Psychiatric University Clinic Erlangen

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The Psychiatric and Psychotherapeutic Clinic is a psychiatric clinic belonging to the Erlangen University Hospital . It is assigned to the head clinics and is located in the center of Erlangen.

Psychiatry at the Friedrich-Alexander-University

Johann Michael Leupoldt held the first psychiatric lectures ("de morbis psychicis") in Erlangen in 1818 as a private lecturer. The later full professor of anatomy and physiology propagated that “madmen” should be more than just kept safe. Rather, the healing or at least the care of the patient should become the goal of psychiatric treatment. Leupoldt himself wanted the psychiatric institution to be linked to the university. However, the university did not expect any benefit from the connection between an “insane asylum” and the university, and so the concept of a “county insane asylum” was initially implemented without any direct reference to the university. As a representative of the psychiatry department at the university, Leupoldt provided expert advice. Middle Franconia can therefore boast of being the first district in Bavaria to have implemented the concept of the “county mental institution” in 1846. Despite his efforts, it was not Leupoldt but his pupil Karl August von Solbrig who was appointed first director in 1846. Like his teacher Leupoldt, he campaigned for a psychiatric clinic as a link between the institution and the university. He gave clinical-psychiatric lessons to interested students. In 1849 Solbrig was appointed honorary professor of psychiatry. He was followed by Friedrich Wilhelm Hagen (1862–1887) and Anton Bumm (1888–1896) - now associate professors of psychiatry - as the institution directors .

The full professorship for psychiatry

In 1896 Gustav Specht was appointed associate professor while still in his function as senior physician at the institution. In 1903, his extraordinary position was converted into a full professor of psychiatry - with this, Gustav Specht became the first full professor for psychiatry in Erlangen and the first director of the University Psychiatric Clinic.

The side wings of the mezzanine floor and the upper floor of the main building of the so-called nursing home were given to the university for the purposes of the psychiatric university clinic. Economically, technically and administratively, the clinic remained integrated into the institutional association for the time being. On October 1, 1903, Gustav Specht received the above-mentioned premises of the institution for the independent treatment of his patients. Thus the Psychiatric Clinic of the University of Erlangen was founded. Gustav Specht was appointed full professor that same month.

The directors of the University Psychiatric Clinic

Pioneering achievements in psychiatry in Erlangen

Erlangen as a trailblazer for modern psychiatric institution building

In 1844, leading German theorists had ridiculed the Kingdom of Bavaria for its backward psychiatric care system. With the completion of the Erlangen District Insane Asylum in 1846, a typological change process began. As the only institution in Germany, it followed architecturally panoptic principles. The panoptic asylum concept forms a milestone in psychiatric architectural history (panoptic [Greek]: to be seen all around). The panoptic construction did not serve the surveillance purpose of the Erlanger institution, as is the case with prison buildings. With the Erlangen panoptic construction concept supplemented by transverse wings, contemporary requirements could be implemented. It was necessary to create a central organizational point on a limited building area. According to the decision of the district administrator of September 18, 1874, a care facility should be built next to the existing structures. This was done according to a progressive room concept as a synthesis of pavilion and corridor system. Modern pavilion buildings were integrated into the connected corridor system in line with contemporary aesthetics. With the completion of the most northerly main building in 1879, the two-phase project was completed.

Psychiatric and psychotherapeutic clinic in 2011

In 1901 the Erlangen institution was one of the largest and best-equipped institutions in Germany. In 1981 the institution building was still counted among the cultural monuments of psychiatry worth preserving in Central Europe. In its basic structure, the buildings of the Erlanger Heil- und Pflegeanstalt (HuPflA) formed a closed ensemble until the demolition work began in 1977. While the former “county insane asylum” was inaugurated as a “district hospital” in the west of Erlangen in 1978, the psychiatric university clinic stayed in the for the time being previous premises. In the spring of 1985, the Psychiatric Clinic of the University of Erlangen-Nuremberg also moved into its new building in the so-called “2nd Construction phase of the head clinic ”.

As a monument to the only panoptic institution in Germany, the former head building remains as an administrative building (since 1975).

