Marc De Hert

KU Leuven | ku leuven · Department of Neurosciences

Metabolic syndrome (MetS) and its components are highly predictive of cardiovascular diseases. The primary aim of this systematic review and meta-analysis was to assess the prevalence of MetS and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder, comparing subjects with diffe...

Background and Hypothesis: Psychosis-related environmental risks are common in autism, with identified genetic connections to psychosis. Therefore, we hypothesized these risks may moderate the relationship between autistic traits (ATs) and psychotic experiences (PEs). Study Design: First-wave data from 792 twins and siblings in the TwinssCan Projec...

Background Previous studies assessing the hypothesis that the construct of ‘aberrant salience’ is associated with psychosis and psychotic symptoms showed conflicting results. For this reason, the association between measures to index aberrant salience and subclinical psychotic symptoms in a general population sample was analysed. In addition, genet...

Background Mood disorders involve a complex interplay between multifaceted internal emotional states, and complex external inputs. Dynamical systems theory suggests that this interplay between aspects of moods and environmental stimuli may hence determine key psychopathological features of mood disorders, including the stability of mood states, the...

Homelessness in psychiatric patients in Flanders, Belgium, has never been investigated. Advocacy groups from patients with lived experience of psychiatric disorders have sounded the alarm on the scarcity of suitable housing options, the strain on psychiatric institutions, and the challenges faced by social service workers. To investigate the extent...

Despite the evidence that no other antipsychotic is effective as clozapine for the treatment of resistant schizophrenia, it is associated with various metabolic, neuroendocrine, cardiovascular, and gastrointestinal adverse effects. Guidelines aiming to address the monitoring of clozapine’s (serious) adverse effects can be helpful to prevent and tre...

Background Professional associations have traditionally been important to the specialization process and identity of medical specialists. Psychiatry and neurology share common origins in the 19th century and subsequently went through a major evolution. However, relatively little is known about the role of neuropsychiatric associations. Aim To provi...

Objectives: Self-esteem and self-esteem stability are important factors during adolescence and young adulthood that can be negatively impacted by childhood adversity and psychiatric symptoms. We examined whether childhood adversity and psychiatric symptoms are associated with decreased global self-esteem as well as increased self-esteem instabilit...

Purpose Adolescents and young adults are at high risk for experiencing loneliness, a well-established risk factor for mental health symptoms. Previous cross-sectional studies show an inverse association between loneliness and physical activity. The causality and directionality of this association remains unclear as longitudinal and interventional s...

Purpose To explore gender differences of the associations between childhood adversity (CA) subtypes and psychiatric symptoms in the general population. Methods Data of 791 participants were retrieved from a general population twin cohort. The Symptom Checklist-90 Revised (SCL-90) and the Childhood Trauma Questionnaire were used to assess overall p...

The present study examines whether neuroticism is predicted by genetic vulnerability, summarized as polygenic risk score for neuroticism (PRS N ), in interaction with bullying, parental bonding, and childhood adversity. Data were derived from a general population adolescent and young adult twin cohort. The final sample consisted of 202 monozygotic...

Introduction There is an urgent need for sustainable thinking and practices in healthcare systems to meet the challenge of climate change (Charlesworth & Jamieson, 2019; Corvalan et al., 2020; Luykx & Voetterl, 2022; Madden et al., 2020). This need is accelerated by the recent energy crisis. According to an international NGO policy paper (Karliner...

Introduction Prior evidence suggests that men and women might be differentially susceptible to distinct types of childhood adversity (CA), but research on gender-specific associations between CA subtypes and psychiatric symptoms is limited. Objectives To test the gender-specific associations of CA subtypes and psychiatric symptoms in the general p...

Introduction Neuroticism has societal, mental and physical health relevance, with an etiology involving genetic predisposition, psychological influence, and their interaction. Objectives To understand whether the association between polygenic risk score for neuroticism (PRS-N) and neuroticism is moderated by affective well-being. Methods Data wer...

The bidirectional relationship between poverty and poor physical and mental health is well-known. All physicians should have sufficient knowledge on poverty as a social determinant and its impact on (mental) health. The knowledge of poverty in physicians is seldom investigated. An online and paper survey was circulated in March/April 2022 in Belgiu...

Achtergrond De Vlaamse en de Nederlandse (geestelijke) gezondheidszorg (ggz) veroorzaken uitstoot van broeikasgassen en zul-len daarom een inspanning moeten leveren om hun klimaatimpact te verminderen. Doel Evalueren of er verschillen zijn vast te stellen in het klimaatbeleid van Vlaamse en Nederlandse ggz-instellingen. Methode Beschrijvend onderzo...

