Editing Dementia praecox (section)

===First use of the term===
[[File:Benedict-Augustin Morel (1809–1873).gif|thumb|Benedict Augustin Morel (1809–1873)]]
''[[Dementia]]'' is an ancient term which has been in use since at least the time of [[Lucretius]] in 50 BC where it meant "being out of one's mind".<ref>{{harvnb|Berrios|1996|p=[https://books.google.com/books?id=XSD_ucVR3E8C&pg=PA172 172]}}; {{harvnb|Malgorzata|Maganti|2004|p=2}}; {{harvnb|Bourgeois|2005|p=[https://books.google.com/books?id=PgRbFxayeQwC&pg=PA199 199]}}; {{harvnb|Adams|1997|p=[https://books.google.com/books?id=rMPxSrpr9YUC&pg=PA183 183]}}</ref> Until the seventeenth century, dementia referred to states of cognitive and behavioural deterioration leading to psychosocial incompetence. This condition could be innate or acquired, and the concept had no reference to a necessarily irreversible condition. It is the concept in this popular notion of psychosocial incapacity that forms the basis for the idea of legal incapacity.<ref>{{harvnb|Berrios|1996|p=[https://books.google.com/books?id=XSD_ucVR3E8C&pg=PA172 172]}}; {{harvnb|Berrios|Luque|Villagran|2003|p=116}}</ref> By the eighteenth century, at the period when the term entered into European medical discourse, clinical concepts were added to the vernacular understanding such that dementia was now associated with intellectual deficits arising from any cause and at any age.{{sfn|Berrios|Luque|Villagran|2003|p=116}} By the end of the nineteenth century, the modern 'cognitive paradigm' of dementia was taking root.{{sfn|Burns|2009|pp=199–200}} This holds that dementia is understood in terms of criteria relating to aetiology, age and course which excludes former members of the family of the demented such as adults with acquired head trauma or children with cognitive deficits. Moreover, it was now understood as an irreversible condition and a particular emphasis was placed on memory loss in regard to the deterioration of intellectual functions.{{sfn|Berrios|Luque|Villagran|2003|p=117}}

