and severity of symptoms over time, and the co-occurrence of other mental disorders and syndromes. It is hoped that differentiating types of schizophrenia based on clinical symptoms will help to determine different etiologies or causes of the disorder.

The evidence that schizophrenia is a biologically-based disease of the brain has accumulated rapidly during the past two decades. Recently this evidence has been also been supported with dynamic brain imaging systems that show very precisely the wave of tissue distruction that takes place in the brain that is suffering from schizophrenia.

With the rapid advances in the genetics of human desease now taking place, the future looks bright that greatly more effective therapies and eventually cures - will be identified.

More "History of Schizophrenia" information

• Schizophrenia Research and Brain Imaging - Harvard University
• First Drug for Schizophrenia Identified - 1952
• History of Psychopharmacology - A brief chapter that summarizes the history and general concepts of psychopharmacology.

More In-Depth History on Schizophrenia
(Source: Karolinska Institute, Department of Clinical Neuroscience)

Schizophrenia during the Middle Ages in the Muslim World

• Different Nursing
• Inspiration
• Accounts of Journeys
• Insane Rulers of Countries
• Therapies
• Psycho-somatic View

Psychiatry during the middle ages in the Western countries- an overview

• Scientific attitude towards disease side-by-side with excorsism
• Mental illness regarded as punishment or trial of God
• Family and monastery nursing
• Laws and discrimination (in Sweden)

Psychiatry during the early 20th century - A European Example

The Old Asylums

• From solitary confinement before psychopharmacological medicines
• Doctors had a difficult task during the early 20th century
• The white town and The castle of the lunatics
• The asylums became self-supporting units with amusements and activities
• The hospital of Säter- a city with 1000 inhabitants
  
• Departments and pavilions
  
  
• In the beginning of the twentieth century no efficacious therapies for psychical diseases were known
• Confinement in bed and means of compulsion
• Bathing therapy, apomorfine and sleeping cures
• Fever- and cramp therapies
• Insulin therapy and electroconvulsive therapy
  
• Lobotomy
  
• Drugs with reserpine changed the psychiatric care
  
• Introduction of chlorpromazine for mitigating effects in psychotic symptoms
• Bengt was treated with chlorpromazine during the fifties