American Journal of Psychiatry and Neuroscience

Submit a Manuscript

Publishing with us to make your research visible to the widest possible audience.

Propose a Special Issue

Building a community of authors and readers to discuss the latest research and develop new ideas.

An Updated Review of Werner Janzarik’s Psychopathological Model of Endogenous (Idiopathic) Psychoses

“Dynamische Grundkonstellationen in endogenen Psychosen” is Werner Janzarik’s most influential work. It is aimed at defining an unitary psychopathological model of endogenous psychoses independently from categorical nosology. His main contribution is the distinction between dynamic (the whole of emotions, impulses and intentions) and structure (the whole of psychic contents which remain stable throughout the course of life), whose intersection is well elicitable both in organic and in endogenous psychoses. Janzarik describes different types of dynamic alterations (dynamic constellations) in the different stages of the psychotic course: dynamic reduction in depressive phases, dynamic expansion in manic states, instability and depletion in the different clinical phases of long-term schizophrenic psychoses. Janzarik’s work is nowadays completely forgotten. In the paper the Authors resume his main clinical ideas on major mental illnesses, because they fit well with long term courses of psychoses as observable in mental health public services, in an era of serious crisis of categorical distinctions. Janzark supports a dynamic model of psychoses, characterized by different stages and switchovers between different psychotic categories over time. In addition, this model could be used in standardized pharmacological trials to define which treatments are really effective in the different “dynamic” alterations of both affective and schizophrenic psychotic courses.

Psychopathology, Endogenous Psychoses, Organic Psychoses, Unitary Psychosis, Structural-Dynamic Model, Werner Janzarik

Riccardo Dalle Luche, Simone Giovannini, Carlo Maggini. (2023). An Updated Review of Werner Janzarik’s Psychopathological Model of Endogenous (Idiopathic) Psychoses. American Journal of Psychiatry and Neuroscience, 11(3), 55-63. https://doi.org/10.11648/j.ajpn.20231103.11

