TY - JOUR A1 - Halfmann, Marie A1 - Castioni, Noah A1 - Wetzel, Lea A1 - Koopmann, Anne A1 - König, Sarah A1 - Schmieder, Astrid T1 - Effects of the COVID-19 pandemic on the mental health of medical students and young physicians in Germany: Gender-specific results of an online survey JF - Heliyon N2 - Background Healthcare workers and medical students faced new challenges during the COVID-19 pandemic. Processes within many hospitals were completely disrupted. In addition, the face to face teaching of medical students was drastically reduced. Those at risk of developing mental health problems appear to be younger health care workers and women. Objective To investigate potential COVID-19 pandemic-related gender differences in psychological distress among medical students and physicians in their first years of practice. Design and setting An anonymous survey was carried out online between December 1, 2021, and March 31, 2022, at the Mannheim Medical Faculty and the Würzburg Medical Faculty, Germany, after obtaining informed consent. Primary outcome measures were changes in anxiety and depression symptoms using the Hospital Anxiety and Depression Scale (HADS), and changes in participants' current quality of life using the WHO Quality of Life BREF. Results The results show wave-like courses for perceived anxiety and burden overlapping with the course of the COVID-19 incidence. In comparison to men, women showed a significant higher increase in HADS (p = 0.005) and a reduced life quality (p = 0.007) after COVID-19. Both sexes showed different frequencies of the factors influencing quality of life, with the presence of a previous mental illness and mean anxiety having a significant higher negative impact in women. Conclusion Future and young female physicians reported a disproportionate higher burden during COVID-19 compared to their male colleges. These observations suggest an increased need for support and prevention efforts especially in this vulnerable population. KW - mental health KW - Covid-19 KW - medical students KW - sex differences Y1 - 2024 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-350502 SN - 2405-8440 VL - 10 IS - 1 ER - TY - THES A1 - Scheiner, Christin T1 - Vulnerability in adolescence: prevalence, pandemic impact and prevention T1 - Vulnerabilität im Jugendalter: Prävalenzen, Einfluss der Pandemie und Prävention N2 - This compilation focuses on adolescent mental disorders and their prevention. It comprises three distinct studies, each contributing to a deeper understanding of this critical topic. This work addresses a critical gap in the understanding of, and approach to, adolescent mental health, and as a result reveals a critically important and urgently needed policy implication for action. The thematic structure of these studies begins with an examination of the epidemiology of child and adolescent mental disorders. Baseline data were collected from N = 877 adolescents with a mean age of 12.43 years (SD = 0.65). Mental health problems, such as depressive symptoms, non-suicidal self-injury, suicidal ideation, symptoms of eating disorders, and gender differences, are thoroughly examined. Results revealed a significant portion of our sample displaying mental health problems as early as the 6th and 7th grades, with girls generally being more affected than boys. The findings underscore the importance of early adolescence in the emergence of mental health problems and thereby emphasize the need for preventive measures. Moving beyond prevalence estimates, the compilation delves into the etiology of these disorders, exploring their potential correlation with a COVID-19 infection. Understanding the early signs and risk factors is crucial for timely support. While numerous studies have investigated potential risk and protective factors during the pandemic, our focus shifts to adolescents’ coping when an infection with the virus was involved (N = 2,154, M = 12.31, SD = 0.67). We hypothesized that students infected or with close family members infected, would exhibit an increased psychopathology and a decreased functioning of protective factors such as self-efficacy or self-esteem. We found no connection between infection and the mental health status within our sample, but protective factors and mental well-being were positively associated. Thus, universal primary prevention appears to be the preferred approach for promoting mental health. Lastly, the compilation introduces LessStress, a noteworthy contribution to more evidence-based prevention programs. This universal approach is designed to reduce stress in