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May 1959

The Pathology of Schizophrenia: A Historical Survey

Author Affiliations

Bethesda, Md.

AMA Arch NeurPsych. 1959;81(5):601-614. doi:10.1001/archneurpsyc.1959.02340170067007

I  "The fact is decisive that the morbid anatomy [of dementia precox] has disclosed not simple inadequacy of the nervous constitution but destructive morbid processes as the background of the clinical picture." This remark of Kraepelin's1 immediately reveals the pronounced neuropathological bias with which schizophrenia was received during the early years of this century.This position on the part of the psychiatrists of the day was, however, not untenable, as Alzheimer2 had by then reported severe changes in the cerebral cortex, with disorganization of the ganglion cells and extensive glial reactions. He described not only swollen nuclei and shrunken neurons, with a frequent falling out of groups of cells, but also proliferative fibrous gliosis and pigmentary changes. He concluded that these changes were responsible for the disturbance in cortical function of these patients.It is worth noting that most of these histopathological descriptions applied to brains of catatonic

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