The Kraepelinian dichotomy: The twin pillars crumbling?

Research output: Contribution to journalReview articlepeer-review


Emil Kraepelin's view that psychotic disorders are naturally-occurring disease entities, and that dementia praecox and manic-depressive psychosis represent two different diseases, has been hugely influential on classificatory systems for psychosis. Corresponding to the Kraepelinian dichotomy, those systems generally differentiated schizophrenia from affective psychosis. This paper examines the debate that took place between 1980 and 2000 regarding this differentiation. During the 1980s, the scientific reliability of the diagnostic criteria was challenged. In the 1990s there were significant critiques of the validity of the Kraepelinian dichotomy. Yet the dichotomy has not been formally abandoned, and the discussion continues to the present day. This paper suggests that before psychiatry can abandon the Kraepelinian dichotomy, a new model for conceptualizing and describing psychotic symptoms may be required.

Original languageEnglish
Pages (from-to)361-379
Number of pages19
JournalHistory of Psychiatry
Issue number3
StatePublished - Sep 2007
Externally publishedYes


  • 20th century
  • Affective disorder
  • Classification
  • Emil Kraepelin
  • Kraepelinian psychiatry
  • Psychosis
  • Schizophrenia

ASJC Scopus subject areas

  • Psychiatry and Mental health


Dive into the research topics of 'The Kraepelinian dichotomy: The twin pillars crumbling?'. Together they form a unique fingerprint.

Cite this