Skip to main content

30% Off New Releases: Explore the List

Harvard University Press - home
American Madness

American Madness

The Rise and Fall of Dementia Praecox

Richard Noll

ISBN 9780674047396

Publication date: 11/28/2011

In 1895 there was not a single case of dementia praecox reported in the United States. By 1912 there were tens of thousands of people with this diagnosis locked up in asylums, hospitals, and jails. By 1927 it was fading away . How could such a terrible disease be discovered, affect so many lives, and then turn out to be something else?

In vivid detail, Richard Noll describes how the discovery of this mysterious disorder gave hope to the overworked asylum doctors that they could at last explain—though they could not cure—the miserable patients surrounding them. The story of dementia praecox, and its eventual replacement by the new concept of schizophrenia, also reveals how asylum physicians fought for their own respectability. If what they were observing was a disease, then this biological reality was amenable to scientific research. In the early twentieth century, dementia praecox was psychiatry’s key into an increasingly science-focused medical profession.

But for the moment, nothing could be done to help the sufferers. When the concept of schizophrenia offered a fresh understanding of this disorder, and hope for a cure, psychiatry abandoned the old disease for the new. In this dramatic story of a vanished diagnosis, Noll shows the co-dependency between a disease and the scientific status of the profession that treats it. The ghost of dementia praecox haunts today’s debates about the latest generation of psychiatric disorders.


  • Between 1895 and the 1930s, tens of thousands of Americans were diagnosed with dementia praecox—an ‘incurable’ psychosis described by German psychiatrist Emil Kraepelin. The diagnoses then petered out. Psychologist Richard Noll traces the trajectory of this near-forgotten disorder, showing how it became the first specified disease of psychiatry, legitimizing that field’s place in medicine. Noll also shows how the debates today around the successor to dementia praecox, schizophrenia, are leading to a trend in psychiatry towards diagnoses that could fit better with genetics.



  • 2012, Winner of the Cheiron Book Prize


  • Richard Noll is Associate Professor of Psychology at DeSales University.

Book Details

  • 408 pages
  • 6-1/8 x 9-1/4 inches
  • Harvard University Press