Dementia Praepelin's Theory Of Schizophrenia

Introduction
The idea of schizophrenia was originally labelled “dementia praecox” by Emil Kraepelin (1919) who considered it to be a degenerative disorder. This cynical view of schizophrenia continued into the contemporary diagnostic classifications. As recently as DSM-III (APA, 1980), the depiction of the patient with schizophrenia was particularly despairing: “A complete return to pre-morbid functioning is unusual – so rare, in fact, that some clinicians would question the diagnosis. However, there is always the possibility of full remission or recovery, although its frequency is unknown. The most common course is one of acute exacerbations with increasing residual impairment between episodes.” (DSM-III, p.185). Correspondingly, the authors

The impairments being described include an increasing failure to carry out daily activites / functions e.g. relationships, work, self-care, in addition to persisting delusions and hallucinations. Such concepts about prognosis and therefore likelihood of recovery have huge inferences for concepts of aetiology and progression and outcomes. Furthermore, such concepts might inform decisions about economic planning, social policy for mental health and treatment (Harding, Brooks, Ashikaga, T, Strauss, & Brier, 1987). Liberman and Kopelowicz (2002a) and Liberman, Kopelowicz, Ventura and Gutkind (2002b) have also debated that such a negative view regarding the diagnosis of schizophrenia can lead to stigmatisation, thus some patients denying the presence of their experiences. It is then likely there would be many not accessing the support that

Improvements of outcomes for those living with psychosis can partly be due to advances in pharmacological treatments. However, it must be noted that not all individuals respond to anti-psychotic medication (Wykes, Steel, Everitt & Tarrier, 2008). This has led to the progress of psychological and social interventions to help restore functioning and to minimise the distress associated with psychosis. Extensive research has been undertaken which has led to a better understanding of the processes behind psychosis, leading to developments in psychological interventions - most evidently Cognitive Behavioural Therapy for Psychosis (CBTp). Cognitive models of psychosis have emphasised the role of ‘thought content’ and ‘thinking styles’ in the progression and maintenance of psychotic experiences (Morrison, Haddock & Tarrier, 1995; Morrison, 2001; Garety, Kuipers, Fowler, Freeman & Bebbington, 2001), these cognitive processes have been likened to those of depression and anxiety. Fundamentally, these ideas have emphasised how delusions and hallucinations can occur when atypical experiences that are shared with the majority of the people, are potentially perceived in a way that has great and intimidating personal importance (Tai & Turkington,