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The Pathology of Schizophrenia: A Historical Survey

The Pathology of Schizophrenia: A Historical Survey Abstract I "The fact is decisive that the morbid anatomy [of dementia precox] has disclosed not simple inadequacy of the nervous constitution but destructive morbid processes as the background of the clinical picture." This remark of Kraepelin's1 immediately reveals the pronounced neuropathological bias with which schizophrenia was received during the early years of this century.This position on the part of the psychiatrists of the day was, however, not untenable, as Alzheimer2 had by then reported severe changes in the cerebral cortex, with disorganization of the ganglion cells and extensive glial reactions. He described not only swollen nuclei and shrunken neurons, with a frequent falling out of groups of cells, but also proliferative fibrous gliosis and pigmentary changes. He concluded that these changes were responsible for the disturbance in cortical function of these patients.It is worth noting that most of these histopathological descriptions applied to brains of catatonic References 1. Kraepelin, E.: Introduction à la psychiatrie clinique , translated from the second German edition by Albert Devaux and Prosper Merklen, Paris, Vigot frères, 1907. 2. Alzheimer, A.: Beiträge zur pathologischen Anatomie der Hirnrinde und zur anatomischen Grundlage einiger Psychosen , Monatsschr. Psychiat. u. Neurol. 2:82, 1897.Crossref 3. Alzheimer, A.: Beiträge zur pathologischen Anatomie der Dementia Praecox , Allg. Ztschr. Psychiat. 70:810, 1913. 4. Bleuler, E.: Physisch und psychisch in der Pathologie , Ztschr. ges. Neurol. u. Psychiat. 30: 426, 1916.Crossref 5. Peters, G.: Dementia Praecox, in Erkrankungen des zentralen Nervensystem, Handbuch der speziellen pathologischen Anatomie und Histologie , edited by O. Lubarsch, F. Henke, and R. Rössle, Berlin, Springer-Verlag, 1956, Vol. 13, Pt. 4. 6. Southard, E. E.: On the Focality of Microscopic Brain Lesions Found in Dementia Praecox , Arch. Neurol. & Psychiat. 1:172, 1919. 7. Mott, F. W.: Studies in the Pathology of Dementia Praecox , Proc. Roy. Soc. Med. 13:652, 1939. 8. Gurd, A. E.: The Structural Brain Lesions of Dementia Praecox , Am. J. Insan. 77:201, 1920. 9. Meyer, A.: Constructive Formulation of Schizophrenia , Am. J. Psychiat. 1:355, 1922. 10. Josephy, H.: Beiträge zur Histopathologie der Dementia Praecox , Ztschr. ges. Neurol. u. Psychiat. 86:391, 1923. 11. von Monakow, C.: Zur Entwickelung und pathologischen Anatomie des Rautenplexus , Schweiz. Arch. Neurol. u. Psychiat. 5:378-392, 1919. 12. Emerson, H.: Note on the Incidence of Status Lymphaticus in Dementia Praecox , Arch. Int. Med. 14:881, 1914. 13. Mott, F. W.: Normal and Morbid Conditions of the Testis from Youth to Old Age in 100 Asylum and Hospital Cases , Brit. M. J. 2:737, 1919. 14. Lewis, N. D. C.: The Constitutional Factors in Dementia Praecox with Particular Attention to the Circulatory System and to Some of the Endocrine Glands , Nervous & Mental Disease Monograph Series No. 35, Washington, D. C., Nervous & Mental Disease Publishing Company, 1923. 15. Dunlap, C. B.: Dementia Praecox—Some Preliminary Observations on Brains from Carefully Selected Cases, and a Consideration of Certain Sources of Errors , Am. J. Psychiat. 3:403, 1923-1924. 16. Spielmeyer, W.: The Problem of the Anatomy of Schizophrenia , J. Nerv. & Ment. Dis. 72:241, 1930. 