Heinz Häfner
In memory of

Heinz Häfner
Universität Heidelberg · Faculty of Medicine Mannheim

Prof. Dr. Dr. h.c. mult.

About

563
Publications
42,308
Reads
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14,908
Citations
Introduction
ABC-Schizophrenia Study: Definition and dissection of the prodromal stage Distribution of schizophrenia onsets over the life-cycle A sensitivity-reducing effect of oestrogen on D2 receptors in animal experiments Oestrogen effect on symptomatology in a controlled clinical trial A biological balance between strength of genetic predisposition and protective effect of oestrogen Consequences of schizophrenia onset in comparison with depressed patients and healthy controls
Additional affiliations
April 1975 - present
Universität Heidelberg
Position
  • Professor emeritus, Dr. med. Dres. h.c.
Description
  • Prof. of Social Psychiatry (Univ. of Heidelberg), 1964; Full Prof. of Psychiatry (Univ.of Heidelberg) since 1968; Founder /Director of the CIMH, 1975-1994; Prof. emer. and Head of Schizophrenia Research Unit since Oct 1st, 1994
April 1975 - May 2012
Central Institute of Mental Health
Position
  • Psychiatric Epidemiology (SFB 116); Explaining Models of Mental Disorder (SFB 258); ABC-Schizophrenia Study
Description
  • Vice-Chairman of two Special Research Branches (SFB) for 25 years; Speaker of the German Research Network on Schizophrenia (GRNS) Sub-Network I: Early Recognition and Intervention; Head, CIMH Schizophrenia Research Unit since 1994
Education
May 1944 - August 1951
University of Munich
Field of study
  • Medicine (M.D.), Psychology and Philosophy (Ph.D.)

Publications

Publications (563)
Article
Full-text available
Aim: Validation of Van Kampen's Schizotypic Syndrome Questionnaire (SSQ) model of schizophrenic pro-dromal unfolding. The SSQ model comprises 12 negative, asocial and psychotic-like symptoms that are hypothesized to determine each other in terms of cause and effect. Method: Use was made of the Interview for the Retrospective Assessment of the Onset...
Article
Full-text available
Aim: Psychological interventions, such as cognitive behavioural therapy (CBT) and supportive counselling (SC), are used to treat people with schizophrenia and people at clinical high risk (CHR) of psychosis. However, little information is available on predictors of treatment response. This study aims to identify such predictors of psychological in...
Article
Full-text available
Depressive symptoms abound in schizophrenia and even in subclinical states of the disorder. We studied the frequency of these symptoms and their relationship to negative symptoms from the first psychotic episode on over a long-term course of 134 months on data for 107 patients in our ABC Schizophrenia Study. Prevalence rates of 90 % for presenting...
Article
Background The German Research Network on Schizophrenia (GRNS) was funded by the Federal Ministry of Education and Research (BMBF) from 1999 to 2011. The aim was to obtain a better horizontal and vertical networking of German research and care facilities on schizophrenia, in order to investigate open research questions, to transfer the results into...
Article
Aim: Functional disability and social consequences frequently occur at the prodromal stage of schizophrenia. Efforts to recognize an increasing risk of psychosis onset have thus become a topical issue worldwide. This is to introduce the English version of the ERIraos early-recognition inventory. Methods: The ERIraos, developed in a systematic, e...
Article
Investigate whether treatment response in people at clinical high risk of psychosis (CHR) is predicted by their cognitive performance. 128 CHR outpatients were randomized into two treatment groups, one receiving integrated psychological intervention (IPI), including psychoeducation, the other receiving supportive counselling (SC) for 12 months. Mul...
Article
Since about 1965 fertility rates in the general population have kept decreasing in Germany. We studies whether fertility rates for patients with schizophrenia decreased in parallel with, more slowly or more rapidly than those for the general population. After finding differences, we explored the underlying reasons. We conducted three subsequent stu...
Article
Most neuropsychological studies on schizophrenia suffer from sample selection bias, with male and chronic patients being overrepresented. This probably leads to an overestimation of cognitive impairments. The present study aimed to provide a less biased estimate of cognitive functions in schizophrenia using a population-representative catchment are...
Article
In the royal drama of 1886 King Ludwig II of Bavaria drowned himself, after drowning Prof. von Gudden, who had tried to hold him back from suicide. The psychiatrist had laid the foundation of the king's dethronement, legal incapacitation and psychiatric internment with the incorrect psychiatric assessment he had been commissioned to deliver. The sc...
