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While the origins of two of Kraepelin's three subtypes of dementia praecox (DP), catatonic and hebephrenic, are well understood, no similar clear narrative exists for his concepts of paranoia and paranoid DP, which require a consideration of both German and French sources. An important milestone in the French literature is the massive 524 page monograph entitled "Le Délire Des Persécutions" published in 1871 by Henri Legrand du Saulle which contained extensive, clinically detailed descriptions of a wide range of cases with prominent, organized persecutory delusions. Many of his cases reported auditory hallucinations (AH), and some bizarre, Schneiderian delusions. The delusional content could evolve to include prominent somatic and/or grandiose themes. Using a symptomatic diagnostic framework, Legrand du Saulle proposed that this syndrome represented an independent "species" of mental illness. He sought to give a voice to the affected individuals, including a chapter devoted entirely to their writings. He described several clinically fascinating features of such patients including how often they moved residence to unsuccessfully flee their persecutors and how delusional beliefs could be communicated to spouses and relatives. Unlike Kraepelin, he was little interested in their course of illness or rates of deterioration, except to note that recoveries occurred in 20% of cases. The clinical richness of this work substantially exceeded that in the contemporaneous German literature. Most of the cases described by du Saulle would fit easily into the two major non-affective delusional syndromes articulated 28 years later in Kraepelin's famous 6th edition of his textbook: paranoia and paranoid DP., (© The Author(s) 2023. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Objective: The writer Elsa Asenijeff was placed under guardianship based on the diagnosis paranoia querulans in 1921. The aim of this study was to commemorate her case and to question how this clinical picture was understood at the time in order to contribute to the history of this little researched disorder., Methods: We illustrate the essence of Asenijeffs forensic examinations and of the descriptions of paranoia querulans in selected German psychiatric literature of the beginning of the 20 th century., Results: The literature describes paranoia querulans as a delusional disorder provoked by judicial conflict. The selected authors offer different theories of its genesis and classification., Conclusions: The symptoms described in the forensic examinations are in accordance with the doctrine of academic psychiatry of the time. The chosen literature also illustrates the difficulties of a clear distinction between mental health and illness., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (© Georg Thieme Verlag KG Stuttgart · New York.)

While the roots of mania and melancholia can be traced to the 18th century and earlier, we have no such long historical narrative for dementia praecox (DP). I, here, provide part of that history, beginning with Kraepelin's chapter on Verrücktheit for his 1883 first edition textbook, which, over the ensuing 5 editions, evolved into Kraepelin's mature concepts of paranoia and paranoid DP. That chapter had 5 references published from 1865 to 1879 when delusional-hallucinatory syndromes in Germany were largely understood as secondary syndromes arising from prior episodes of melancholia and mania in the course of a unitary psychosis. Each paper challenged that view supporting a primary Verrücktheit as a disorder that should exist alongside mania and melancholia. The later authors utilized faculty psychology, noting that primary Verrücktheit resulted from a fundamental disorder of thought or cognition. In particular, they argued that, while delusions in mania and melancholia were secondary, arising from primary mood changes, in Verrücktheit, delusions were primary with observed changes in mood resulting from, and not causing, the delusions. In addition to faculty psychology, these nosologic changes were based on the common-sense concept of understandability that permitted clinicians to distinguish individuals in which delusions emerged from mood changes and mood changes from delusions. The rise of primary Verrücktheit in German psychiatry in the 1860-1870s created a nosologic space for primary psychotic illness. From 1883 to 1899, Kraepelin moved into this space filling it with his mature diagnoses of paranoia and paranoid DP, our modern-day paranoid schizophrenia., (© The Author(s) 2020. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

During the winter of 1930, Princess Alice of Battenberg was admitted to Kurhaus Schloß Tegel, where she was diagnosed with schizophrenic paranoia. When Freud was consulted about her case by Ernst Simmel, the Sanatorium's Director, he recommended that the patient's ovaries be exposed to high-intensity X-rays. Freud's suggestion was not based on any psychoanalytic treatment principles, but rooted in a rejuvenation technique to which Freud himself had subscribed. In recommending that psychotic patients should be treated with physical interventions, Freud confirmed his conviction that the clinical applicability of psychoanalysis should not be extrapolated beyond the neuroses, yet he also asserted that a proper consideration of endocrinological factors in the aetiology and treatment of the psychoses should never be excluded.