17. Conn, J. H.: An Examination of the Clinico-Pathological Evidence Offered for the Concept of Dementia Praecox as a Specific Disease Entity , Am. J. Psychiat. 90:1039, 1934. 18. Lewis, N. D. C.: Pathology of Dementia Precox , J. Nerv. & Ment. Dis. 62:225, 1925. 19. Winkelman, N. W.: Importance of Small Blood Vessels of Brain in Psychiatric Problems , Am. J. Psychiat. 12:775, 1933. 20. Ferraro, A.: Histopathological Findings in 2 Cases Clinically Diagnosed Dementia Praecox , Am. J. Psychiat. 13:883, 1934. 21. Ferraro, A.: Pathological Changes in the Brain of a Case Clinically Diagnosed Dementia Praecox , J. Neuropath. & Exper. Neurol. 2:84, 1943. 22. Polatin, P.; Eisenstein, V. W., and Barrera, S. E.: Organic Psychoses Simulating Dementia Praecox , Psychiat. Quart. 18:391, 1944. 23. Roizin, L.; Moriarty, J. D.. and Weil, A. A.: Schizophrenic Reaction Syndrome in Course of Acute Demyelination of Central Nervous System: Clinicopathologic Report of a Case, with Brief Review of the Literature , Arch. Neurol. & Psychiat. 54:202, 1945. 24. Wohlfahrt, S.: Die Histopathologie der Schizophrenie , Acta psychiat. et neurol. 11:687, 1936.Crossref 25. Elvidge, A. R., and Reed, G. E.: Biopsy Studies of Cerebral Pathologic Changes in Schizophrenia and Manic-Depressive Psychosis , Arch. Neurol. & Psychiat. 40:227, 1938. 26. Olkon, D. M.: Capillary Structure in Patients with Schizophrenia , Arch. Neurol. & Psychiat. 42:652, 1939. 27. Cotton, J. M.; Lewis, N. D. C., and Egenhofer, A. W.: Vascular Bed of the Retina in Mental Disease , Arch. Neurol. & Psychiat. 43:891, 1940. 28. Bessalko, S. A. Macroscopic Findings in 200 Autopsies of Schizophrenics , Sovet. psikhonevrol. 15:75, 1939. 29. Malamud, N., and Boyd, D. A., Jr.: Sudden "Brain Death" in Schizophrenia with Extensive Lesions in Cerebral Cortex , Arch. Neurol. & Psychiat. 41:352, 1939. 30. Gaupp, R.: Ein weiterer Beitrag zur pathologischen Anatomie der Katatonie , Nervenarzt 15: 476, 1942. 31. Lingjaerde, O.: Delirium acutum—eine akute Nebenniereninsuffizienz? Mit einigen Bemerkungen über die Rolle der Nebennieren in der Pathogenese gewisser Schizophrenien , Nervenarzt 14:97, 1941. 32. Hemphill, D. E.: Significance of Atrophy of Testis in Schizophrenia , J. Ment. Sc. 90:696, 1944. 33. Meyer, A.: Critical Evaluation of Histopathological Findings in Schizophrenia , J. Ment. Sc. 96:32, 1952. 34. Papez, J. W., and Bateman, J. F.: Changes in Nervous Tissues and Study of Living Organisms in Mental Disease , J. Nerv. & Ment. Dis. 114:400, 1951. 35. Braitenberg, V.: Histopathologic Research on the Frontal Cortex in Schizophrenia , Proceedings First International Congress of Neuropathology, Rome, 1952, p. 621. 36. Bäumer, H.: Investigations on the Nucleus Medialis and Lateralis of the Thalamus in Schizophrenia , Proceedings First International Congress of Neuropathology, Rome, 1952, p. 636. 37. Füngfeld, E. W.: Pathologic Anatomic Investigations on the Anterior Thalamic Nucleus in Schizophrenia , Proceedings First International Congress of Neuropathology, Rome, 1952, p. 648. 38. Hopf, A.: On the Histopathological Changes in the Pallidum and Striatum in Schizophrenia , Proceedings First International Congress of Neuropathology, Rome, 1952, p. 627. 39. Wahren, W.: The Changes of Hypothalmic Nuclei in Schizophrenia , Proceedings First International Congress Neuropathology, Rome, 1952, p. 660. 40. Scharenberg, K., and Brown, E. O.: Histopathology of Catatonic States: Study with Silver Carbonate , J. Neuropath. & Exper. Neurol. 13: 592, 1954. 41. Ferraro, A.: Interpretation of Cerebral Histopathologic Changes in Cases of Schizophrenia , J. Neuropath. & Exper. Neurol. 