Article
We studied a population-based sample of 232 first-onset cases of schizophrenia aged 12 to 59 years at first admission retrospectively back to illness onset and prospectively up to 11.2 years later. We compared them with psychiatrically healthy age- and sex-matched population controls and equally matched first-admission patients diagnosed with major...
Article
In the present study we set out to explore the long-term clinical course of schizophrenia in a holistic manner by adopting sequence analysis. Our aim was to identify course types of illness by means of cluster analysis. The study was based on course and outcome data for 107 patients followed up over 134 months after first admission in the ABC Schiz...
Article
Full-text available
With his early publications (1910-1913), Karl Jaspers created a comprehensive methodological arsenal for psychiatry, thus laying the foundation for descriptive psychopathology. Following Edmund Husserl, the founder of philosophical phenomenology, Jaspers introduced phenomenology into psychopathology as "static understanding," ie, the unprejudiced i...
Article
In der Geschichte der Medizin hat kein Ereignis das Schicksal der Kranken und die psychiatrische Versorgung so einschneidend verbessert wie die Psychiatrie-Enquête der Bundesrepublik Deutschland in den jahren von 1971 bis 1975. Dieser radikalen Reform ging der Übergang von der Wegsperrtradition der europäischen Wohlfahrtspolitik zum medizinischen M...
Article
Full-text available
After over 100 years of research without clarifying the aetiology of schizophrenia, a look at the current state of knowledge in epidemiology, genetics, precursors, psychpathology, and outcome seems worthwhile. The disease concept, created by Kraepelin and modified by Bleuler, has a varied history. Today, schizophrenia is considered a polygenic diso...
Article
Full-text available
The ERIraos Checklist (CL) is a screening instrument for assessing psychosis risk. Measuring CL data on a Rasch scale means that this scale locates individuals on a dimension of “proximity to psychosis onset” according to their current prodromal status. The probabilistic Rasch model leads to interval (difference) scales. The CL data from the German...
Article
Full-text available
Objectives: Screening questionnaires are often used at first-contact with psychiatric services to identify, among those displaying psychological distress, those who need more in-depth assessment. The Early Recognition Inventory for the retrospective assessment of the Onset of Schizophrenia Checklist (ERIraos-CL) may be a useful tool to prompt furth...
Article
The German Research Network on Schizophrenia (GRNS) was funded by the Federal Ministry of Education and Research (BMBF) from 1999 to 2011. The objectives and the structure of the network with its horizontal and vertical networking of German research and care facilities served for the scientific investigation of open research questions for schizophr...
Article
Im Jahr 1913 hat Karl Jaspers mit der ,,Allgemeinen Psychopathologie“ der Psychiatrie erstmals eine umfassende methodisch-systematische Grundlage geschaffen. In Anlehnung an den Begründer der philosophischen Phänomenologie, Edmund Husserl, führte Jaspers die unvoreingenommene Vergegenwärtigung bewusster Phänomene als ,,statisches Verstehen“ ein. Vo...
Article
With his "Allgemeine Psychopathologie" (general psychopathology) published in 1913, Karl Jaspers laid a comprehensive methodological and systematic foundation in psychiatry. Following Edmund Husserl, the founder of philosophical phenomenology, Jaspers introduced "static understanding" into psychopathology, i.e. the unprejudiced reproduction of cons...
Article
The deaths of King Ludwig II of Bavaria and Bernhard von Gudden, Professor of Psychiatry in Munich, in Lake Starnberg near Munich on 13 June 1886 have often been mentioned in the psychiatric-historical literature and in fiction. Von Gudden had written a psychiatric assessment of the King, rating him permanently mentally ill and incapable of reignin...
Article
Full-text available
The underlying structures of clinical caseness and need of care in prodromal (i.e., at-risk) and early phases of schizophrenia remain poorly characterized in their essential psycho-behavioral coherence. To identify the schizophrenia proneness-related subtypes within a population of young help-seekers referred to a dedicated, community-based early d...
Article
Background: The ABC schizophrenia study conducted by the same team over 25 years initially aimed at illuminating the onset, prodromal stage and sex differences in age at first hospitalization in schizophrenia. New hypotheses were systematically generated from the results achieved. Methods: A population-based sample of 276 first admission cases (...
Article
Purpose The ABC Schizophrenia study, led by a single research team, investigated a schizophrenia sample systematically over quarter of a century. This paper summarises results from 1996 onwards. The initial goals were to explain the considerably higher age at first admission in women, and to obtain precise information on the onset and early course...
Article
Science is a quintessential human social activity, basedas it is on the mutual criticism of collaborating agents.Communication lies at its heart, and advances in commu-nication have always resulted in surges in scientificknowledge. The establishment of networks of scholarsallowed the rapid transmission of information—only a fewmonths lay between Lip...