schools, accompanied by a cluster-randomized trial to evaluate its effectiveness (estimated sample size N = 1,894). Existing studies have demonstrated the effectiveness of stress prevention, leading us to introduce a short and easy-to-implement prevention program. There is positive evidence for one-lesson interventions in schools for promoting well-being and health behaviors among adolescents. LessStress is designed based on a life skills approach that not only imparts psychoeducational content but also teaches skills relevant to everyday life and directly applicable. Throughout these studies, a common thread emerges: the pressing need to address mental disorders during childhood and adolescence. These formative years play a pivotal role in the development of mental health problems. These formative years play a crucial role in the development of mental health problems. They highlight the importance of epidemiological data collection and analysis based on the latest models to develop prevention interventions that are not only effective but also reach young people on a global level. N2 - Diese Zusammenstellung konzentriert sich auf psychische Störungen bei Jugendlichen und deren Prävention. Sie umfasst drei verschiedene Studien, die jeweils zu einem tieferen Verständnis dieses wichtigen Themas beitragen. Es wird eine kritische Lücke im Verständnis und Umgang mit der psychischen Gesundheit Jugendlicher adressiert und damit ein wichtiger und dringender politischer Handlungsbedarf aufgezeigt. Die thematische Struktur dieser Studien beginnt mit einer Untersuchung der Epidemiologie psychischer Störungen bei Kindern und Jugendlichen. Es wurden Ausgangsdaten von N = 877 Jugendlichen mit einem Durchschnittsalter von 12,43 Jahren (SD = 0,65) erhoben. Psychische Gesundheitsprobleme wie depressive Symptome, nicht-suizidale Selbstverletzungen, Suizidgedanken, Symptome von Essstörungen und geschlechtsspezifische Unterschiede werden eingehend untersucht. Die Ergebnisse zeigen, dass ein erheblicher Teil der Stichprobe bereits in der 6. und 7. Klasse psychische Probleme aufweist, wobei Mädchen stärker betroffen sind als Jungen. Die Ergebnisse unterstreichen die Bedeutung des frühen Jugendalters für die Entstehung psychischer Probleme und verdeutlichen damit die Notwendigkeit von Präventionsmaßnahmen. Die Zusammenstellung geht über Prävalenzschätzungen hinaus und befasst sich mit der Ätiologie dieser Störungen und untersucht ihren möglichen Zusammenhang mit einer COVID-19-Infektion. Während zahlreiche Studien potenzielle Risiko- und Schutzfaktoren während der Pandemie untersucht haben, konzentriert sich unsere Studie auf die Bewältigung von Jugendlichen im Zusammenhang mit einer Infektion mit dem Virus (N = 2.154, M = 12.31, SD = 0,67). Wir stellten die Hypothese auf, dass eine Infektion mit einer erhöhten Psychopathologie und einer verminderten Funktion von Schutzfaktoren einhergeht. Wir fanden keinen Zusammenhang zwischen der Infektion und dem psychischen Gesundheitszustand in unserer Stichprobe, aber Schutzfaktoren und psychisches Wohlbefinden waren positiv assoziiert. Somit scheint die universelle Primärprävention der bevorzugte Ansatz zur Förderung der psychischen Gesundheit zu sein. Schließlich wird in der Zusammenstellung mit LessStress ein entscheidender Beitrag zu evidenzbasierten Präventionsprogrammen vorgestellt. Dieses universelle Konzept zur Stress-reduzierung in Schulen wird von einer cluster-randomisierten Studie zur Bewertung seiner Wirksamkeit begleitet (geschätzte Stichprobengröße N = 1.894). LessStress wurde auf der Grundlage eines Life-Skills-Ansatzes entwickelt, der nicht nur psychoedukative Inhalte vermittelt, sondern auch alltagsrelevante und direkt anwendbare Fähigkeiten lehrt. Aus den drei vorgestellten Studien geht ein roter Faden hervor: die dringende Notwendigkeit, psychische Störungen im Kindes- und Jugendalter anzugehen. Diese prägenden Jahre spielen eine entscheidende Rolle bei der Entwicklung von Problemen der psychischen Gesundheit. Sie machen deutlich, wie wichtig die Sammlung epidemiologischer Daten und deren Analyse auf der Grundlage neuester Modelle für die Entwicklung von Präventionsmaßnahmen ist, die nicht nur wirksam sind, sondern auch junge Menschen auf globaler Ebene erreichen. KW - Jugend KW - Psychische Belastung KW - Resilienz KW - Stress KW - mental health KW - epidemiology KW - depression KW - etiology KW - Depression KW - Psychische Gesundheit KW - Epidemiologie KW - Ätiologie KW - COVID-19 KW - Primärprevention Y1 - 2024 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-351644 ER - TY - JOUR A1 - Fekete, Stefanie A1 - Kulpok, Christine A1 - Taurines, Regina A1 - Egberts, Karin A1 - Geissler, Julia A1 - Gerlach, Manfred A1 - Malonga Makosi, Dorothée A1 - König, Jochem A1 - Urschitz, Michael S. A1 - Toni, Irmgard A1 - Neubert, Antje A1 - Romanos, Marcel T1 - Value of a web-based pediatric drug information system to prevent serious adverse drug reactions in child and adolescent psychiatry JF - Journal of Neural Transmission N2 - Psychotropic drugs are frequently prescribed ‘off-label’ to children and adolescents and carry the risk of serious adverse drug reactions (sADR). We examined the frequency of sADRs of psychotropic drugs in pediatric inpatients and explored their potential preventability through following the recommendations of a web-based pediatric drug information system (PDIS). The potential socio-economic impacts of using this online system is also addressed. Routine clinical data from all inpatients treated in a child and adolescent psychiatry department between January 2017 and December 2018 were retrospectively examined for the occurrence of sADRs as defined by the European Medicines Agency. The preventability of the sADRs was assessed based on the information of the PDIS. Furthermore, the expected prolongation of the hospital stay due to sADRs was calculated as well as the associated treatment costs. The study was supported by the Innovation Fund of the Joint Federal Committee, grant number 01NVF16021. In total, 1036 patients were screened of whom 658 (63.5%) received psychopharmacological treatment. In 53 (8.1%) of these patients 54 sADRs were documented, of which 37 sADRs were identified as potentially preventable through PDIS. Mitigating sADR through PDIS would likely have prevented prolonged hospital stays and conferred considerable savings for health insurance companies. PDIS provides systematic and evidence-based information about pediatric psychopharmacotherapy and helps to prevent prescribing errors. Therefore, PDIS is a useful tool to increase drug therapy safety in child and adolescent psychiatry. Further prospective studies are needed to confirm the results. KW - adverse effects KW - pharmacovigilance KW - drug safety KW - psychotropic drugs KW - mental health Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-324817 VL - 130 IS - 1 ER - TY - JOUR A1 - Kleinert, Evelyn A1 - Müller, Frank A1 - Furaijat, Ghefar A1 - Hillermann, Nele A1 - Jablonka, Alexandra A1 - Happle, Christine A1 - Simmenroth, Anne T1 - Does refugee status matter? Medical needs of newly arrived asylum seekers and resettlement refugees - a retrospective observational study of diagnoses in a primary care setting JF - Conflict and Health N2 - Background Providing adequate healthcare to newly arrived refugees is considered one of the significant challenges for the German healthcare system. These refugees can be classified mainly into two groups: asylum seekers (who have applied for asylum after arrival in Germany and are waiting for the refugee-status decision) and resettlement refugees (who have already been granted asylum status before arriving in Germany). Whereas earlier studies have explored the health status of asylum seekers especially in terms of mental and behavioural disorders and infectious diseases without distinguishing between these two groups, our study aims to evaluate possible relationships of asylum status and medical needs of these two groups with a special focus on mental and behavioural disorders and infectious diseases. Methods In this retrospective observational study, collected data on all asylum-seeker and resettlement-refugee patients (N = 2252) of a German reception centre (August 2017 to August 2018) is analysed by absolute and relative frequencies and medians. Patient data, collected by chart review, include age, gender, country of origin, asylum status, and diagnoses (ICD-10). To describe the relationship between sociodemographic factors (including asylum status) and diagnoses, we used tests of significance and bivariate correlations with Spearman correlation coefficients. All collected data are pseudonymised. Results Of all 2252 patients, 43% were resettlement refugees. In almost all ICD-10 categories, asylum seekers received significantly more diagnoses than resettlement refugees. According to our data, asylum seekers presented with mental and behavioural disorders nine times more often (9%) than resettlement refugees (1%). In the case of infectious diseases, the results are mixed: asylum seekers were twice as frequently (11%) diagnosed with certain infectious and parasitic diseases than resettlement