10:104, 1951. 42. Shattock, F. M.: Somatic Manifestations of Schizophrenia: A Clinical Study of Their Significance , J. Ment. Sc. 96:32, 1950. 43. Zeligs, M. A.: Central Angiospastic Retinopathy: Psychosomatic Study of Its Occurrence in Military Personnel , Psychosom. Med. 9:110, 1947. 44. Blair, J. H.; Sniffen, R. C.; Cranswick, E. H.; Jaffe, D., and Kline, N. S.: The Question of Histopathological Changes in the Testes of Schizophrenics , J. Ment. Sc. 98:464, 1952. 45. Buscaino, V. M.: Extraneural Pathology in Schizophrenia: Liver, Digestive Tract, Reticuloendothelial System , Acta neurol. Napoli , 8:1, 1953. 46. Scheidegger, S.: Liver-Tissue Changes in Schizophrenia: Brief Critical Note , J. Neuropath. & Exper. Neurol. 12:397, 1953. 47. Weinstein, M. R.: Histopathological Changes in the Brain of Schizophrenia: A Critical Review , A. M. A. Arch. Neurol. & Psychiat. 71:539, 1954. 48. Kety, S. S.; Woodford, R. B.; Harmel, M. H.; Freyhan, F A.; Appel, K. E., and Schmidt, C. F.: Cerebral Blood Flow and Metabolism in Schizophrenia: Effects of Barbiturate Semi-Narcosis, Insulin Coma and Electroshock , Am. J. Psychiat. 104:765, 1948. 49. Cardon, P.: Unpublished observations. 50. Reiter, P. J.: Zur Pathologie der Dementia praecox: Gastrointestinale Störungen, ihre klinische und ätiologische Bedeutung , Acta psychiat. et neurol. , (Supp. 1) , 1929. 51. Witte, F.: Über anatomische Befunde am Verdauungsapparat von Schizophrenen , Arch. Psychiat. 88:624, 1929.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives of Neurology & Psychiatry American Medical Association

The Pathology of Schizophrenia: A Historical Survey

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American Medical Association
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Copyright © 1959 American Medical Association. All Rights Reserved.
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0096-6886
DOI
10.1001/archneurpsyc.1959.02340170067007
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Abstract

Abstract I "The fact is decisive that the morbid anatomy [of dementia precox] has disclosed not simple inadequacy of the nervous constitution but destructive morbid processes as the background of the clinical picture." This remark of Kraepelin's1 immediately reveals the pronounced neuropathological bias with which schizophrenia was received during the early years of this century.This position on the part of the psychiatrists of the day was, however, not untenable, as Alzheimer2 had by then reported severe changes in the cerebral cortex, with disorganization of the ganglion cells and extensive glial reactions. He described not only swollen nuclei and shrunken neurons, with a frequent falling out of groups of cells, but also proliferative fibrous gliosis and pigmentary changes. He concluded that these changes were responsible for the disturbance in cortical function of these patients.It is worth noting that most of these histopathological descriptions applied to brains of catatonic References 1. Kraepelin, E.: Introduction à la psychiatrie clinique , translated from the second German edition by Albert Devaux and Prosper Merklen, Paris, Vigot frères, 1907. 2. Alzheimer, A.: Beiträge zur pathologischen Anatomie der Hirnrinde und zur anatomischen Grundlage einiger Psychosen , Monatsschr. Psychiat. u. Neurol. 2:82, 1897.Crossref 3. Alzheimer, A.: Beiträge zur pathologischen Anatomie der Dementia Praecox , Allg. Ztschr. Psychiat. 70:810, 1913. 