Erlangen system of open care

As director of the Erlangen institute (1911–1933), Gustav Kolb introduced the placement of mentally ill people into their own families from 1914 onwards. 1930 in a welfare area of ​​approx. 3,200 square kilometers 4,200 people of the total of 770,000 residents of open welfare. The "Erlanger System" was the largest organization of its kind in Germany.

First use of electroconvulsion therapy in Germany

At the end of 1939, Adolf Bingel , then senior physician at the psychiatric clinic, received an electroconvulsive device from the Erlangen Siemens-Reiniger-Werke for clinical use. Thus, electroconvulsions could be used for the first time to treat a patient in Germany at the Psychiatric Clinic of the University of Erlangen . The procedure is still a valuable addition to modern therapeutic methods in psychiatry today.

Clinical introduction of modern psychotropic drugs in German psychiatry

Chlorpromazine as an antipsychotic drug

Chlorpromazine , the first substance from the group of antipsychotic drugs, could be used at the Psychiatric University Clinic in Erlangen under Fritz Flügel from the spring of 1953 - even before its official introduction. Chlorpromazine is at the beginning of modern psychopharmacotherapy. The long-term research cooperation between the Erlangen University Psychiatry under Fritz Flügel and the pharmacological institute of the Bayer company shows an early and sustained interest of the Erlangen Psychiatric Clinic in the further development of psychotropic drugs . Wing was a founding member of the Collegium Internationale Neuro-Psychopharmacologicum (CINP), established in 1957 at the Second World Congress for Psychiatry.

Dieter Bentes' EEG examinations formed an important basis for Flugel's research . In 1958, Bente founded the German Working Group for Neuropsychopharmacology (AGNP).

Organic psychoses

The concept of special status for mental illnesses caused by an organ disorder is relatively new. The term “organic” damage to the brain has been used since Philippe Pinel (1745–1826), but the term “organic psychosis” came about later. It can be found for the first time in Emanuel Mendel's (1839–1907) “Guide to Psychiatry” from 1902. Erlangen University Psychiatry made important contributions to the discussion, further development and research of the concept of organic psychoses. Gustav Specht supplemented the theory of symptomatic psychoses developed by Karl Bonhoeffer (1868–1948) with the depressive states .

Friedrich Meggendorfer wrote the chapter on “intoxication psychoses” in Bumke's handbook during his time in Hamburg before accepting the call to Erlangen. The organic psychoses were at the center of Hans-Heinrich Wieck's research. Above all, he worked on the question to what extent clouding of consciousness is a necessary key symptom. In his textbook from 1967 Wieck chose the purely psychopathological-descriptive approach. Like Kurt Schneider (1887–1967), Wieck described dementia and the decline in personality as hallmarks of irreversible defect syndromes . Wieck classified the reversible syndromes as " functional psychoses " with the following classification:

  • Mild passage syndrome
  • Moderate passage syndrome
  • Severe passage syndrome
  • Clouding of consciousness
  • unconsciousness
  • coma

The term "passage syndrome" introduced by Wieck became part of general medical, especially surgical and internal specialist jargon. The psychiatric clinic is also working intensively on a better understanding of the fine structure of organic psychoses. Under Johannes Kornhuber , dementia research is an important part of the Psychiatric Clinic.

Psychopathometry

With the help of psychological methods, Wieck was able to expand the static view of organic psychoses to include the focus on syndrome dynamics. Wieck's endeavors reached their climax in "psychopathometry". Wieck first used this term in 1964 to measure pathological phenomena of mental processes. Under Wieck's impulses, the psychological working group of the Erlangen Psychiatric University Clinic worked on the development of psychopathometric tests. The short syndrome test (SKT) is used across the board. In the 1980s, a nationwide use of the SKT to prove the effectiveness of drug treatment was discussed. The SKT is currently being tested as an instrument for the early detection of dementia. The SKT is used in the conception and planning of pharmacological studies in mild cognitive disorder (MCI) or early stages of dementia. The multiple choice vocabulary intelligence test (MWT) was also established in Erlangen . The MWT is a one-dimensional procedure for the investigation of intelligence performance. The home care scale (HPS) developed in Erlangen in 1993 to record the exposure of caregivers was incorporated in 2005 by the German Society for General Medicine and Family Medicine (DEGAM) into the guideline “Nursing relatives " integrated.