Background Previous studies assessing the hypothesis that the construct of ‘aberrant salience’ is associated with psychosis and psychotic symptoms showed conflicting results. For this reason, the association between measures to index aberrant salience and subclinical psychotic symptoms in a general population sample was analysed. In addition, genet...

Belgium is one of very few countries where euthanasia on the basis of psychiatric illness is legally possible. Three physicians involved in the euthanasia of a 38-year-old woman suffering from psychiatric illness recently faced a criminal trial for “murder by poisoning”, for allegedly having failed to comply with several requirements of the Belgian...

The Belgian euthanasia law passes the human rights test, except for the a posteriori control Mortier versus Belgium (no. 78017/17) On several occasions, the European Court of Human Rights (ECtHR) has ruled on the human rights compliance of national regulations regarding medical assistance in dying. However, ‘Mortier versus Belgium’ is the first dec...

Introduction Sleep quality is closely linked with mental health. Two factors that influence sleep are coping style and locus of control, yet these have not been investigated in daily life. In this study, we examined associations between coping styles and sleep quality in daily life and the potential mediating effect of daily locus of control in a s...

Background Belgium is one of the few countries worldwide where euthanasia on the grounds of unbearable suffering caused by a psychiatric disorder is legally possible. In April 2010 euthanasia was carried out on a 38-year-old Belgian woman with borderline personality disorder and/or autism. After a complaint by the family, three physicians were refe...

Background: The Flemish and Dutch (mental) health sectors cause greenhouse gas emissions and therefore will have to make an effort to reduce their climate impact. Aim: To assess whether differences can be found in the climate policies of Flemish and Dutch mental health institutions. Method: Descriptive research based on a sustainability questi...

Adolescents and young adults are at high risk for experiencing loneliness, a well-established risk factor for mental health symptoms. Being physically active is known to reduce feelings of loneliness. We explored the association between physical activity and loneliness using the experience sampling method, allowing us to investigate moment-to-momen...

For more than 20 years, euthanasia in Belgium and The Netherlands is allowed for unbearable suffering caused by terminal or non-terminal illnesses, including psychiatric disorders. Although euthanasia numbers have been increasing over the years, the percentage of cases involving people with a primary psychiatric diagnosis has remained stable (betwe...

The Belgian euthanasia law passes the human rights test, except for the a posteriori control Mortier versus Belgium (no. 78017/17) On several occasions, the European Court of Human Rights (ECtHR) has ruled on the human rights compliance of national regulations regarding medical assistance in dying. However, ‘Mortier versus Belgium’ is the first dec...

Objectives Falls in elderly patients treated in general hospitals have already been the focus of several studies. Research within psychiatric settings, however, remains limited, despite the fact that this population has a number of characteristics that could increase the fall risk. The aim of this retrospective study was to estimate the prevalence...

Background Research indicates that perinatal loss can cause profound psychological consequences in parents. However, a comprehensive summary of existing quantitative literature describing the association between perinatal loss and the development of depression/depressive symptoms or post-traumatic stress disorder (PTSD)/post-traumatic stress (PTS)...

This article explores whether 'digital pills' that track medication intake should be used to enhance adherence. We concentrate on psychiatric conditions since these pose unique challenges. We analyze two public policies that potentially encourage the development of systems for remote monitoring of intake, namely the granting of patents and marketin...

Classical psychedelics as a treatment for depression: where are we today? Over the past few years, psychedelics have made an exciting comeback in the field of psychiatric and neuroscientific research. Scientists are inspired by early work from the 1960s and find themselves supported by new entrepreneurial interest in this potentially lucrative mark...

Reduced positive future thinking has been associated with suicidal ideation and behavior in adults, and appears to be exacerbated by negative affect. Yet, this has received little attention in youth. Prior research has also focused on longer-term future thinking, e.g., months and years, and relied on lab-based assessments. Using the experience samp...

Background: Falls among psychiatric inpatients are common and have significant health consequences. The purpose of this study is to systematically review the published research on risk factors and consequences. Methods: PubMed and Embase were searched for relevant studies. A total of 18 studies were included in this systematic review. The hetero...

People with severe mental illness, consisting of schizophrenia, bipolar disorder, and major depression, have a high burden of modifiable cardiovascular risk behaviors and conditions and have a cardiovascular mortality rate twice that of the general population. People with acute and chronic cardiovascular disease are at a higher risk of developing m...

Background Belgium is one of very few countries that legally allow euthanasia for suffering caused by psychiatric illness. In the first criminal trial in Belgium of physicians involved in euthanasia, three physicians recently faced the accusation of “murder by poisoning,” for allegedly having failed to comply with several requirements of the Belgia...