4. Bleuler, E.: Physisch und psychisch in der Pathologie , Ztschr. ges. Neurol. u. Psychiat. 30: 426, 1916.Crossref 5. Peters, G.: Dementia Praecox, in Erkrankungen des zentralen Nervensystem, Handbuch der speziellen pathologischen Anatomie und Histologie , edited by O. Lubarsch, F. Henke, and R. Rössle, Berlin, Springer-Verlag, 1956, Vol. 13, Pt. 4. 6. Southard, E. E.: On the Focality of Microscopic Brain Lesions Found in Dementia Praecox , Arch. Neurol. & Psychiat. 1:172, 1919. 7. Mott, F. W.: Studies in the Pathology of Dementia Praecox , Proc. Roy. Soc. Med. 13:652, 1939. 8. Gurd, A. E.: The Structural Brain Lesions of Dementia Praecox , Am. J. Insan. 77:201, 1920. 9. Meyer, A.: Constructive Formulation of Schizophrenia , Am. J. Psychiat. 1:355, 1922. 10. Josephy, H.: Beiträge zur Histopathologie der Dementia Praecox , Ztschr. ges. Neurol. u. Psychiat. 86:391, 1923. 11. von Monakow, C.: Zur Entwickelung und pathologischen Anatomie des Rautenplexus , Schweiz. Arch. Neurol. u. Psychiat. 5:378-392, 1919. 12. Emerson, H.: Note on the Incidence of Status Lymphaticus in Dementia Praecox , Arch. Int. Med. 14:881, 1914. 13. Mott, F. W.: Normal and Morbid Conditions of the Testis from Youth to Old Age in 100 Asylum and Hospital Cases , Brit. M. J. 2:737, 1919. 14. Lewis, N. D. C.: The Constitutional Factors in Dementia Praecox with Particular Attention to the Circulatory System and to Some of the Endocrine Glands , Nervous & Mental Disease Monograph Series No. 35, Washington, D. C., Nervous & Mental Disease Publishing Company, 1923. 15. Dunlap, C. B.: Dementia Praecox—Some Preliminary Observations on Brains from Carefully Selected Cases, and a Consideration of Certain Sources of Errors , Am. J. Psychiat. 3:403, 1923-1924. 16. Spielmeyer, W.: The Problem of the Anatomy of Schizophrenia , J. Nerv. & Ment. Dis. 72:241, 1930. 17. Conn, J. H.: An Examination of the Clinico-Pathological Evidence Offered for the Concept of Dementia Praecox as a Specific Disease Entity , Am. J. Psychiat. 90:1039, 1934. 18. Lewis, N. D. C.: Pathology of Dementia Precox , J. Nerv. & Ment. Dis. 62:225, 1925. 19. Winkelman, N. W.: Importance of Small Blood Vessels of Brain in Psychiatric Problems , Am. J. Psychiat. 12:775, 1933. 20. Ferraro, A.: Histopathological Findings in 2 Cases Clinically Diagnosed Dementia Praecox , Am. J. Psychiat. 13:883, 1934. 21. Ferraro, A.: Pathological Changes in the Brain of a Case Clinically Diagnosed Dementia Praecox , J. Neuropath. & Exper. Neurol. 2:84, 1943. 22. Polatin, P.; Eisenstein, V. W., and Barrera, S. E.: Organic Psychoses Simulating Dementia Praecox , Psychiat. Quart. 18:391, 1944. 23. Roizin, L.; Moriarty, J. D.. and Weil, A. A.: Schizophrenic Reaction Syndrome in Course of Acute Demyelination of Central Nervous System: Clinicopathologic Report of a Case, with Brief Review of the Literature , Arch. Neurol. & Psychiat. 54:202, 1945. 24. Wohlfahrt, S.: Die Histopathologie der Schizophrenie , Acta psychiat. et neurol. 11:687, 1936.Crossref 25. Elvidge, A. R., and Reed, G. E.: Biopsy Studies of Cerebral Pathologic Changes in Schizophrenia and Manic-Depressive Psychosis , Arch. Neurol. & Psychiat. 40:227, 1938. 26. Olkon, D. M.: Capillary Structure in Patients with Schizophrenia , Arch. Neurol. & Psychiat. 42:652, 1939. 27. Cotton, J. M.; Lewis, N. D. C., and Egenhofer, A. W.: Vascular Bed of the Retina in Mental Disease , Arch. Neurol. & Psychiat. 43:891, 1940. 28. Bessalko, S. A. Macroscopic Findings in 200 Autopsies of Schizophrenics , Sovet. psikhonevrol. 15:75, 1939. 