Differential diagnosis of some emotional disorders of adolescence with special reference to early schizophrenia.

Abstract

In my student days, after the first world war, teachers and text-books still used the term dementia praecox. It was looked upon as a disease sui generis, and descriptions were entirely in terms of clear-cut asylum cases with the usual classification into simple, hebephrenic, katatonic and paranoid. There was no psychopathology worth noting, and no anticipation of the immense gap waiting to be explored between “normality” and complete mental breakdown. In effect this meant that there was no half-way house in diagnosis: it was either dementia praecox or nothing. The revolutionary change in diagnostic approach began with Bleuler's highly original conception of the disorder as a progressive splitting of the psyche, indicated by the name schizophrenia which he gave to it, and which now holds the field. Added to this there are the researches of the psycho-analytical schools (the Jungians in particular) which have succeeded in opening up a huge and fascinating borderland on the fringe of normality, with a corresponding enlargement of our notions of schizophrenic disorders.