PSYCHIATRY IN POST-WAR GERMANY

Even a brief report of the development of German psychiatry since 1945 should not omit a reference to a dominant tradition, characterized by the names of Kraepelin and Jaspers. Last year we celebrated the centennial of Kraepelin. On this occasion a great deal was written about the significance of his ideas in our time. We no longer share Kraepelin’s conception of human nature. We have lost interest in the nuances of his differentiation of various forms of insanity and, by the way, Kraepelin’s schema of the non-psychotic mental abnormalities has never been accepted. On the other hand, the diagnostic classification of the so-called endogenous psychoses, dividing them into the two groups of dementia praecox-now, following E. Bleuler, called the schizophrenias-and manic-depressive insanity-now called cyklothymia-is still widely accepted. Atypical forms as well as borderline cases were also known to Kraepelin. However, he doubted the occurrence of “real transitions” and believed firmly in the basic differences between these pathological processes. In relation to this problem our views over there are not as divergent as may appear at first glance. Kleist assumes two main groups; he distinguishes “phasic diseases” and “deteriorating diseases” (the schizophrenias), dividing them into about 40 subgroups to which he assigns atypical and intermediate cases. Kretschmer speaks about constitutional and hereditary spheres (schizothymcyklothym) which, just as they overlap in the area of the normal, may also be mixed in the area of character disorders and of psychoses. Therefore, Kretschmer postulates that atypical cases and intermediate forms which are transitional from schizophrenia to the manic-depressive should be considered as “genuine biological alloys.” K. Schneider rejects this assumption: to him such cases are