Marc De Hert

Marc De Hert
KU Leuven | ku leuven · Department of Neurosciences

MD PhD

About

632
Publications
218,665
Reads
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29,852
Citations
Additional affiliations
January 2001 - present
Universitair Psychiatrisch Centrum KU Leuven
Position
  • Professor
January 1995 - December 2012
Katholieke Universiteit Leuven
September 1984 - September 1989
University of Antwerp
Position
  • Medical student, trainee psychiatry

Publications

Publications (632)
Article
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...
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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...
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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...
Preprint
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...
Article
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...
Article
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...
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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 thes...
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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...
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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...
Article
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...
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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;...
Article
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...
Article
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...
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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...
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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...
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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...
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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...
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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...
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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...
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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...
Article
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...
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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...
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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...
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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...
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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...
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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...
Article
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...
Preprint
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...
Article
Full-text available
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...
Article
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...
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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...
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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,...
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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...
Article
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...
Article
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...
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Objectives To investigate the risk of hospitalized fall or hip fracture among older adults using mental health services. Design Retrospective cohort study. Setting and Participants Residents of a South London catchment aged >60 years receiving specialist mental health care between 2008 and 2016. Measures Falls and/or a hip fracture leading to ho...
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Parenting experiences are hypothesized to provide a lasting basis for adaptive social functioning, but little is known about the manifestation of this effect in naturalistic, daily-life social interactions and experiences. To explore this question, adolescent and young adult twins and their siblings living with their parents (N = 628) completed the...
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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. Since 2014 many antipsychotic agents have moved to generic provision. In 2017_18 supplies of certa...
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Introduction: There is growing evidence that mental disorders behave like complex dynamic systems. Complex dynamic systems theory states that a slower recovery from small perturbations indicates a loss of resilience of a system. This study is the first to test whether the speed of recovery of affect states from small daily life perturbations predi...
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Objective: To test whether polygenic risk score for schizophrenia (PRS-S) interacts with childhood adversity and daily-life stressors to influence momentary mental state domains (negative affect, positive affect, and subtle psychosis expression) and stress-sensitivity measures. Methods: Data were retrieved from a general population twin cohort i...
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Background: A considerable social stigma is attached to psychiatric disorders. Evidence shows that the portrayal of schizophrenia in the media is particularly negative. It has been proposed to replace the term schizophrenia by psychosis susceptibility or psychosis spectrum disorder. AIM: Follow-up of the study of the seven Flemish newspapers publ...
Article
Meta-analyses suggest that clinical psychopathology is preceded by dimensional behavioral and cognitive phenotypes such as psychotic experiences, executive functioning, working memory and affective dysregulation that are determined by the interplay between genetic and nongenetic factors contributing to the severity of psychopathology. The liability...
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Clozapine is considered the golden standard in the treatment of therapy‐resistant schizophrenia; however, it associated with bothersome side effects such as sialorrhea. Current evidence suggests that the sublingual use of atropine seems to be safe and effective and could be considered as a first‐line treatment of clozapine‐induced sialorrhea. Cloza...
Article
The aim of this study was to investigate the test-retest reliability of the 2-minute walk test (2MWT) and the concurrent validity with the 6-minute walk test (6MWT) in outpatients with psychosis. We also explored whether there was a practice effect, determined minimal detectable changes (MDC) and assessed which factors are associated with the 2MWT...
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Introduction: A specific clinically relevant staging model for schizophrenia has not yet been developed. The aim of the current study was to evaluate the factor structure of the PANSS and to develop such a staging method. Materials and methods: Twenty-nine centers from 25 countries contributed 2358 patients aged 37.21±11.87 years with schizophre...
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Background: The earliest stages of the pluripotent psychopathology on the pathway to psychotic disorders is represented by emotional dysregulation and subtle psychosis expression, which can be measured using the Ecological Momentary Assessment (EMA). However, it is not clear to what degree common genetic and environmental risk factors for psychosis...
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Objective: We aimed to investigate which clinical and metabolic tests offer optimal accuracy and acceptability to help diagnose diabetes among a large sample of people with serious mental illness in receipt of antipsychotic medication. Methods: A prospective observational study design of biochemical and clinical factors was used. Biochemical mea...
Preprint
Introduction Brain connectivity is disturbed in schizophrenia, both during resting state and during active tasks. Schizophrenia is characterised by a corpus callosum pathology and an inability to suppress overstimulation, both of which relate to this disturbed connectivity. We wanted to verify whether network analysis on EEG sensor level can reveal...
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Purpose Whilst childhood trauma (CT) is a known risk factor across the spectrum of psychosis expression, little is known about possible interplay with genetic liability. Methods The TwinssCan Study collected data in general population twins, focussing on expression of psychosis at the level of subthreshold psychotic experiences. A multilevel mixed...
Article
Background: People with mental illness are at an increased risk for developing cardio-metabolic disorders. Routine screening following pharmacotherapy is however unacceptably low in sub-Saharan African countries with less than 1% adequately screened. It is unknown whether this is due to a lack of adequate competences. Objectives: The aim of this...
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Background: Exercise is nowadays considered as an evidence-based treatment modality in people with mental illness. Nurses and occupational therapists working in low-resourced mental health settings are well-placed to provide exercise advice for people with mental illness. Objectives: We examined the current exercise prescription practices employ...
Article
Background Emotional dysregulation and subtle psychosis expression mark the earliest manifestation of psychopathology. Furthermore, using Ecological Momentary Assessment (EMA), studies indicate that emotional and psychotic reactivity to daily-life stressors are associated with psychosis expression in individuals at varying clinical stages (e.g. ser...
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BACKGROUND:This study investigated whether reported neighborhood variables explained variance in time spent walking, exercising, and being sedentary, in addition to mental health and demographic variables among Ugandan outpatients with mental illness. METHODS: Ninety-nine outpatients (78 men; 31.1 [8.6] y) of the Butabika National Referral Hospital...
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Background: In patients taking clozapine, about 30% experience sialorrhoea, with its related potentially important medical and psychosocial implications. Until now, systemic treatments have been unsuccessful and also have unfavourable side-effects. AIM: To examine the current evidence regarding the use of local atropine in clozapine-induced sialor...
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Background: Sleep disorders are a frequent problem with an important impact on the quality of life. Given its physiological properties, melatonin is often associated with sleep disorders and their treatment. In addition, melatonin has been recognized by the European Medicines Agency (ema) since 2007 for primary insomnia in adults over 55 years of...
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The α7 acetylcholine receptor (AChR) has been linked with the onset of psychotic symptoms and we hypothesized therefore that it might also be an autoimmune target. Here, we describe a new radioimmunoassay (RIA) using iodine 125-labelled α-bungarotoxin and membrane extract from transfected HEK293 cells expressing human α7 AChR. This RIA was used to...
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Adolescents and young adults are highly focused on peer evaluation, but little is known about sources of their differential sensitivity. We examined to what extent sensitivity to peer evaluation is influenced by interacting environmental and genetic factors. A sample of 354 healthy adolescent twin pairs (n = 708) took part in a structured, laborato...