We can trace, with high congruence, the clinical syndromes of depression and mania as described over the 20th century in psychiatric textbooks back to 1880 and to the earliest writing of Kraepelin published in 1883. However, this is not the case for Kraepelin's 2 delusional syndromes central to his overall nosology: Dementia Paranoides (later paranoid schizophrenia) and Paranoia. A detailed examination of 28 textbook descriptions of delusional psychoses from 1880 to 1900 reveals a diverse and partially overlapping set of syndromes with an admixture of symptoms and signs that would later be considered indicative of Dementia Paranoides and Paranoia. A similar pattern in seen in Kraepelin's own description of "Primäre Verrücktheit" from the first edition of his textbook (1883). No clear prototypes emerged in these textbooks or in Kraepelin's early writings for the 2 distinct delusional syndromes that would later evolve in his mature writings. Rather, the nosologic approach taken in these writings was symptom based and assumed that a viable diagnostic category could be constituted by including all delusional patients once those suffering from organic or mood disorders were excluded. While Kraepelin used the historical syndromes of mania and depression, with no appreciable change, as building blocks for his category of manic-depressive insanity, his nosologic system for the psychotic disorders-the syndromes of Dementia Praecox and Paranoia-was more innovative and without clear precedent in the prior psychiatric literature., (© The Author(s) 2019. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Literature on the history of 'paranoia' (as a clinical concept) is large and confusing. This is partly explained by the fact that over the centuries the word 'paranoia' has been made to participate in several convergences (clinical constructs), and hence it has named different forms of behaviour and been linked to different explanatory concepts. The Classic Text that follows provides information on the internal clinical evolution of the last convergence in which 'paranoia' was made to participate. August Wimmer maps the historical changes of ' Verrücktheit' as it happened within the main European psychiatric traditions since the early 19th century. After World War II, that clinical profile was to become reified and renamed as 'delusional disorder'.

This review traces, through psychiatric textbooks, the history of the Kraepelinian concept of paranoia in the 20th century and then relates the common reported symptoms and signs to the diagnostic criteria for paranoia/delusional disorder in DSM-III through DSM-5. Clinical descriptions of paranoia appearing in 10 textbooks, published 1899 to 1970, revealed 11 prominent symptoms and signs reported by 5 or more authors. Three symptoms (systematized delusions, minimal hallucinations, and prominent ideas of reference) and 2 signs (chronic course and minimal affective deterioration) were reported by 8 or 9 of the authors. Four textbook authors rejected the Kraepelinian concept of paranoia. A weak relationship was seen between the frequency with which the clinical features were reported and the likelihood of their inclusion in modern DSM manuals. Indeed, the diagnostic criteria for paranoia/delusional disorder shifted substantially from DSM-III to DSM-5. The modern operationalized criteria for paranoia/delusional disorder do not well reflect the symptoms and signs frequently reported by historical experts. In contrast to results of similar reviews for depression, schizophrenia and mania, the clinical construct of paranoia/delusional disorder has been somewhat unstable in Western Psychiatry since the turn of the 20th century as reflected in both textbooks and the DSM editions., (© The Author 2017. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

The author analyze conceptions of mental signs of predisposition (diathesis, vulnerability) to non-psychotic and delusional mental disorders of functional origin described in the works of leading French psychiatrists of the late 19th/early 20th centuries (E. Regis, P. Serieux, J. Capgras, E. Dupre, J. Levy-Valensi etc). The descriptions of characteristics of some constitutional types and the differences in the structure of constitutional types and the structure of delusional disorders developed on their basis are compared.