Article
Serotonergic transmission is considered relevant in the pathophysiology and the treatment of schizophrenia. Tryptophan hydroxylase (TPH) is the rate limiting enzyme in the biosynthesis of serotonin. While the TPH1 gene has been found to be associated with schizophrenia, studies focusing on TPH2 variants did not yield conclusive results for schizoph...
Book
Mit Unterstützung der Robert Bosch Stiftung behandelte die Heidelberger Akademie das Thema „Alter und Altern“ in einer Reihe von drei wissenschaftlichen Kolloquien. Das erste zur umfassenden Frage „Was ist Alter?“ fand 2006 statt, das zweite, das den Naturwissenschaften einschließlich der Medizin und den Technikwissenschaften gewidmet war, folgte 2...
Chapter
Die Einladung, einen persönlichen Beitrag zu einem »Viele-Leute-Buch« zu leisten, um den Lesern zu zeigen, welch unterschiedliche Menschen den Beruf des Psychiaters gewählt und ausgeübt haben, löst erst einmal Verlegenheit aus. Ein Bericht über das eigene Leben ist bei meiner zwei Generationen überschreitenden Berufsbiographie auf ein paar Seiten s...
Article
Full-text available
Recently, the neuropeptide S (NPS) neurotransmitter system has been identified as a promising psychopharmacological drug target given that NPS has shown anxiolytic-like and stress-reducing properties and memory-enhancing effects in rodent models. NPS binds to the G-protein-coupled receptor encoded by the neuropeptide S receptor gene (NPSR1). A func...
Article
Young people with self-experienced cognitive thought and perception deficits (basic symptoms) may present with an early initial prodromal state (EIPS) of psychosis in which most of the disability and neurobiological deficits of schizophrenia have not yet occurred. To investigate the effects of an integrated psychological intervention (IPI), combini...
Article
Mutations in postsynaptic scaffolding genes contribute to autism, thus suggesting a role in pathological processes in neurodevelopment. Recently, two de novo mutations in SHANK3 were described in schizophrenia patients. In most cases, abnormal SHANK3 genotype was also accompanied by cognitive disruptions. The present study queries whether common SH...
Chapter
Under the contemporary conditions of mental health care first contact with mental health services of persons falling ill with schizophrenia is usually precipitated by the dramatic symptoms of the first psychotic episode. In most cases this event is preceded by an extended period of a more or less rapid accumulation of non-specific, negative and, fi...
Chapter
Akut, d.h. innerhalb eines Monats ab Krankheitsausbruch, entwickeln sich nur 18% der schizophrenen Erkrankungen in unserer Bevölkerung. In den meisten Fällen handelt es sich dabei um den Ausbruch einer akuten Psychose, bei der die psychotischen oder positiven Symptome wie Wahn, Halluzinationen und Denkstörungen allerdings auch von rasch zunehmenden...
Article
Asking whether E. Kraepelin's early dementia praecox and disease concepts (1896) are still valid today, we condensed his early theory into four theses:1) schizophrenia is a disease entity, distinguishable from affective psychosis. 2) It is caused by a specific neuropathology. 3) It usually manifests itself in adolescence or early adulthood. 4) Unde...
Article
Even today the deaths of King Ludwig II of Bavaria and the Munich-based psychiatrist Bernhard von Gudden on 13 June 1886 remain something of a mystery. In his psychiatric expertise von Gudden had rated Ludwig as insane and incapable of governing. Ludwig was placed under tutelage, deposed and interned under the supervision of guards. After the catas...
Article
Even today the deaths of King Ludwig II of Bavaria and the Munich-based psychiatrist Bernhard von Gudden on 13 June 1886 remain something of a mystery. In his psychiatric expertise von Gudden had rated Ludwig as insane and incapable of governing. Ludwig was placed under tutelage, deposed and interned under the supervision of guards. After the catas...
Chapter
Affective symptoms, depression in particular, show high rates in schizophrenia. When occurring in combination with subclinical psychotic symptoms they are precursors of psychosis risk. Their increase over time is associated with an increase in psychosis risk and their decrease with a fall therein. The prodromal stage of severe depression and the pr...
Article
Background: Recently, a role of the transcription factor 4 (TCF4) gene in schizophrenia has been reported in a large genome-wide association study. It has been hypothesized that TCF4 affects normal brain development and TCF4 has been related to different forms of neurodevelopmental disorders. Schizophrenia patients exhibit strong impairments of ve...
