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  1. Home
  2. Issue 1968/1
  3. De waarde van het begrip 'degeneratie' in ...
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De waarde van het begrip 'degeneratie' in de hedendaagse psychiatrie

Th.B. Kraft
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On the basis of some case histories of patients with so-called 'Wahnhaf te Einbildungen' (deluded notions) or 'Einfiille' (caprices) a historical review is given of the concept of mental degeneration, beginning with Morel (1859). From studies by Ziehen, Binswanger, Stransky and — recently — Riimke, a review is given of what might be understood by mental stigmata of degeneration, with the reserve that such disturbances might also be explained otherwise (toxic, neurophysiological or biochemical factors). It appears that somatic 'stigmata of degeneration' definitely cannot be related to these mental changes. Attention is drawn to the Pact that in the earlier French and German literature the concept of degeneration is used in a much too wide sense and was moreover, confused with 'psychopathic' so that it acquired too depreciative overtones and became discredited. It is thought that the concept of degeneration, used by Dutch psychiatrists especially in the diagnosis of so-called degenerative hysteria and degenerative psychosis, should only be used if there is a serious hereditary affection with psychiatric disorders. A distinction — albeit somewhat speculative — should be made between the concepts of constitutionally abnormal (possibly an incorrect combination of genes) and degeneratively abnormal (possibly in the descendants). Riimke recently proposed introducing the term of genetic minus variant instead of 'degenerative'. The interesting phenomenon of 'Wahnhaf te Einfdlle der Degenerierten' phenomenologically an intermediate stage between 'delusion' and 'compulsion' is illustrated with the example of a woman of 30 with a 'delire de toucher' of sudden onset. This case illustrated that — as usual in modern psychiatry — many conditions help in determining the clinical picture: psychogenic, somatogenic and sociogenic factors in addition to hereditary traits.
This study does not offer anything new, but draws attention to a psychiatric view that may have been overstressed formerly but still has retained some value. It should be mentioned that in Anglo-Saxon countries this is not, or not sufficiently, taken into account in diagnostic considerations.

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Dit artikel is onderdeel van: Editie 1968/1
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