refugees (5%), but resettlement refugees were treated twice as often (22% of the asylum seekers and 41% of the resettlement refugees) for diseases of the respiratory system, of which 84% were acute respiratory infections (in both groups). Conclusion This study indicates that patients with unregulated migration more frequently present symptoms of psychiatric diseases and somatoform symptoms than resettlement refugees. A health policy approach within migration policy should aim to enable persecuted persons to migrate under regulated and safe conditions. Trial registration German Clinical Trials Register: DRKS00013076, retrospectively registered on 29.09.2017. KW - primary healthcare KW - resettlement refugees KW - asylum seekers KW - asylum status KW - common diseases KW - migrant KW - infections KW - mental health Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-325869 VL - 13 ER - TY - JOUR A1 - Scheiner, Christin A1 - Seis, Christian A1 - Kleindienst, Nikolaus A1 - Buerger, Arne T1 - Psychopathology, protective factors, and COVID-19 among adolescents: a structural equation model JF - International Journal of Environmental Research and Public Health N2 - Since the outbreak of the COVID-19 pandemic in December 2019 and the associated restrictions, mental health in children and adolescents has been increasingly discussed in the media. Negative impacts of the pandemic, including a sharp increase in psychopathology and, consequently, reduced quality of life, appear to have particularly affected children and young people, who may be especially vulnerable to the adverse effects of isolation. Nevertheless, many children and adolescents have managed to cope well with the restrictions, without deterioration of their mental health. The present study therefore explored the links between COVID-19 infection (in oneself or a family member, as well as the death of a family member due to the virus), protective factors such as self-efficacy, resilience, self-esteem, and health-related quality of life, and measures of psychopathology such as depression scores, internalizing/externalizing problems, emotion dysregulation, and victimization. For this purpose, we examined data from 2129 adolescents (mean age = 12.31, SD = 0.67; 51% male; 6% born outside of Germany) using a structural equation model. We found medium to high loadings of the manifest variables with the latent variables (COVID-19, protective factors, and psychopathology). Protective factors showed a significant negative correlation with psychopathology. However, COVID-19 had a weak connection with psychopathology in our sample. External pandemic-related factors (e.g., restrictions) and their interaction with existing psychopathology or individual protective factors appear to have a greater influence on young people’s mental health than the impact of the virus per se. Sociopolitical efforts should be undertaken to foster prevention and promote individual resilience, especially in adolescence. KW - adolescence KW - mental health KW - psychopathology KW - protective factors KW - COVID-19 Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-304475 SN - 1660-4601 VL - 20 IS - 3 ER - TY - JOUR A1 - Perra, Alessandra A1 - Riccardo, Chiara Laura A1 - De Lorenzo, Valerio A1 - De Marco, Erika A1 - Di Natale, Lorenzo A1 - Kurotschka, Peter Konstantin A1 - Preti, Antonio A1 - Carta, Mauro Giovanni T1 - Fully immersive virtual reality-based cognitive remediation for adults with psychosocial disabilities: a systematic scoping review of methods intervention gaps and meta-analysis of published effectiveness studies JF - International Journal of Environmental Research and Public Health N2 - Background: Cognitive Remediation (CR) programs are effective for the treatment of mental diseases; in recent years, Virtual Reality (VR) rehabilitation tools are increasingly used. This study aimed to systematically review and meta-analyze the published randomized controlled trials that used fully immersive VR tools for CR programs in psychiatric rehabilitation. We also wanted to map currently published CR/VR interventions, their methods components, and their evidence base, including the framework of the development intervention of CR in fully immersive VR. Methods: Level 1 of evidence. This study followed the PRISMA extension for Scoping Reviews and Systematic Review. Three electronic databases (Pubmed, Cochrane Library, Embase) were systematically searched, and studies were included if they met the eligibility criteria: only randomized clinical trials, only studies with fully immersive VR, and only CR