Emil Wilhelm Georg Magnus Kraepelin (; German: [ˈeːmiːl 'kʁɛːpəliːn]; 15 February 1856 – 7 October 1926) was a German psychiatrist. Fellow psychiatrist Hans Eysenck's Encyclopedia of Psychology identified him as partially responsible for laying the foundations of modern scientific psychiatry, psychopharmacology, and psychiatric genetics.
Kraepelin believed the chief origin of psychiatric disease to be a combination of biological process and genetic disorder or malfunction. Kraepelin's theories dominated psychiatry at the start of the 20th century and, despite the later psychodynamic influence of Sigmund Freud and his disciples, enjoyed a revival at the 20th century's end. While he proclaimed his own high clinical standards of gathering information "by means of expert analysis of individual cases", he also drew on reported observations of officials not trained in psychiatry.
Kraepelin's textbooks do not contain detailed medical case histories of individuals, instead offering mosaic-like compilations of typical statements and behaviors from patients with a specific diagnosis. Kraepelin has been described as a "scientific manager" and "political operator" who developed "a large-scale, clinically oriented, epidemiological research programme".
Some of Kraepelin's theories were considered racist or discriminatory by some.
Kraepelin, whose father, Karl Wilhelm, was a former opera singer, music teacher, and later successful story teller, was born in 1856 in Neustrelitz, in the Duchy of Mecklenburg-Strelitz in Germany. He was first introduced to biology by his brother Karl, 10 years older and, later, the director of the Naturhistorisches Museum Hamburg.
Kraepelin began his medical studies in 1874 at the University of Leipzig and completed them at the University of Würzburg (1877–1878). At Leipzig, he studied neuropathology under Paul Flechsig and experimental psychology with Wilhelm Wundt. Kraepelin would be a disciple of Wundt and had a lifelong interest in experimental psychology based on his theories. While there, Kraepelin wrote a prize-winning essay, "The Influence of Acute Illness in the Causation of Mental Disorders".
In Würzburg, he completed his Rigorosum (roughly equivalent to a PhD level viva-voce examination, literally "rigorous exam") in March 1878, his Staatsexamen (licensing examination) in July 1878, and his Approbation (his license to practice medicine; roughly equivalent to an MBBS) on 9 August 1878. From August 1878 to 1882, he worked with Bernhard von Gudden at the Ludwig-Maximilians-Universität München.
Returning to the University of Leipzig in February 1882, he worked in Wilhelm Heinrich Erb's neurology clinic and in Wundt's psychopharmacology laboratory. He completed his habilitation thesis - major postdoc publication and process - at Leipzig; it was entitled "The Place of Psychology in Psychiatry". On 3 December 1883, he completed his umhabilitation (habilitation recognition procedure to obtain a "habilitation" at another institution than originally applied for) at the Ludwig-Maximilians-Universität München.
Kraepelin's major work, Compendium der Psychiatrie: Zum Gebrauche für Studirende und Aerzte (Compendium of Psychiatry: For the Use of Students and Physicians), was first published in 1883 and was expanded in subsequent multivolume editions to Ein Lehrbuch der Psychiatrie (A Textbook: Foundations of Psychiatry and Neuroscience). In it, he argued that psychiatry was a branch of medical science and should be investigated by observation and experimentation like the other natural sciences. He called for research into the physical causes of mental illness, and started to establish the foundations of the modern classification system for mental disorders. Kraepelin proposed that by studying case histories and identifying specific disorders, the progression of mental illness could be predicted, after taking into account individual differences in personality and patient age at the onset of disease.
In 1884, he became senior physician in the Prussian provincial town of Leubus, Silesia Province, and the following year he was appointed director of the Treatment and Nursing Institute in Dresden. On 1 July 1886, at the age of 30, Kraepelin was named Professor of Psychiatry at the Imperial University of Dorpat (today the University of Tartu) in what is today Tartu, Estonia (see Burgmair et al., vol. IV). Four years later, on 5 December 1890, he became department head at the University of Heidelberg, where he remained until 1904. While at Dorpat he became the director of the 80-bed University Clinic, where he began to study and record many clinical histories in detail and "was led to consider the importance of the course of the illness with regard to the classification of mental disorders".
In 1903, Kraepelin moved to Munich to become Professor of Clinical Psychiatry at the Ludwig-Maximilians-Universität München. In 1908, he was elected a member of the Royal Swedish Academy of Sciences. In 1912, at the request of the DVP (Deutscher Verein für Psychiatrie; German Association for Psychiatry), of which he was the head from 1906 to 1920, he began plans to establish a centre for research. Following a large donation from the Jewish German-American banker James Loeb, who had at one time been a patient, and promises of support from "patrons of science", the German Institute for Psychiatric Research was founded in 1917 in Munich. Initially housed in existing hospital buildings, it was maintained by further donations from Loeb and his relatives. In 1924 it came under the auspices of the Kaiser Wilhelm Society for the Advancement of Science. The German-American Rockefeller family's Rockefeller Foundation made a large donation enabling the development of a new dedicated building for the institute along Kraepelin's guidelines, which was officially opened in 1928.
Kraepelin spoke out against the barbarous treatment that was prevalent in the psychiatric asylums of the time, and crusaded against alcohol, capital punishment and the imprisonment rather than treatment of the insane. For the sedation of agitated patients, Kraepelin recommended potassium bromide. He rejected psychoanalytical theories that posited innate or early sexuality as the cause of mental illness, and he rejected philosophical speculation as unscientific. He focused on collecting clinical data and was particularly interested in neuropathology (e.g., diseased tissue).
He also firmly rejected the assumption of natural difference in relation to homosexuality, which he regarded as a vice caused by masturbation. In 1918 he called for "educational discipline": severe punishments for the crime of 'corruption' (seduction), applicable to any act related to sexual gratification. This extended the anti-gay policy of the time, which only punished sexual intercourse between men. These ideas eventually went on to lend legitimacy to Nazi policies that persecuted gay men, allowing the Nazi party to do so under the guise of conforming to scientific opinions. His work legitimized the persecution and inhumane treatment of gay people in Nazi Germany.
In the later period of his career, as a convinced champion of social Darwinism, he actively promoted a policy and research agenda in racial hygiene and eugenics. Kraepelin retired from teaching at the age of 66, spending his remaining years establishing the institute. The ninth and final edition of his Textbook was published in 1927, shortly after his death. It comprised four volumes and was ten times larger than the first edition of 1883. In the last years of his life, Kraepelin was preoccupied with Buddhist teachings and was planning to visit Buddhist shrines at the time of his death, according to his daughter, Antonie Schmidt-Kraepelin.
Theories and classification schemes
Kraepelin announced that he had found a new way of looking at mental illness, referring to the traditional view as "symptomatic" and to his view as "clinical". This turned out to be his paradigm-setting synthesis of the hundreds of mental disorders classified by the 19th century, grouping diseases together based on classification of syndrome—common patterns of symptoms over time—rather than by simple similarity of major symptoms in the manner of his predecessors. Kraepelin described his work in the 5th edition of his textbook as a "decisive step from a symptomatic to a clinical view of insanity. ... The importance of external clinical signs has ... been subordinated to consideration of the conditions of origin, the course, and the terminus which result from individual disorders. Thus, all purely symptomatic categories have disappeared from the nosology".