Copyright © 2023 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

1. Schneider K. Klinische Psychopathologie. 8. Aufl. Thieme, Stuttgart 1962.
2. Janzarik W.: “Dynamische Grundkonstellationen in endogenen Psychosen”. Springer, Berlin, 1959.
3. Kraepelin E. Psychiatrie. Ein Lehrbuch für Studierende und Ärzte. 4 Aufl. Abel, Leipzig.
4. Janzarik W.: “Die Krise der Psychopathologie”. Nervenarzt, 47, 73-80, 1976.
5. Gross G, Huber G. Die idiopathischen Psychosyndrome in der Sicht Werner Janzariks [Idiopathic psychosyndromes in the sight of Werner Janzarik]. Fortschr Neurol Psychiatr. 2004 Oct; 72 Suppl 1: S7-13.
6. Berner P. Strukturdynamik und Vulnerabilitätsmodelle [Structural dynamics and vulnerability models]. Fortschr Neurol Psychiatr. 2004 Oct; 72 Suppl 1: S3-6.
7. Janzarik W.: “Basic dynamic states in endogenous psychoses, with special reference to the pharmacotherapy of depressive states”. McGill University Conference on Depression and Allied States, 1958.
8. Mundt C. The life and work of Professor Werner Janzarik. History of Psychiatry. 1992; 3 (9): 1-3.
9. Tellenbach H.: “Melancholie. Zur Problemgeschichte, Typologie, Pathogenese und Klinik. Mit einem Geleitwort von V. E. von Gebsattel”. Berlin, Göttingen, Heidelberg, Springer, 1961 (tr. it. “Melancolia: storia del problema, endogenicità, tipologia, patogenesi, clinica”, Il pensiero scientifico, Roma, 2015).
10. Ey H.: H. Jackson’s principles and the organodynamic concept of psychiatry. Am J Psychiatry. 1962; 118: 706-14.
11. Jaspers K. Allgemeine Psychopathologie. 1. Aufl. Springer-Verlag, Berlin, 1913.
12. Bonhoeffer K. Zur Frage der Klassifikation der symptomatischen Psychosen. Berlin, August Hirschwald (1908).
13. Popper E. Der schizophrene Reaktionstypus. Zschr. Neuro. 1920; 62: 194.
14. Janzarik, W. Der strukturdynamische Ansatz. Psychopathologische Herkunft und menschenkundliche Perspektive. Nervenarzt. 2007; 78: 1296-1302.
15. Kraepelin, E. Die erscheinungsformen des Irreseins. Z. f. d. g. Neur. u. Psych. 62, 1–29 (1920).
16. Ey, H., Bernard, P., Brisset, C. Manuel de psychiatrie. Paris, Masson (1960).
17. Conrad, K. Die beginnende Schizophrenie. Versuch einer Gestaltanalyse des Wahns. Stuttgart, G. Thieme (1958).
18. Kapur S. Psychosis as a state of aberrant salience: a framework linking biology, phenomenology, and pharmacology in schizophrenia. Am J Psychiatry. 2003 Jan; 160 (1): 13-23.
19. Grühle HW. Über den Wahn. Nervenarzt. 1915; 22: 125.
20. American Psychiatric Association (APA). Diagnostic and Statistical Manual of Mental Disorders (DSM-5 TR). APA Publishing, 2022.
21. Jablensky A. Psychiatric classifications: validity and utility. World Psychiatry. 2016 Feb; 15 (1): 26-31.
22. Maj M. Why the clinical utility of diagnostic categories in psychiatry is intrinsically limited and how we can use new approaches to complement them. World Psychiatry. 2018 Jun; 17 (2): 121-122.
23. Szasz, T. S. (1960). The myth of mental illness. American Psychologist, 15 (2), 113–118.
24. Cardno AG, Owen MJ. Genetic relationships between schizophrenia, bipolar disorder, and schizoaffective disorder. Schizophr Bull. 2014 May; 40 (3): 504-15.
25. Brainstorm Consortium; Anttila V, Bulik-Sullivan B, Finucane HK, Walters RK et al. Analysis of shared heritability in common disorders of the brain. Science. 2018 Jun 22; 360 (6395): eaap8757.
26. Derry S, Moore RA. Atypical antipsychotics in bipolar disorder: systematic review of randomised trials. BMC Psychiatry. 2007 Aug 16; 7: 40.
27. Caspi A, Houts RM, Belsky DW, Goldman-Mellor SJ, Harrington H, Israel S, Meier MH, Ramrakha S, Shalev I, Poulton R, Moffitt TE. The p Factor: One General Psychopathology Factor in the Structure of Psychiatric Disorders? Clin Psychol Sci. 2014 Mar; 2 (2): 119-137.
28. McGorry PD. Issues for DSM-V: clinical staging: a heuristic pathway to valid nosology and safer, more effective treatment in psychiatry. Am J Psychiatry. 2007 Jun; 164 (6): 859-60.
29. Tschacher W, Giersch A, Friston K. Embodiment and Schizophrenia: A Review of Implications and Applications. Schizophr Bull. 2017 Jul 1; 43 (4): 745-753.
30. Sass L, Byrom G. Phenomenological and neurocognitive perspectives on delusions: A critical overview. World Psychiatry. 2015 Jun; 14 (2): 164-73.
31. Dalle Luche R:, Di Piazza G. P.: La «pensée» délirante. Penséee ou pseudo-pensée delirante?. In: A. Ballerini, G. Di Piazza (Eds.): Délirer. Analyse du phénomène délirant. Le Cercle Hermeneutique, Second Semestre 2011, Numéro 17, Paris, Argeneuil.
32. Molstrom, I. M., Nordgaard, J., Urfer-Parnas, A., Handest, R., Berge, J., & Henriksen, M. G. (2022). The prognosis of schizophrenia: A systematic review and meta-analysis with meta-regression of 20-year follow-up studies. Schizophrenia research, 250, 152-163.
33. Haddad PM, Correll CU. The acute efficacy of antipsychotics in schizophrenia: a review of recent meta-analyses. Ther Adv Psychopharmacol. 2018 Oct 8; 8 (11): 303-318.
34. Huber G, Gross G. The concept of basic symptoms in schizophrenic and schizoaffective psychoses. Recenti Prog Med. 1989 Dec; 80 (12): 646-52.
35. Schültze-Lutter F, Theodoridou A. The concept of basic symptoms: its scientific and clinical relevance. World Psychiatry. 2017 Feb; 16 (1): 104-105.
36. Janzarik W. Der strukturdynamische ansatz: psychopathologische herkunft und menschenkundliche perspektive [The structural dynamic approach: its psychopathologic origin and application to considerations of personality]. Nervenarzt. 2007 Nov; 78 (11): 1296-302.
37. Dalle Luche R. Concettualizzazioni cliniche e psicopatologiche degli esordi psicotici dalla seconda metà dell’800 ai nativi digitali [Clinical and psychopathological models of psychotic onsents from last nineteenth century up to digital-born generation]. Riv Sperim Freniatr in press Submitted 23.01.2023 Accepted 23.05.2023 RSF (ISSN 1129-6437, ISSNe 1972-5582), VOL. CXLVII, 2023, 2.
38. Andreasen N. DSM and the Death of Phenomenology in America: An Example of Unintended Consequences. Schizophrenia Bull. 2007 Jan; 33 (1): 108-112.