Objective: To illustrate the use of fiction in understanding psychiatric disorders and refocus attention towards fiction as a valuable source of psychopathology, thereby contributing to the restoration of the narrative in psychiatry., Method: A psychopathological analysis of the novella Michael Kohlhaas written by Heinrich von Kleist, one of the outstanding literary figures of the German romantic movement of the early 19th century., Results: The protagonist of Kleist's novella, Michael Kohlhaas, a querulant horse trader, carries out an armed uprising disproportionate to the minor injustice of the unlawful seizure of his horses. Following unsuccessful attempts at legal recourse, Kohlhaas takes up arms against the authorities, and in the course of his uncompromising pursuit of justice eventually sacrifices his own and his family's lives. Kleist accurately portrays Kohlhaas' psychopathological development from a psychologically balanced, emotionally warm family man to one who causes utter destruction, mayhem and the loss of innocent lives. This literary work is a remarkably authentic, insightful and rich representation of litigious/querulant behaviour, described by classical authors as litigious paranoia, a diagnostic category currently subsumed under 'delusional disorder, persecutory type', in DSM-5 and 'persistent delusional disorder' in ICD-10., Conclusions: Kleist's novella offers important clues to better understand the development of litigious-querulant behaviour and the inner world of its sufferers. An analysis of the novella also illustrates the contribution that fiction could make to resuscitate the narrative as a complement to criterion-based diagnostic practice prevailing in contemporary psychiatry. © 2014 S. Karger AG, Basel.

On July 22, 2011, Anders Breivik, a Norwegian citizen, detonated a fertilizer bomb near government buildings in Oslo, killing eight people, and then proceeded to a nearby island where the Labor Party was holding a youth camp. There, he killed 69 people before being arrested. Just before these events, he posted a "compendium" on the Web explaining his actions and encouraging others to do likewise. Much of the ensuing media coverage and trial focused on whether he was sane and whether he had a psychiatric diagnosis. One team of court-appointed psychiatrists found him to be psychotic with a diagnosis of paranoid schizophrenia and legally insane. A second team found him neither psychotic nor schizophrenic and, thus, legally sane. Their contrary opinions were not reconciled by observing his behavior in court. We discuss why experienced psychiatrists reached such fundamentally opposing diagnostic conclusions about a "home-grown" terrorist holding extreme political views.

n his famous 1918 book „The sensitive relative delusion” Ernst Kretschmer not only described this specific delusional disorder but also the underlying sensitive personality disorder. Until now, relatively little attention has been paid to this part of his work. The incomplete reception is outlined, followed by a description of the symptoms, psychodynamics and course of sensitive personality disorder. The interpretation of "Anton Reiser: a psychological novel" - the autobiographical work by Karl Philipp Moritz in 1785 – is used as an example since it describes Anton Reiser as a sensitive personality.

Paraphrenia is a chronic psychotic disorder similar to paranoid schizophrenia, but with a better-preserved affect and rapport, and a much less personality deterioration. It was at first described by Kraepelin in 1913 as a group of patients who exhibited delusional symptoms typical of dementia praecox, but with minimal disturbances of emotion and volition. After the publication of Mayer-Gross's report in 1921, the view to differentiate paraphrenia from schizophrenia was considered to be unfounded and the term "paraphrenia" was not included in the current DSM-IV-TR and ICD-10 diagnostic criteria. Consequently, this disorder is now diagnosed relatively infrequently. However, several authors have recently suggested that the paraphrenia concept has not lost its usefulness. It seems to be that many psychiatrists recognize the illness, but labelled it as "atypical psychosis", "schizoaffective disorder" or "psychotic disorder not otherwise specified" for the lack of a better diagnostic category. Very few systematic studies on paraphrenia have been conducted in the past 70 years. Aim of this article is to underline the modernity of Kraepelin's thinking and his "paraphrenia" concept, suggesting that it could be possible to define and recognize the illness if practitioners would be induced to use a viable diagnostic entity.

We describe a 62-year-old patient with a chronic delusional disorder who presented with severely matted hair ("plica polonica"). Until the late 19th century such dreadlocks were considered as cause, consequence and treatment of mental disease. The historical development of "plica polonica" is briefly reviewed as an example of early and once popular psychiatric disease concepts.

Both of Thorstein Veblen's wives and another woman he loved had nervous breakdowns, while a fourth woman to whom he was emotionally very close committed suicide. Yet when Veblen published an article entitled "Dementia praecox," he did not mention his personal contact with serious mental disorder. This detachment is consistent with Veblen's approach to writing. Veblen considered himself to be a detached observer who wrote objectively about society rather than subjectively about himself., ((c) 2007 Wiley Periodicals, Inc.)