Background: Adolescence is a period of both great social change, and of vulnerability to psychiatric distress. However, little is known about the associations between early psychopathology and social interactions at the fundamental level of daily life. To better understand the social correlates of subclinical psychopathology in adolescence, we ass...

Reduced positive future thinking has been associated with suicidal ideation and behaviour in adults, and appears to be exacerbated by negative affect. Yet, this has received little attention in youth. Prior research has also focussed on longer-term future thinking, e.g. months and years, and relied on lab-based assessments. Using the experience sam...

Parents are known to provide a lasting basis for their children's social development. Understanding parent-driven socialization is particularly relevant in adolescence, as an increasing social independence is developed. However, the relationship between key parenting styles of care and control and the microlevel expression of daily-life social inte...

Disparities in access to, use of and delivery of somatic health care contribute to widening gaps in morbidity and mortality between psychiatric patients and the general population. We conducted a qualitative semi-structured interview study with psychiatric patients and health professionals from different psychiatric care settings to understand thes...

Background A huge and still growing mortality gap between people with severe mental illness (SMI) and the general population exists. Physical illnesses, mainly cardiovascular diseases, substantially contribute to the high mortality rates in patients with SMI. Disparities in somatic health care access, utilisation, and provision contribute to these...

Background: Increasing clinical evidence suggests that people with severe mental illness (SMI), including schizophrenia spectrum disorders, bipolar disorder (BD), and major depressive disorder (MDD), are at higher risk of dying from COVID-19. Several systematic reviews examining the association between psychiatric disorders and COVID-19-related mor...

Background: Patients with mental illness are at increased risk for COVID-19-related morbidity and mortality. Vaccination against COVID-19 is important to prevent or mitigate these negative consequences. However, concerns have been raised over vaccination rates in these patients. Methods: We retrospectively examined vaccine uptake in a large sample...

Objective Major depressive disorder (MDD) is closely related to obesity, inflammation, and insulin resistance, all together being etiologically linked to metabolic syndrome development. The depressive disorder has a neuroendocrinological component, co-influencing the metabolic syndrome, while metabolic syndrome (MetS) is characterized by increased...

Background The aim of the current study was to explore the effect of gender, age at onset, and duration on the long-term course of schizophrenia. Methods Twenty-nine centers from 25 countries representing all continents participated in the study that included 2358 patients aged 37.21 ± 11.87 years with a DSM-IV or DSM-5 diagnosis of schizophrenia;...

Physical activity has positive effects on self-esteem and sense of belongingness and vice versa. The experience sampling method allows for a level of analysis of the within-subject temporal dynamics of these interactions. We hypothesized that physical activity would predict prospective increases of self-esteem and belongingness in the flow of daily...

Environmental and individual contextual factors profoundly influence how people regulate their emotions. The current article addresses the role of event intensity and psychopathology (an admixture of depression, anxiety, and psychoticism) on emotion regulation in response to naturally occurring events. For six days each evening, a youth sample (age...

Euthanasia: opinions and experiences of Flemish psychiatrists working at a university S. Wouters, J. Vandenberghe, J. De Lepeleire, L. Van Bouwel, M. De Hert Background Aim Method Results Conclusion Little is known about the attitude of Belgian psychiatrists and psychiatrists in training towards euthanasia for psy- chiatric reasons. To analyse opin...

A number of studies have demonstrated pragmatic language difficulties in people with Schizophrenia Spectrum and Other Psychotic Disorders. However, research about how people with schizophrenia spectrum and other psychotic disorders understand scalar implicatures (SIs) is surprisingly rare, since SIs have generated much of the most recent literature...

Le monde universitaire s'intéresse de plus en plus à la manière dont des facteurs liés au mode de vie qui ont généralement une incidence sur la santé physique, peuvent également jouer un rôle important dans la santé mentale et le bien-être psycholo-gique. Un certain nombre de directives internationales tenant compte de ces facteurs dans le cadre de...

Er is in toenemende mate academische interesse in hoe levensstijlfactoren die tra-ditioneel gerelateerd worden aan de lichamelijke gezondheid, ook van belang zijn voor de geestelijke gezondheid en het psychologisch welbevinden. De voorbije jaren zijn er internationaal een aantal richtlijnen uitgewerkt die aandacht hebben voor deze levensstijlfactor...

Aims This cross-sectional pharmacoepidemiologic study examined the prevalence of polypharmacy and psychotropic polypharmacy among inpatients in a tertiary psychiatric hospital in Belgium. Methods Current prescriptions of all inpatients suffering from mental disorders were extracted from the hospital Computerized Physician Order Entry. Two methods...

Background Recent theories argue that an interplay between (i.e., network of) experiences, thoughts and affect in daily life may underlie the development of psychopathology. Objective To prospectively examine whether network dynamics of everyday affect states are associated with a future course of psychopathology in adolescents at an increased ris...

