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Was Bleuler Right? - or the Perils of Procrastination

The Letter, Issue 40, Spring 2009, Pages 33 - 41


Was Bleuler Right? - or the Perils of Procrastination

Eadbhard O’Callaghan and Nicolas Ramperti


This article employs recent empirical data to confirm Eugen Bleuler’s view that delays between the appearance of psychotic symptoms and treatment are harmful. It also bears out Bleuler’s less ominous view of Kraepelin’s dementia praecox by demonstrating that when delays are reduced patients are less unwell.

Keywords: Bleuler; first-episode psychosis; early intervention; treatment

“The sooner the patients can be restored to an earlier life and the less they are allowed to withdraw into the world of their own ideas, the sooner do they become socially functional” (Eugen Bleuler, 1908).[1]

Emil Kraepelin distinguished manic-depressive psychosis from dementia praecox on the basis that those with manic depression had a later onset, and that people usually recovered between episodes, whereas those with dementia praecox followed an essentially downhill course. Some years later, Eugen Bleuler renamed dementia praecox by introducing the concept of “the group of Schizophrenias”. This was noteworthy because Bleuler did not consider Kraepelin’s dementia praecox to be a single condition, but rather a group of disorders whose final common pathway was psychotic symptoms.

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