To examine the more than 70-year history of a connection between University and Institutional Psychiatry.

Relevant archival material as well as primary and secondary literature were examined.

As early as 1818 Johann Michael Leupoldt (1794–1874) held a seminar on “madness” as an assistant professor in Erlangen. But the University Psychiatric Clinic did not begin until 1903 within the association of the mental asylum founded on a contract agreement between the Friedrich-Alexander, University Erlangen and the County Senate of Middle-Franconia. The history of the “Hochschulpsychiatrie Erlangen” reflects part of the history of German psychiatry. The plans to accomplish independence were doomed to impracticability by the social-political situation before, during and after the First and also Second World Wars. Clinic patients were registered as “Institutional residents”, the Clinic had no income of its own, the Head of Department and Director of the Clinic was formally considered as the “senior doctor of the asylum”.

The complicated duty dependence of the Head of Department on the Director of the asylum undoubtedly contributed to their decades spanning “mésalliance tradition”. A public scandal arose in 1978 from an accusation of dereliction of duty to the government of Middle-Franconia because of lacking protection of patient documentation and medications during the relocation of the former institution departments to the newly constructed Regional Hospital on the Europakanal.

Cooperation between the University Clinic and the Regional Hospital exists in altered form today. The Psychiatric Clinic can thus include patients from the Regional Hospital in scientific studies.

The authors have not supplied their declaration of competing interest.