The current management of patients with primary psychosis worldwide is often remarkably stereotyped. In almost all cases an antipsychotic medica­tion is prescribed, with second‐generation antipsychotics usually preferred to first‐generation ones. Cognitive behavioral therapy is rarely used in the vast majority of countries, although there is eviden...

Psychiatric disorders, and especially severe mental illness, are associated with an increased risk of severe acute respiratory syndrome coronavirus 2 infection and COVID-19-related morbidity and mortality. People with severe mental illness should therefore be prioritised in vaccine allocation strategies. Here, we discuss the risk for worse COVID-19...

The etiology of psychotic disorders is still unknown, but in a subgroup of patients symptoms might be caused by an autoimmune reaction. In this study, we tested patterns of autoimmune reactivity against potentially novel hippocampal antigens. Serum of a cohort of 621 individuals with psychotic disorders and 257 controls were first tested for reacti...

Background Patients with schizophrenia spectrum disorders (SSD) have worse physical health and reduced life expectancy compared to the general population. In 2009, the European Psychiatric Association, the European Society of Cardiology and the European Association for the Study of Diabetes published a position paper aimed to improve cardiovascular...

(Reprinted with permission from World Psychiatry 2019;18:53-66).

Background: Little is known about the attitude of Belgian psychiatrists and psychiatrists in training towards euthanasia for psychiatric reasons. Aim: To analyse opinions about and experiences with euthanasia in physicians from a university psychiatric hospital. Method: A mail with a questionnaire was sent to the 111 psychiatrists and psychiat...

E. THYS, C.I. STRUYVEN, M. DE HERT ACHTERGROND Er rust een aanzienlijk maatschappelijk stigma op psychiatrische stoornissen. Er zijn aanwijzingen dat de beeldvorming over schizofrenie in de media bijzonder negatief is. Sommigen stellen dan ook voor om deze term te vervangen door psychosegevoeligheid of psychosespectrumstoornis. DOEL Vervolgonderzoe...

Background Antipsychotic medications are the first-line pharmacological intervention for severe mental illnesses (SMI) such as schizophrenia and other psychoses, while also being used to relieve distress and treat neuropsychiatric symptoms in dementia. Our aim was to examine the factors relating to antipsychotic prescribing in general practices acr...

In the DSM-5 Section III Alternative Model for Personality Disorders (AMPD), the severity of personality pathology (criterion A) and the presence of pathological personality trait domains and facets (criterion B) are assessed independently. Recent studies have challenged this assumption of independence but the interplay between criterion A and crit...

Environmental and individual contextual factors profoundly influence how people regulate their emotions. The current article addresses the role of event intensity and psychopathology (an admixture of depression, anxiety, and psychoticism) on emotion regulation in response to naturally occurring events. For six days each evening, a youth sample (age...

Background Despite the increasing understanding of factors that might underlie psychiatric disorders, prospectively detecting shifts from a healthy towards a symptomatic state has remained unattainable. A complex systems perspective on psychopathology implies that such symptom shifts may be foreseen by generic indicators of instability, or early wa...

People with serious mental illness (SMI), including schizophrenia, bipolar disorder, and major depressive disorder, have a higher mortality rate and shortened life expectancy. This is mainly attributable to physical diseases, particularly cardiovascular diseases (CVDs). Important risk factors for CVDs are obesity and other metabolic abnormalities,...

Background: There is a growing recognition of the importance of encouraging people with alcohol use disorders (AUD) to become more active as an achievable strategy to reduce the disability-associated burden. Objective: We investigated whether physical activity and sedentary behaviour in men with AUD contribute to their quality of life (QoL). Me...

Depression is widely acknowledged to be a heterogeneous entity, and the need to further characterize the individual patient who has received this diagnosis in order to personalize the management plan has been repeatedly emphasized. However, the research evidence that should guide this personalization is at present fragmentary, and the selection of...

Background: Alterations in the quantity and quality of social interactions play a role in early psychopathology, but not much is known about their involvement at the level of daily life. Aims: To better understand the social correlates of early psychopathology, the authors assessed associations between general psychopathology and the quantity and q...

Emotional complexity (EC) involves the ability to distinguish between distinct emotions (differentiation) and the experience of a large range of emotions (diversity). Lower EC has been related to psychopathology in cross-sectional studies. This study aimed to investigate (a) whether EC prospectively predicts psychopathology and (b) whether this eff...

Background The aim of the current study was to explore the changing interrelationships among clinical variables through the stages of schizophrenia in order to assemble a comprehensive and meaningful disease model. Methods Twenty-nine centers from 25 countries participated and included 2358 patients aged 37.21 ± 11.87 years with schizophrenia. Mul...