Emil Kraepelin

Emil Kraepelin, professor of psychiatry first in Heidelberg then Munich, originated modern psychiatric diagnosis. So it was a fateful error when, in 1899, Kraepelin made catatonia a “subtype” of schizophrenia (which Kraepelin called “dementia praecox”). He did so on the basis of what Kraepelin considered a downhill course and outcome. Catatonia thus disappeared into the schizophrenia tent and ceased to be an independent disease entity. There it remained for the next century. It was because of Kraepelin’s immense prestige that his disease classification has survived virtually until the present. Kraepelin thus saved catatonia from extinction as a diagnosis, but at the cost of ensuring that it would be diagnosed only in “schizophrenics.” Clinicians who did not think their patients had schizophrenia would miss the catatonia diagnosis.