for the adult population with mental disorders. Results: We found 4905 (database) plus 7 (manual/citation searching articles) eligible studies. According to inclusion criteria, 11 studies were finally reviewed. Of these, nine included patients with mild cognitive impairment, one with schizophrenia, and one with mild dementia. Most studies used an ecological scenario, with improvement across all cognitive domains. Although eight studies showed significant efficacy of CR/VR, the interventions’ development was poorly described, and few details were given on the interventions’ components. Conclusions: Although CR/VR seems to be effective in clinical and feasibility outcomes, the interventions and their components are not clearly described. This limits the understanding of the effectiveness and undermines their real-world implementation and the establishment of a gold standard for fully immersive VR/CR. KW - virtual reality KW - cognitive remediation KW - mental health KW - recovery KW - psychiatric rehabilitation Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-304948 SN - 1660-4601 VL - 20 IS - 2 ER - TY - JOUR A1 - Perra, Alessandra A1 - Galetti, Alessia A1 - Zaccheddu, Rosanna A1 - Locci, Aurora A1 - Piludu, Federica A1 - Preti, Antonio A1 - Primavera, Diego A1 - Di Natale, Lorenzo A1 - Nardi, Antonio Egidio A1 - Kurotshka, Peter Konstantin A1 - Cossu, Giulia A1 - Sancassiani, Federica A1 - Stella, Giusy A1 - De Lorenzo, Valerio A1 - Zreik, Thurayya A1 - Carta, Mauro Giovanni T1 - A recovery-oriented program for people with bipolar disorder through virtual reality-based Cognitive Remediation: results of a feasibility randomized clinical trial JF - Journal of Clinical Medicine N2 - Background: Cognitive impairment is a frequent consequence of bipolar disorder (BD) that is difficult to prevent and treat. In addition, the quality of the preliminary evidence on the treatment of BD through Cognitive Remediation (CR) with traditional methods is poor. This study aims to evaluate the feasibility of a CR intervention with fully immersive Virtual Reality (VR) as an additional treatment for BD and offers preliminary data on its efficacy. Methods: Feasibility randomized controlled cross-over clinical study, with experimental condition lasting three months, crossed between two groups. Experimental condition: CR fully immersive VR recovery-oriented program plus conventional care; Control condition: conventional care. The control group began the experimental condition after a three months period of conventional care (waiting list). After the randomization of 50 people with BD diagnosis, the final sample consists of 39 participants in the experimental condition and 25 in the control condition because of dropouts. Results: Acceptability and tolerability of the intervention were good. Compared to the waitlist group, the experimental group reported a significant improvement regarding cognitive functions (memory: p = 0.003; attention: p = 0.002, verbal fluency: p = 0.010, executive function: p = 0.003), depressive symptoms (p = 0.030), emotional awareness (p = 0.007) and biological rhythms (p = 0.029). Conclusions: The results are preliminary and cannot be considered exhaustive due to the small sample size. However, the evidence of efficacy, together with the good acceptability of the intervention, is of interest. These results suggest the need to conduct studies with larger samples that can confirm this data. Trial registration: ClinicalTrialsgov NCT05070065, registered in September 2021 KW - virtual reality KW - Cognitive Remediation KW - mental health KW - recovery Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-311201 SN - 2077-0383 VL - 12 IS - 6 ER - TY - JOUR A1 - Wohnrade, Camilla A1 - Velling, Ann-Kathrin A1 - Mix, Lucas A1 - Wurster, Claudia D. A1 - Cordts, Isabell A1 - Stolte, Benjamin A1 - Zeller, Daniel A1 - Uzelac, Zeljko A1 - Platen, Sophia A1 - Hagenacker, Tim A1 - Deschauer, Marcus A1 - Lingor, Paul A1 - Ludolph, Albert C. A1 - Lulé, Dorothée A1 - Petri, Susanne A1 - Osmanovic, Alma A1 - Schreiber-Katz, Olivia T1 - Health-related quality of life in spinal muscular atrophy patients and their caregivers — a prospective, cross-sectional, multi-center analysis JF - Brain Sciences N2 - Spinal muscular atrophy (SMA) is a disabling disease that affects not only the patient’s health-related quality of life (HRQoL), but also causes a high caregiver burden (CGB). The aim of this study was to evaluate HRQoL, CGB, and their predictors in SMA. In two prospective, cross-sectional, and multi-center studies, SMA patients (n = 39) and SMA