[Eugen Bleulers propositions to psychiatric treatment].
The historical review of Eugen Bleulers concepts and proposals to treatment in psychiatry, generally and especially for schizophrenia, covers the years between his inaugural lecture 1898 as professor of psychiatry at the University of Zurich to his last edition of his textbook 1937. Already at the beginning of his career as professor in Zurich, he had a very intimate knowledge of psychiatric patients from his 12 years as director of the Mental Hospital Rheinau (near Zurich) where he lived as a bachelor with his patients in the same building. In his inaugural lecture, Bleuler already discussed very practical problems of psychiatric service. e.g. work, employment, marriage, situation in patient's family, housing, occupational therapy etc. Working in the group of other patients should help to re-establish the relationship to the common reality and the society. Psychotherapy for schizophrenics was mentioned in 1911 as the only serious therapy, but was not further elaborated. In 1939, Bleuler was much more sceptical concerning the realistic possibilities of an efficient psychotherapy of schizophrenia. Psychoanalysis would only allow a psychological understanding of some symptoms in schizophrenia but would be unable to contribute to a theory of the underlying pathogenesis. In his view, schizophrenia has its own inherent development. This resignation concerning constructive and efficient therapy dominates his confession even in his last lecture when retiring 1927. Considering the paucity of therapeutic possibilities, Bleuler underlined the importance of prophylactic eugenic strategies.
Möller
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Psychiatrische Universitätsklinik Zürich, Schweiz, Germany. arnulf.moeller@puk.zh.ch
Scharfetter
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D005858:Germany; D049673:History, 20th Century; D011570:Psychiatry / Q000266:history*; D012559:Schizophrenia / Q000266:history