Erlangen Psychiatry in the Third Reich

During the Nazi era, 908 patients were housed on the site of what was then the sanatorium and nursing home, who were then murdered in killing centers. 1500 more patients died as a direct or indirect result of poor nutrition. The role of the then university psychiatry under the direction of Friedrich Meggendorfer has not been conclusively clarified.

The Psychiatric University Clinic Erlangen today

The Psychiatric University Clinic Erlangen has 94 beds in four wards, a day clinic with 20 treatment places as well as the institute outpatient department and the university outpatient department. At the clinic, there are further training authorizations for psychiatry and psychotherapy (full), forensic psychiatry (two years) and for clinical geriatrics.

The clinically oriented basic research focuses on dementias , addictions and depression . The basis for this is formed by five laboratories: Laboratory for Molecular Neurobiology, Neurophotonics, Sensory Laboratory, Laboratory for Behavioral Pharmacology and the Laboratory for Clinical Neurochemistry and Neurochemical Dementia Diagnostics. Health services research is bundled in the Center for Medical Health Services Research. In addition to the Chair of Psychiatry and Psychotherapy, research is being driven by the Extraordinary for Molecular Psychiatry, the Extraordinary for Addiction Medicine and various working groups.

Current publications

  • J. Kornhuber, CP Muller, KA Becker, M. Reichel, E. Gulbins: The ceramide system as a novel antidepressant target. In: Trends Pharmacol Sci. 35, 2014, pp. 293-304.
  • MA De Souza Silva et al .: Neurokinin3 receptor as a target to predict and improve learning and memory in the aged organism. In: Proc Natl Acad Sci US A. 110, 2013, pp. 15097-15102.
  • AC Easton et al .: CAMK2A polymorphisms predict working memory performance in humans. In: Molecular Psychiatry. August 18, 2013, pp. 850-852.
  • E. Gulbins et al .: Acid sphingomyelinase-ceramide system mediates effects of antidepressant drugs. In: Nature Medicine. 19 (7), 2013, pp. 934-938.
  • CH Tischbirek et al .: Use-Dependent Inhibition of Synaptic Transmission by the Secretion of Intravesicularly Accumulated Antipsychotic Drugs. In: Neuron. 74, 5, June 7, 2012, pp. 830-844.
  • M. Wagner et al: Biomarker validation of a cued recall memory deficit in prodromal Alzheimer disease. In: Neurology. vol. 78, no. 6, February 2012, pp. 379–386.
  • P. Lewczuk et al: Soluble amyloid precursor proteins in the cerebrospinal fluid as novel potential biomarkers of Alzheimer's disease: a multicenter study. In: Mol Psychiatry. 15, 2010, pp. 138-145.