29. Malamud, N., and Boyd, D. A., Jr.: Sudden "Brain Death" in Schizophrenia with Extensive Lesions in Cerebral Cortex , Arch. Neurol. & Psychiat. 41:352, 1939. 30. Gaupp, R.: Ein weiterer Beitrag zur pathologischen Anatomie der Katatonie , Nervenarzt 15: 476, 1942. 31. Lingjaerde, O.: Delirium acutum—eine akute Nebenniereninsuffizienz? Mit einigen Bemerkungen über die Rolle der Nebennieren in der Pathogenese gewisser Schizophrenien , Nervenarzt 14:97, 1941. 32. Hemphill, D. E.: Significance of Atrophy of Testis in Schizophrenia , J. Ment. Sc. 90:696, 1944. 33. Meyer, A.: Critical Evaluation of Histopathological Findings in Schizophrenia , J. Ment. Sc. 96:32, 1952. 34. Papez, J. W., and Bateman, J. F.: Changes in Nervous Tissues and Study of Living Organisms in Mental Disease , J. Nerv. & Ment. Dis. 114:400, 1951. 35. Braitenberg, V.: Histopathologic Research on the Frontal Cortex in Schizophrenia , Proceedings First International Congress of Neuropathology, Rome, 1952, p. 621. 36. Bäumer, H.: Investigations on the Nucleus Medialis and Lateralis of the Thalamus in Schizophrenia , Proceedings First International Congress of Neuropathology, Rome, 1952, p. 636. 37. Füngfeld, E. W.: Pathologic Anatomic Investigations on the Anterior Thalamic Nucleus in Schizophrenia , Proceedings First International Congress of Neuropathology, Rome, 1952, p. 648. 38. Hopf, A.: On the Histopathological Changes in the Pallidum and Striatum in Schizophrenia , Proceedings First International Congress of Neuropathology, Rome, 1952, p. 627. 39. Wahren, W.: The Changes of Hypothalmic Nuclei in Schizophrenia , Proceedings First International Congress Neuropathology, Rome, 1952, p. 660. 40. Scharenberg, K., and Brown, E. O.: Histopathology of Catatonic States: Study with Silver Carbonate , J. Neuropath. & Exper. Neurol. 13: 592, 1954. 41. Ferraro, A.: Interpretation of Cerebral Histopathologic Changes in Cases of Schizophrenia , J. Neuropath. & Exper. Neurol. 10:104, 1951. 42. Shattock, F. M.: Somatic Manifestations of Schizophrenia: A Clinical Study of Their Significance , J. Ment. Sc. 96:32, 1950. 43. Zeligs, M. A.: Central Angiospastic Retinopathy: Psychosomatic Study of Its Occurrence in Military Personnel , Psychosom. Med. 9:110, 1947. 44. Blair, J. H.; Sniffen, R. C.; Cranswick, E. H.; Jaffe, D., and Kline, N. S.: The Question of Histopathological Changes in the Testes of Schizophrenics , J. Ment. Sc. 98:464, 1952. 45. Buscaino, V. M.: Extraneural Pathology in Schizophrenia: Liver, Digestive Tract, Reticuloendothelial System , Acta neurol. Napoli , 8:1, 1953. 46. Scheidegger, S.: Liver-Tissue Changes in Schizophrenia: Brief Critical Note , J. Neuropath. & Exper. Neurol. 12:397, 1953. 47. Weinstein, M. R.: Histopathological Changes in the Brain of Schizophrenia: A Critical Review , A. M. A. Arch. Neurol. & Psychiat. 71:539, 1954. 48. Kety, S. S.; Woodford, R. B.; Harmel, M. H.; Freyhan, F A.; Appel, K. E., and Schmidt, C. F.: Cerebral Blood Flow and Metabolism in Schizophrenia: Effects of Barbiturate Semi-Narcosis, Insulin Coma and Electroshock , Am. J. Psychiat. 104:765, 1948. 49. Cardon, P.: Unpublished observations. 50. Reiter, P. J.: Zur Pathologie der Dementia praecox: Gastrointestinale Störungen, ihre klinische und ätiologische Bedeutung , Acta psychiat. et neurol. , (Supp. 1) , 1929. 51. Witte, F.: Über anatomische Befunde am Verdauungsapparat von Schizophrenen , Arch. Psychiat. 88:624, 1929.Crossref

Journal

A.M.A. Archives of Neurology & PsychiatryAmerican Medical Association

Published: May 1, 1959

References