Article
Background Aim was to evaluate influencing factors of response and symptomatic remission in first-episode schizophrenia patients treated with risperidone or haloperidol. Methods 229 first-episode schizophrenic patients were examined within a double blind controlled trial of the German Study Group on first-episode schizophrenia with biweekly PANSS...
Article
Background and Objectives: Testing Kraepelin´s dichotomy model, we studied the separability of schizophrenia and affective disorders by their symptoms and course. Methods: To this end symptoms and illness course were assessed retrospectively in individually matched untreated probands with schizophrenia and depression (n=130 each) from first admissi...
Article
Full-text available
Early improvement with treatment is thought to be important in patients with first-episode schizophrenia, yet a valid definition is still outstanding. To develop a valid definition of early improvement and test its predictive validity regarding response and remission. We examined 188 in-patients with first-episode schizophrenia. Early improvement w...
Article
Torrey and Yolken wonder whether the killing of mentally ill persons in Nazi Germany reduced the risk for schizophrenia in the following generation. Epidemiological data from Germany do not permit reliable comparisons. Torrey and Yolken point out that horrible crime is still only little known. Strous and several contributors on the Schizophrenia Re...
Article
Sustained attention as measured by the Continuous Performance Test (CPT) has proved a valuable endophenotype for schizophrenia. Recently pharmacological studies suggested a role of the serotonin (5-HT) 3 receptor in schizophrenia. The 5-HT3 receptors are the only ligand-gated ion channels within the 5-HT receptor family. Applying an endophenotype a...
Chapter
Der junge Kraepelin hat auf der Grundlage kategorial definierter Krankheitseinheiten das Dichotomiemodell der funktionellen Psychosen präsentiert. Im Zuge der Entwicklung von DSM-V und ICD-11 stellen wir dieses Paradigma durch die Untersuchung der Häufigkeit und Abfolge der Syndrome Depression, Psychose, Manie und Negativsymptomatik in zwei Verlauf...
Book
Die Wiedergründung der Heidelberger Akademie der Wissenschaften jährte sich 2009 zum hundertsten Mal. Aus diesem Anlass veranstaltete unsere Landesakademie jeweils gemeinsam mit den acht Universitäten Baden-Württembergs Tagungen oder Vortragsreihen. Das Symposium „Altern gestalten – Medizin, Technik, Umwelt“, dessen systematisch geordnete Beiträge...
Article
Validation of Van Kampen's Schizotypic Syndrome Questionnaire (SSQ) model of schizophrenic prodromal unfolding. The SSQ model comprises 12 negative, asocial and psychotic-like symptoms that are hypothesized to determine each other in terms of cause and effect. Use was made of the Interview for the Retrospective Assessment of the Onset of Schizophre...
Article
In recent years, evidence has been accumulating indicating a major role of glutamate in the pathogenesis and pathophysiology of schizophrenia. Of particular importance in this regard are the metabotropic glutamate receptors (GRM). Thus, a recently published trial of the amino acid analogue LY2140023, which exerts its effects through the activation...
Article
We tested Kraepelin's dichotomy model by studying the separability of schizophrenia and depression on the basis of symptoms and illness course. Matched untreated patients with schizophrenia and depression (n = 130 each) and 130 "healthy" controls were assessed from onset to first admission. In a second study the same variables were studied in 107 p...
Article
Objective We tested Kraepelin’s dichotomy model by studying the separability of schizophrenia and depression on the basis of symptoms and illness course. Materials and methods Matched untreated patients with schizophrenia and depression (n = 130 each) and 130 “healthy” controls were assessed from onset to first admission. In a second study the same...
Chapter
Schizophrenia as a Secondary DisorderSubstance Misuse as a Secondary DisorderCausation by a Third Common FactorClarification Through Assessment of the Temporal SequenceTemporal Order in a Representative First-Episode SampleReferences
Chapter
Full-text available
Der vorliegende Band ist das Ergebnis eines Symposiums zum Thema „Was ist Alter?“, das im November 2006 in Heidelberg stattgefunden hat. Mit dieser Konferenz wollte die Heidelberger Akademie der Wissenschaften, mit Unterst ützung der Robert Bosch Stiftung, sich einmischen in die gegenwärtige, meist einseitig auf begrenzte Problemfelder fokussierte...
Chapter
State-of-the-art knowledge on the course and outcome of schizophrenia is reviewed from an epidemiological point of view. A systematic overview of the methodological prerequisites for longitudinal studies is followed by a discussion of current results on the stages of schizophrenia, ranging from risk factors, early prognostic indicators, prepsychoti...