patient/caregiver couples (n = 49) filled in the EuroQoL Five Dimension Five Level Scale (EQ-5D-5L) and the Short Form Health Survey 36 (SF-36). Caregivers (CGs) additionally answered the Zarit Burden Interview (ZBI) and the Hospital Anxiety and Depression Scale (HADS). Patients were clustered into two groups with either low or high HRQoL (EQ-5D-5L index value <0.259 or >0.679). The latter group was mostly composed of ambulatory type III patients with higher motor/functional scores. More severely affected patients reported low physical functioning but good mental health and vitality. The CGB (mean ZBI = 22/88) correlated negatively with patients’ motor/functional scores and age. Higher CGB was associated with a lower HRQoL, higher depression and anxiety, and more health impairments of the CGs. We conclude that patient and CG well-being levels interact closely, which highlights the need to consider the health of both parties while evaluating novel treatments. KW - caregiver KW - caregiver burden KW - mental health KW - quality of life KW - spinal muscular atrophy KW - patient reported outcome measures Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-305048 SN - 2076-3425 VL - 13 IS - 1 ER - TY - JOUR A1 - Janson, Patrick A1 - Willeke, Kristina A1 - Zaibert, Lisa A1 - Budnick, Andrea A1 - Berghöfer, Anne A1 - Kittel-Schneider, Sarah A1 - Heuschmann, Peter U. A1 - Zapf, Andreas A1 - Wildner, Manfred A1 - Stupp, Carolin A1 - Keil, Thomas T1 - Mortality, morbidity and health-related outcomes in informal caregivers compared to non-caregivers: a systematic review JF - International Journal of Environmental Research and Public Health N2 - A systematic overview of mental and physical disorders of informal caregivers based on population-based studies with good methodological quality is lacking. Therefore, our aim was to systematically summarize mortality, incidence, and prevalence estimates of chronic diseases in informal caregivers compared to non-caregivers. Following PRISMA recommendations, we searched major healthcare databases (CINAHL, MEDLINE and Web of Science) systematically for relevant studies published in the last 10 years (without language restrictions) (PROSPERO registration number: CRD42020200314). We included only observational cross-sectional and cohort studies with low risk of bias (risk scores 0–2 out of max 8) that reported the prevalence, incidence, odds ratio (OR), hazard ratio (HR), mean- or sum-scores for health-related outcomes in informal caregivers and non-caregivers. For a thorough methodological quality assessment, we used a validated checklist. The synthesis of the results was conducted by grouping outcomes. We included 22 studies, which came predominately from the USA and Europe. Informal caregivers had a significantly lower mortality than non-caregivers. Regarding chronic morbidity outcomes, the results from a large longitudinal German health-insurance evaluation showed increased and statistically significant incidences of severe stress, adjustment disorders, depression, diseases of the spine and pain conditions among informal caregivers compared to non-caregivers. In cross-sectional evaluations, informal caregiving seemed to be associated with a higher occurrence of depression and of anxiety (ranging from 4 to 51% and 2 to 38%, respectively), pain, hypertension, diabetes and reduced quality of life. Results from our systematic review suggest that informal caregiving may be associated with several mental and physical disorders. However, these results need to be interpreted with caution, as the cross-sectional studies cannot determine temporal relationships. The lower mortality rates compared to non-caregivers may be due to a healthy-carer bias in longitudinal observational studies; however, these and other potential benefits of informal caregiving deserve further attention by researchers. KW - cohort studies KW - longitudinal studies KW - cross-sectional studies KW - family caregivers KW - informal caregiving KW - mental health KW - physical health KW - population-based studies KW - systematic review Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-275219 SN - 1660-4601 VL - 19 IS - 10 ER - TY - JOUR A1 - Willeke, Kristina A1 - Janson, Patrick A1 - Zink, Katharina A1 - Stupp, Carolin A1 - Kittel-Schneider, Sarah A1 - Berghöfer, Anne A1 - Ewert, Thomas A1 - King, Ryan A1 - Heuschmann, Peter U. A1 - Zapf, Andreas A1 - Wildner, Manfred A1 - Keil, Thomas T1 - Occurrence of mental illness and mental health risks among the self-employed: a systematic review JF - International Journal of Environmental