title: Kraepelin's views on obsessive neurosis: a comparison with DSM-5 criteria for obsessive-compulsive disorder.
abstract: Emil Kraepelin (1856-1926) is considered one of the founders of modern psychiatric nosology. However, his conceptualization of obsessive-compulsive phenomena is relatively understudied. In this article, we compare and contrast excerpts from the eighth edition (1909-1915) of Kraepelin's Textbook of Clinical Psychiatry focusing on what Kraepelin called "obsessive neurosis" and related "original pathological conditions" with the current DSM-5 criteria for obsessive-compulsive disorder (OCD). Consistently with DSM-5 OCD, Kraepelin described obsessive neurosis as characterized by obsessive ideas, compulsive acts, or both together. His detailed descriptions of these symptoms are broadly coherent with their characterization in DSM-5, which is also true for the differential diagnoses he provided. He also mentioned cases illustrating decreased insight into symptoms and association with tic disorders. In conclusion, Kraepelin's experience, which reflects decades of consistent clinical work, may help validate current ideas and explain how the current conceptualization has emerged and developed. Even though one can hardly say that the classification laid out in DSM-5 goes back to Kraepelin's views directly, it still is true that Kraepelin played an outstanding role in systematizing psychiatric diagnostic criteria in general, and provided a major contribution to the conceptual history of OCD.
authors.affiliation: Archives for the History of Psychiatry in Leipzig, Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany.
authors.forename: Holger
authors.initials: H
authors.lastname: Steinberg
authors.affiliation: Archives for the History of Psychiatry in Leipzig, Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany.
authors.forename: Dirk
authors.initials: D
authors.lastname: Carius
authors.affiliation: Programa de Ansiedade, Obsessões e Compulsões, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil.|Instituto D'Or de Pesquisa e Ensino (IDOR), Rio de Janeiro, RJ, Brazil.|MONASH Institute of Cognitive and Clinical Neurosciences, MONASH University, Melbourne, Australia.
authors.forename: Leonardo F
authors.initials: LF
authors.lastname: Fontenelle
mesh_terms: D003937:Diagnosis, Differential; D039721:Diagnostic and Statistical Manual of Mental Disorders; D049673:History, 20th Century; D006801:Humans; D038801:International Classification of Diseases; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis* / Q000266:history; D013782:Textbooks as Topic / Q000266:history