Book
Das Thema Alter und Altern mit seinen vielfältigen Aspekten, von der kontinuierlichen Zunahme der mittleren Lebenserwartung seit 1850 um etwa 3 Monate pro Jahr und der erheblichen Abnahme der Fortpflanzungshäufigkeit bis zur Gefährdung des Generationenvertrags und der Altersversorgung jüngerer Jahrgänge, wird seit einigen Jahren, wenn auch mit beac...
Article
People in a putatively late prodromal state not only have an enhanced risk for psychosis but already suffer from mental and functional disturbances. To evaluate the acute effects of a combined supportive and antipsychotic treatment on prodromal symptoms. Putatively prodromal individuals were randomly assigned to a needs-focused intervention without...
Article
Second-generation antipsychotics (SGAs) have proven superior to first-generation antipsychotics regarding relapse prevention, mainly in multiple-episode patients. Practice guidelines recommend SGAs as first-line treatment particularly in first-episode patients, although evidence for this group is still limited. Accordingly, the hypothesis of whethe...
Chapter
IntroductionMethodological aspects of course and outcome researchComorbidity with alcohol and drug abuseLong-term course of schizophreniaQuality of life
Article
The evaluation of intra- and extramural psychiatric care nowadays calls for new models and methods of services research as the transition from custodial to community mental health care results in patterns of utilization of high complexity. Not only the capacity and the components of the care system has changed considerable but also the composition...
Article
The development of a comprehensive community mental health service in Mannheim, a West-German industrial city, is evaluated on an epidemiological basis with the data recorded by the case register of the Central Institute for Mental Health. The initial bed rate of 1.5 beds per 1,000 population was comparably low. In spite of an increase in hospital...
Article
To analyse what psychotic, depressive and manic syndromes have in common and what separates them, we compared 130 population-based first-admission cases of schizophrenia and depression from illness onset until first admission and 130 "healthy" controls. We also studied 107 first-episode cases of schizophrenia over 11.2 years. Illness onset in depre...
Article
To analyse what psychotic, depressive and manic syndromes have in common and what separates them, we compared 130 population-based first-admission cases of schizophrenia and depression from illness onset until first admission and 130 "healthy” controls. We also studied 107 first-episode cases of schizophrenia over 11.2 years. Illness onset in depre...
Article
Efforts to achieve early detection of and timely intervention in incipient psychotic conditions are characteristic of an extremely innovative area of schizophrenia research over the last ten years or more. Within the Competency Network on Schizophrenia, the Early Recognition Inventory, ERIraos was developed and tested with the aim of identifying pe...
Article
Schizophrenia may follow a course of amelioration, deterioration or stability. It is possible that deterioration at the aggregate level may be due to a sub-group of patients with a tendency to deteriorate. To examine the course of schizophrenia in a national population-based cohort. All first admissions for schizophrenia in Israel 1978-1986 were fo...
Article
Lange bevor die Patienten in die psychotische Phase einer Schizophrenie eintauchen, gibt es Hinweise auf diese Entwicklung. Ein Zweistufenprogramm soll künftig Hausärzten und Spezialisten helfen, die Warnzeichen richtig zu interpretieren. So kann schon in der Prodromalphase versucht werden, den Krankheitsverlauf positiv zu beeinflussen.
Chapter
Die Diagnose einer Psychose oder einer Schizophrenie hat dann Einfluss auf die Geschlechtsverteilung des Krankheitsrisikos, wenn sie Kriterien enthalt, die ungleich uber die beiden Geschlechter verteilt sind. Studien auf der Grundlage der Feighner-Kriterien (Feighner et al. 1972) wie Alter bis zu 40 Jahren oder DSM-III-Diagnosen (APA 1980) mit der...
Article
Detection of those at risk for the development of schizophrenia would enable early intervention in psychosis. Prerequisites for early detection include factors such as public awareness and knowledge of psychotic disorders but also the availability of suitable early-intervention treatment facilities. A further precondition is the existence of reliab...
Article
Despite suggestions that an earlier age of onset and being male confer to a poorer course of schizophrenia, evidence regarding when these effects are most salient appears to be ambiguous. To examine the relationship of age of first hospitalization and sex with the course of hospitalization in a population based cohort. All first admissions for schi...
Article
RESEARCH INTO THE EARLY COURSE OF SCHIZOPHRENIA HAS IDENTIFIED A PREPSYCHOTIC PRODROMAL STAGE (MEAN DURATION: 4.8 years) and a psychotic prephase (mean duration: 1.3 years). Comparisons of individually matched samples have demonstrated prodromal symptoms common to schizophrenia and moderate to severe depression. It is not until positive symptoms em...