During his three stays in psychiatric institutions between 1884 and 1911, Daniel Paul Schreber was also twice treated in the psychiatric and neurological hospital of Leipzig University headed by Paul Flechsig. In his "Memoirs of a Nervous Patient," Schreber also described the treatment he had received there, which in his perception seemed to be of crucial importance for his later fate. Research on the Schreber case in the last 25 years, based mainly on the interpretation of his own memoirs, supported the view that in fact Flechsig was to blame to a great extent for the outbreak of Schreber's paranoid schizophrenia in February 1894. This paper aims at forwarding exonerating arguments in favor of Flechsig, concluding that what he did did not differ distinctively from the standard tenets of organic psychiatry taught at that time. Of course this does not change the fact that Schreber did not receive the right kind of treatment. However, it puts Flechsig's approach into the right perspective.

Objective: A brief biographical review of the poet Francis Webb was carried out, with reference to his mental illness and recurring themes in his poetry., Method: Material is drawn from a recent biography and the author's personal encounters with the poet. Reference is also made to Lacan's theory of psychosis and Winnicott's construct of the 'transitional object'., Results: The poetry may be seen in part as a transitional object whereby the poet sought to repair deficits in the structure of the self and contain psychotic chaos., Conclusions: The poems have a beauty and power beyond any psychoanalytic theorising, but may also be read as a vital striving toward self-healing on the part of the poet.

Camille Claudel was confined to a mental hospital in 1913, when she was 50. In fact she had been ill long before and it is that morbid personality which the author describes. Her life had always been a tragedy and her love for Rodin had nothing to do whatsoever with her illness; such a feeling was just a symptom of her diseases. She remained 30 years in hospital and she was considered as a paranoiac systematized chronic delirious patient. The author explains why such a case could not be judged differently in France in 1913. Whereas today it would be referred to as schizophrenic paranoid psychosis, with polymorphic delirious ideas and main persecution theme.

Dr. Diamond's courageous defense of the diminished capacity plea in People v. Gorshen (1959) emphasized mental disturbances negating malice aforethought. Diminished capacity as a defense in California remained effective from 1978 to 1982 until overturned by a modified American Law Institute rule. Diamond's advocacy of psychologic elements, including motivation, did much to enliven forensic thinking re: the death sentence and the fated diminished capacity defense.

Melancholy originally had another meaning from the present one. Only since the last century has melancholy taken on the meaning of severe depression. The Arabs were the first to introduce special wards for the mentally ill in their hospitals in the 8th and 9th centuries. In the West, mental wards in general hospitals have been known since the 13th century only. In the Renaissance dietary measures played an important part in the treatment of depression. Lean meat, fresh eggs, freshwater fish and particularly grapes were recommended. In the 17th and 18th centuries music therapy against depression came back into favour after being used in ancient times. In the 19th century opium was recommended and held its ground well into the middle of our century. Various methods and drugs were recommended and used for the therapy of depression in the 19th century, such as baths and massage, ferrous iodide, arsenic, ergot, strophantin, and cinchona. Actual antidepressants have been known only for approximately 30 years. The classic papers concerning therapy with lithium salts date back to the years 1948/49. It is a little known fact, however, that lithium salts had been used as prophylactic treatment against periodic depression 50 years earlier.

The history of nosologic approaches to paranoid schizophrenia and the other paranoid psychoses is traced from the time of Kraepelin. Kraepelin, emphasizing the course of illness, proposed a narrow definition for paranoid dementia praecox (paranoid schizophrenia). He created the entity of paraphrenia for cases with symptoms similar to those in paranoid dementia praecox but without a deteriorating course. Bleuler, emphasizing underlying psychological mechanisms, broadened the concept of paranoid schizophrenia to include nearly all delusional functional psychotic states. After Bleuler, the controversy continued as to whether the paranoid psychoses belonged within or separate from the schizophrenic disorders. Emerging from these historical controversies, current nosologic approaches to paranoid schizophrenia and paranoid psychosis differ substantially. Approaches to paranoid schizophrenia range from broad global criteria, which include patients with thought disorder and affective deterioration (e.g., ICD-9), to narrow criteria such as those proposed by Tsuang and Winokur (1974), which specifically exclude such patients. While some criteria for paranoid psychosis exclude patients with hallucinations or other than persecutory or jealous delusions (e.g., DSM-III), other criteria include such patients.

The available historical information concerning Freud's subject Daniel Paul Schreber's life, family, and the phenomenology of his illness is reviewed. The author challenges the traditional diagnosis of paranoid schizophrenia in favor of a diagnosis of affective disorder.