Research and Public Health N2 - We aimed to systematically identify and evaluate all studies of good quality that compared the occurrence of mental disorders in the self-employed versus employees. Adhering to the Cochrane guidelines, we conducted a systematic review and searched three major medical databases (MEDLINE, Web of Science, Embase), complemented by hand search. We included 26 (three longitudinal and 23 cross-sectional) population-based studies of good quality (using a validated quality assessment tool), with data from 3,128,877 participants in total. The longest of these studies, a Swedish national register evaluation with 25 years follow-up, showed a higher incidence of mental illness among the self-employed compared to white-collar workers, but a lower incidence compared to blue-collar workers. In the second longitudinal study from Sweden the self-employed had a lower incidence of mental illness compared to both blue- and white-collar workers over 15 years, whereas the third longitudinal study (South Korea) did not find a difference regarding the incidence of depressive symptoms over 6 years. Results from the cross-sectional studies showed associations between self-employment and poor general mental health and stress, but were inconsistent regarding other mental outcomes. Most studies from South Korea found a higher prevalence of mental disorders among the self-employed compared to employees, whereas the results of cross-sectional studies from outside Asia were less consistent. In conclusion, we found evidence from population-based studies for a link between self-employment and increased risk of mental illness. Further longitudinal studies are needed examining the potential risk for the development of mental disorders in specific subtypes of the self-employed. KW - incidence KW - mental disorders KW - mental health KW - mental illness KW - prevalence KW - self-employed KW - small business KW - systematic review Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-245085 SN - 1660-4601 VL - 18 IS - 16 ER - TY - JOUR A1 - Scheiner, Christin A1 - Grashoff, Jan A1 - Kleindienst, Nikolaus A1 - Buerger, Arne T1 - Mental disorders at the beginning of adolescence: Prevalence estimates in a sample aged 11-14 years JF - Public Health in Practice N2 - Objectives This study aims to provide a deeper insight into mental disorders in early adolescence. We report prevalence rates (mental health problems, depressive symptoms, eating disorders, NSSI, STBs) to be used in future studies and clinical ventures. We also expected to find gender differences, with girls being be more affected than boys are. Study design 877 adolescents (M = 12.43, SD = 0.65) from seven German high schools completed a series of questionnaires assessing their mental health (SDQ, PHQ-9, SEED, DSHI-9, Paykel Suicide Scale, FAS III). Methods We calculated cut-off-based prevalence estimates for mental health issues for the whole sample and compared estimates between genders. Results 12.5% of the sample reported general mental health problems. The estimated prevalence of depressive symptoms lay at of 11.5%. Additionally, 12.1% and 1.3% of the participants displayed relevant symptoms of anorexia or bulimia nervosa, respectively. A total of 10.8% reported engaging in non-suicidal self-injury (NSSI) at least once in their lifetime, of whom 5.6% reported repetitive NSSI. 30.1% of the participants described suicidal thoughts, 9.9% suicide plans, and 3.5% at least one suicide attempt. Girls were generally more affected than boys, except for bulimia nervosa, suicidal behavior, and partly NSSI. Conclusion Our findings corroborate the established relevance of early adolescence for the development of mental health problems and suggest that a substantial proportion of young adolescents suffer from such problems early on. Considering the ongoing COVID-19 pandemic and reported negative mental health consequences, the current findings underline the importance of preventive interventions to avoid the manifestation of mental disorders during adolescence. KW - STBS KW - depression KW - eating disorders KW - mental health KW - adolescence KW - prevalence KW - NSSI Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-300404 VL - 4 ER - TY - JOUR A1 - Heß, Verena A1 - Meng, Karin A1 - Schulte, Thomas A1 - Neuderth, Silke A1 - Bengel, Jürgen A1 - Faller, Hermann A1 - Schuler, Michael T1 - Decreased mental health, quality of life, and utilization of professional help in cancer patients with unexpressed needs: A longitudinal analysis JF - Psycho-Oncology N2 - Background Cancer patients' mental