The contributions of Franz Josef Kallmann to the genetics of schizophrenia

Eugenics ideals, racial hygiene, and the emigration process of German-American neurogeneticist Franz Josef Kallmann (1897-1965)

Biological psychiatry in the early twentieth century was based on interrelated disciplines, such as neurology and experimental biology. Neuropsychiatrist Franz Josef Kallmann (1897-1965) was a product of this interdisciplinary background who showed an ability to adapt to different scientific contexts, first in the field of neuromorphology in Berlin, and later in New York. Nonetheless, having innovative ideas, as Kallmann did, could be an ambiguous advantage, since they could lead to incommensurable scientific views and marginalization in existing research programs. Kallmann followed his Dr. Med. degree (1919) with training periods at the Charité Medical School in Berlin under psychiatrist Karl Bonhoeffer (1868-1948). Subsequently, he collaborated with Ernst Ruedin (1874-1952), investigating sibling inheritance of schizophrenia and becoming a protagonist of genetic research on psychiatric conditions. In 1936, Kallmann was forced to immigrate to the USA where he published The Genetics of Schizophrenia (1938), based on data he had gathered from the district pathological institutes of Berlin's public health department. Kallmann resumed his role as an international player in biological psychiatry and genetics, becoming president (1952) of the American Society of Human Genetics and Director of the New York State Psychiatric Institute in 1955. While his work was well received by geneticists, the idea of genetic differences barely took hold in American psychiatry, largely because of émigré psychoanalysts who dominated American clinical psychiatry until the 1960s and established a philosophical direction in which genetics played no significant role, being regarded as dangerous in light of Nazi medical atrocities. After all, medical scientists in Nazi Germany had been among the social protagonists of racial hygiene which, under the aegis of Nazi philosophies, replaced medical genetics as the basis for the ideals and application of eugenics.

Forty-five years of schizophrenia: personal reflections

Views about schizophrenia can change dramatically, even within one lifetime. In order to illustrate such changes over last forty-five years, this article uses the example of 'Mandy', a composite woman patient with a diagnosis of schizophrenia. It shows that, although there have been many advances over this period, understanding of schizophrenia continues to be elusive, and treatments remain imperfect. Therefore, as perspectives shift and the ground moves beneath us, the psychiatric profession needs to anchor itself firmly in the stories our patients tell us.

Family and twin strategies as a head start in defining prodromes and endophenotypes for hypothetical early-interventions in schizophrenia

In an effort to share the experiences of 'genotype-hunters'-who have approached the difficult task of forecasting future schizophrenia in the young offspring or other relatives of index cases, in new samples guided by the prior probabilities of 15% in offspring or 50% in identical co-twins-with 'early-interventionists'-who focus on purported prodromal symptoms in children who would be treated pharmacologically to prevent the development of schizophrenia-we provide a focused review that emphasizes the hazards of false positives in both approaches. Despite the advantages prospective high-risk strategies have had from clinical and laboratory findings that implicate some prodromal signs and endophenotypes, e.g. attention, memory, and information processing evaluations, the yields are not sufficient for practical applications involving antipsychotic drugs for undiagnosed children. Even more caution than usual is required, given the suggestions that the developing neocortex is vulnerable to dopaminergic exposure.

Legacy of German psychiatric genetics: hindsight is always 20/20

The history of psychiatric genetics is informed by this paper, which serves to review the legacy of German psychiatric genetics and its antecedents during the twentieth century. It also serves as an introduction to two new annotated abstracts of basic research papers on family studies of schizophrenia by Ernst Rüdin in 1916 and by Bruno Schulz in 1932, submitted by Kenneth Kendler and Edith Zerbin-Rüdin, together with another paper by them describing the origin and activities of Rüdin's Munich School of Psychiatric Genetics (1917-1945). Our paper also introduces an invited critical summary of the work of Ernst Rüdin by his biographer Matthias M. Weber, a medical historian working in the Historical Archives of the Clinical Institute of the Max Planck Institute of Psychiatry in Munich. We raise a number of bioethical questions in the context of the uses and misuses made of genetic information in the service of the Nazi programs of eugenics, "euthanasia," and genocide.