The term {{lang|fr|démence précoce}} was used in passing to describe the characteristics of a subset of young mental patients by the French physician [[Bénédict Morel|Bénédict Augustin Morel]] in 1852 in the first volume of his {{lang|fr|Études cliniques}}.<ref>{{harvnb|Hoenig|1995|p=337}}; {{harvnb|Boyle|2002|p=46}}. Berrios, Luque and Villagran contend in their 2003 article on schizophrenia that Morel's first use dates to the publication in 1860 of {{lang|fr|Traité des maladies mentales }} ({{harvnb|Berrios|Luque|Villagran|2003|p=117}}; {{harvnb|Morel|1860}}). Dowbiggin inaccurately states that Morel used the term on page 234 of the first volume of his 1852 publication {{lang|fr|Etudes cliniques}} ({{harvnb|Dowbiggin|1996|p=388}}; {{harvnb|Morel|1852|p=[https://books.google.com/books?id=n9hEAAAAcAAJ&pg=PA234 234]}}). On page 235 Morel does refer to {{lang|fr|démence juvénile}} in positing that senility is not an age specific condition and he also remarks that at his clinic he sees almost as many young people experiencing senility as old people ({{harvnb|Morel|1852|p=[https://books.google.com/books?id=n9hEAAAAcAAJ&pg=PA235 235]}}). Also, as Hoenig accurately states, Morel uses the term twice in his 1852 text on pages 282 and 361 ({{harvnb|Hoenig|1995|p=337}}; {{harvnb|Morel|1852|pp=[https://books.google.com/books?id=n9hEAAAAcAAJ&pg=PA282 282], [https://books.google.com/books?id=n9hEAAAAcAAJ&pg=PA361 361]}}). In the first instance the reference is made in relation to young girls of asthenic build who have often also had typhoid. It is a description and not a diagnostic category ({{harvnb|Morel|1852|p=[https://books.google.com/books?id=n9hEAAAAcAAJ&pg=PA282 282]}}). In the next instance the term is used to argue that the illness course for those with mania does not normally terminate in an early form of dementia ({{harvnb|Morel|1852|p=[https://books.google.com/books?id=n9hEAAAAcAAJ&pg=PA361 361]}}).</ref> and the term is used more frequently in his textbook {{lang|fr|Traité des maladies mentales}} which was published in 1860.<ref>{{harvnb|Berrios|Luque|Villagran|2003|p=117}}. The term {{lang|fr|démence précoce}} is used by Morel once in his 1857 text {{lang|fr|Traité des dégénérescence physiques, intellectuelles, et morales de l'espèce humaine}} ({{harvnb|Morel|1857|p=[https://books.google.com/books?id=lu85F4UGpT0C&pg=PA391 391]}}) and seven times in his 1860 book {{lang|fr|Traité des maladies mentales}} ({{harvnb|Morel|1860|pp=[https://books.google.com/books?id=yp8_AAAAcAAJ&pg=PA119 119], [https://books.google.com/books?id=yp8_AAAAcAAJ&pg=PA279 279], [https://books.google.com/books?id=yp8_AAAAcAAJ&pg=PA516 516], [https://books.google.com/books?id=yp8_AAAAcAAJ&pg=PA526 526], [https://books.google.com/books?id=yp8_AAAAcAAJ&pg=PA532 532], [https://books.google.com/books?id=yp8_AAAAcAAJ&pg=PA536 536], [https://books.google.com/books?id=yp8_AAAAcAAJ&pg=PA552 552]}}).</ref> Morel, whose name will be forever associated with religiously inspired concept of [[Social degeneration|degeneration theory]] in psychiatry, used the term in a descriptive sense and not to define a specific and novel diagnostic category. It was applied as a means of setting apart a group of young men and women with "stupor".{{sfn|Dowbiggin|1996|p=388}} As such their condition was characterised by a certain torpor, enervation, and disorder of the will and was related to the diagnostic category of [[melancholia]]. He did not conceptualise their state as irreversible and thus his use of the term dementia was equivalent to that formed in the eighteenth century as outlined above.{{sfn|Berrios|Luque|Villagran|2003|p=118}}

While some have sought to interpret, if in a qualified fashion, the use by Morel of the term {{lang|fr|démence précoce}} as amounting to the discovery of schizophrenia,{{sfn|Dowbiggin|1996|p=388}} others have argued convincingly that Morel's descriptive use of the term should not be considered in any sense as a precursor to Kraepelin's dementia praecox disease concept.{{sfn|Berrios|Luque|Villagran|2003|p=117}} This is due to the fact that their concepts of dementia differed significantly from each other, with Kraepelin employing the more modern sense of the word and that Morel was not describing a diagnostic category. Indeed, until the advent of Pick and Kraepelin, Morel's term had vanished without a trace and there is little evidence to suggest that either Pick or indeed Kraepelin were even aware of Morel's use of the term until long after they had published their own disease concepts bearing the same name.<ref>While Berrios, Luque and Villagran argue this point forcefully ({{harvnb|Berrios|Luque|Villagran|2003|p=117}}), others baldly state that Kraepelin was clearly inspired by Morel's lead. Yet no evidence of this claim is offered. For example, {{harvnb|Stone|2006|p=[https://books.google.com/books?id=bk4IPCprqicC&pg=PA1 1]}}.</ref> As Eugène Minkowski stated, "An abyss separates Morel's {{lang|fr|démence précoce|italics=no}} from that of Kraepelin."<ref>Quoted in {{harvnb|Berrios|Luque|Villagran|2003|p=117}}.</ref>

Morel described several psychotic disorders that ended in dementia, and as a result he may be regarded as the first alienist or psychiatrist to develop a diagnostic system based on presumed outcome rather than on the current presentation of signs and symptoms. Morel, however, did not conduct any long-term or [[quantitative research]] on the course and outcome of dementia praecox (Kraepelin would be the first in history to do that) so this prognosis was based on speculation. It is impossible to discern whether the condition briefly described by Morel was equivalent to the disorder later called dementia praecox by Pick and Kraepelin.