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The Mutability of Schizophrenia: From Hafners Epidemiology to Hafners Psychopathology

Paul Brown

This article examines the psychopathological mutability of schizophrenia and schizophreniform psychosis. It pursues this objective through the lens of the epidemiological investigations of schizophrenia of Heinz Hafner in Mannheim, Baden-Wurttemberg, over the half-century between 1965, and the present day. It suggests that variations in the incidence of schizophrenia, in post-war Germany, can be accounted for partly by social pressures, and partly by liberal diagnosticcum- epidemiological, professional practice. Core schizophrenia in post-war Germany, was accompanied by a wide range of schizophreniform psychoses, usually with affective features, better prognosis, and most importantly, probable environmental reactivity against a backdrop of genetic and epigenetic stresssensitivity. Comorbidity with alcohol and drug abuse was the rule. Hafner’s findings are emblematic of those in both the Old World and the New, which demonstrate the mutability of schizophrenia in the modern era.