Paraphrenia: The modernity of Kraepelin's thinking

Paraphrenia is a chronic psychotic disorder similar to paranoid schizophrenia, but with a better-preserved affect and rapport, and a much less personality deterioration. It was at first described by Kraepelin in 1913 as a group of patients who exhibited delusional symptoms typical of dementia praecox, but with minimal disturbances of emotion and volition. After the publication of Mayer-Gross's report in 1921, the view to differentiate paraphrenia from schizophrenia was considered to be unfounded and the term " paraphrenia" was not included in the current DSM-IV-TR and ICD-10 diagnostic criteria. Consequently, this disorder is now diagnosed relatively infrequently. However, several authors have recently suggested that the paraphrenia concept has not lost its usefulness. It seems to be that many psychiatrists recognize the illness, but labelled it as "atypical psychosis", "schizoaffective disorder" or "psychotic disorder not otherwise specified" for the lack of a better diagnostic category. Very few systematic studies on paraphrenia have been conducted in the past 70 years. Aim of this article is to underline the modernity of Kraepelin's thinking and his "paraphrenia" concept, suggesting that it could be possible to define and recognize the illness if practitioners would be induced to use a viable diagnostic entity.