See also

Web links

Individual evidence

  1. ↑ a b E. Lungershausen, R. Baer: Psychiatry in Erlangen. Festschrift for the opening of the new building of the Psychiatric University Clinic Erlangen. Perimed, Erlangen 1985.
  2. ↑ Ida Valeton: God gave me wings . Publishing house Dr. Kovač, Hamburg 2000, ISBN 3-8300-0220-3 .
  3. ↑ Renate Wittern, Astrid Ley: The professors and lecturers at the Friedrich-Alexander University Erlangen-Nürnberg 1743-1960 . Part 2: Faculty of Medicine . Universitätsbund, Erlangen 1999, ISBN 3-930357-30-5 , p. 128 .
  4. ↑ a b J. Sandmeier: The former sanatorium and nursing home Erlangen. Brochure for the Open Monument Day in Erlangen. September 8, 2013: "Beyond the good and the beautiful: Inconvenient monuments?"
  5. ↑ B. Braun, J. Kornhuber: The only "panoptic" institution in Germany: An appreciation of the "Kreis-Irrenanstalt Erlangen". In: Fortschr Neurol Psychiatr. 81, 2013, pp. 162-168.
  6. ↑ D. Jetter: Principles of the history of the madhouse. Darmstadt 1981.
  7. ^ A b A. Würschmidt: The Erlangen District Insane Asylum, The Insane Asylums of the Middle Franconia District - Memorandum on the establishment of the Ansbach District Insane Asylum. Publishing house of the k. Government of Middle Franconia, 1904, pp. 23–72.
  8. ↑ B. Braun, J. Kornhuber: The "Erlanger System" of open care: An appreciation of Gustav Kolb (1870-1938). In: Fortschr Neurol Psychiatr. 82, 2014, pp. 401-413.
  9. ↑ A. Bingel, F. Meggendorfer: About the first German attempts at electroconvulsive treatment of mental illnesses. In: Psychiatr Neurol Woschr. 42 (5), 1940, p. 41.
  10. ^ B. Braun, J. Kornhuber: Adolf Abraham Gustav Bingel (1901–1982): Pioneer of electroconvulsive treatment in Germany. In: Fortschr Neurol Psychiatr. 81, 2013, pp. 586-591.
  11. ↑ C. Radouco-Thomas, S. Radouco-Thomas: The first three executives. An overview. In: TA Ban, OS Ray (Ed.): A history of the CINP. JM Productions, Brentwood 1996, pp. 349-355.
  12. ↑ S. Bleich, L. Breuer, J. Kornhuber: Fritz Flügel (1897–1973). Early research in the field of neuroleptics. In: The neurologist. 2006, pp. 350-354.
  13. ↑ AGNP
  14. ↑ H. Hippius: CINP founding members, personal accounts. In: TA Ban, OS Ray (Ed.): A history of the CINP. JM Productions, Brentwood 1996, pp. 210-213.
  15. ↑ a b R. Baer: Organic psychoses: A scientific focus of Erlangen psychiatry. In: G. Nissen, B. Holdorff (Hrsg.): Series of publications of the German Society for the History of Neurology. K&N: Würzburg 9, 2003, pp. 7-23.
  16. ↑ G. Specht: On the question of the exogenous types of damage. In: Ztschr Neurol. 19, 1913, pp. 104-116.
  17. ^ F. Meggendorfer: intoxication psychoses. In: O. Bumke: Handbuch d. Mental illness. Volume 7: spec. Part. Part 3, Springer, Berlin 1928.
  18. ↑ HH Wieck: Textbook of Psychiatry. Schattauer, Stuttgart 1967.
  19. ↑ HH Wieck, KH Stäcker: On the dynamics of the "amnestic" passage syndrome. In: Arch Psychiat Nervenkrankh. 205, 1964, p. 479.
  20. ↑ HH Wieck, H. Erzigkeit: On the use of psychopathometric short tests in the clinical field. In: Hospital doctor. 51, 1978, pp. 31-26.
  21. ↑ H. Erzigkeit: Manual for the syndrome short test, forms AE. Fless, Vaterstetten / Munich 1977.
  22. ^ Symposium “SKT ─ yesterday, today, tomorrow”. Psychiatric and psychotherapeutic clinic at Erlangen University Hospital, October 15, 2011.
  23. ^ Siegfried Lehrl (Ed.): Multiple choice vocabulary intelligence test. (Manual for MWT-B) Perimed, Erlangen 1977.
  24. ↑ E. Gräßel, M. Leutbecher: Home care scale HPS for recording the exposure of caring or caring persons. Vless, Ebersberg 1993.
  25. ↑ HPS - Home Care Scale. (PDF) (No longer available online.) Archived from the original on December 31, 2014 ; accessed on December 1, 2014 . Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. @1@ 2Template: Webachiv / IABot / www.degam.de
  26. ^ "Violent dispute about the former Nazi" nursing home " Süddeutsche Zeitung, accessed on August 2, 2019
  27. ↑ B Braun: Friedrich Meggendorfer. Person and ethics of a psychiatrist under National Socialism . Franz Steiner Verlag, Stuttgart 2017, ISBN 978-3-515-11964-1 .
  28. ↑ Psychiatric University Clinic Erlangen - Continuing Education Website of the Psychiatric University Clinic Erlangen, accessed on December 9, 2014.
  29. ↑ Psychiatric University Clinic Erlangen - Laboratories Website of the Psychiatric University Clinic Erlangen, accessed on December 9, 2014.
  30. ↑ Psychiatric University Clinic Erlangen - Medical Services Research Website of the Psychiatric University Clinic Erlangen, accessed on December 9, 2014.
  31. ↑ Psychiatric University Clinic Erlangen - Research website of the Psychiatric University Clinic Erlangen, accessed on December 9, 2014.