health and quality of life can be improved through professional support according to their needs. In previous analyses of the UNSAID study, we showed that a relevant proportion of cancer patients did not express their needs during the admission interview of inpatient rehabilitation. We now examine trajectories of mental health, quality of life, and utilization of professional help in cancer patients with unexpressed needs. Methods We enrolled 449 patients with breast, prostate, and colon cancer at beginning (T0) and end (T1) of a 3-week inpatient rehabilitation and 3 (T2) and 9 (T3) months after discharge. We explored depression (PHQ-2), anxiety (GAD-2), emotional functioning (EORTC QLQ-C30), fear of progression (FoP-Q-SF), and global quality of life (EORTC QLQ-C30) using structuring equation models. Furthermore, we evaluated self-reports about expressing needs and utilization of professional help at follow-up. Results Patients with unexpressed needs (24.3%, n = 107) showed decreased mental health compared to other patients (e.g., depression: d T0 = 0.32, d T1-T3 = 0.39). They showed a significant decline in global quality of life at discharge and follow-up (d = 0.28). Furthermore, they had a higher need for support (Cramer's V T2 = 0.10, T3 = 0.15), talked less about their needs (Cramer’s V T2 = 0.18), and made less use of different health care services at follow-up. Conclusion Unexpressed needs in cancer patients may be a risk factor for decreased mental health, quality of life, and non-utilization of professional help in the long term. Further research should clarify causal relationships and focus on this specific group of patients to improve cancer care. KW - cancer KW - longitudinal decrease KW - mental health KW - psycho-oncology KW - quality of life KW - unexpressed needs Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-257662 VL - 31 IS - 5 ER - TY - JOUR A1 - Weber, Silvana A1 - Lorenz, Christopher A1 - Hemmings, Nicola T1 - Improving stress and positive mental health at work via an app-based intervention: a large-scale multi-center randomized control trial JF - Frontiers in Psychology N2 - Mobile health interventions (i.e., “apps”) are used to address mental health and are an increasingly popular method available to both individuals and organizations to manage workplace stress. However, at present, there is a lack of research on the effectiveness of mobile health interventions in counteracting or improving stress-related health problems, particularly in naturalistic, non-clinical settings. This project aimed at validating a mobile health intervention (which is theoretically grounded in the Job Demands-Resources Model) in preventing and managing stress at work. Within the mobile health intervention, employees make an evidence-based, personalized, psycho-educational journey to build further resources, and thus, reduce stress. A large-scale longitudinal randomized control trial, conducted with six European companies over 6 weeks using four measurement points, examined indicators of mental health via measures of stress, wellbeing, resilience, and sleep. The data were analyzed by means of hierarchical multilevel models for repeated measures, including both self-report measures and user behavior metrics from the app. The results (n = 532) suggest that using the mobile health intervention (vs. waitlist control group) significantly improved stress and wellbeing over time. Higher engagement in the intervention increased the beneficial effects. Additionally, use of the sleep tracking function led to an improvement in sleeping troubles. The intervention had no effects on measures of physical health or social community at work. Theoretical and practical implications of these findings are discussed, focusing on benefits and challenges of using technological solutions for organizations to support individuals’ mental health in the workplace. KW - stress KW - work KW - RCT KW - mental health KW - digital health KW - mobile health intervention KW - smartphone app Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-194337 SN - 1664-1078 VL - 10 IS - 2745 ER - TY - JOUR A1 - Appel, Patricia A1 - Schuler, Michael A1 - Vogel, Heiner A1 - Oezelsel, Amina A1 - Faller, Hermann T1 - Short Questionnaire for Workplace Analysis (KFZA): factorial validation in physicians and nurses working in hospital settings JF - Journal of Occupational Medicine and Toxicology N2 - Background: In recent years, there has been an increasing interest in psychosocial workplace risk assessments in Germany. One of the questionnaires commonly employed for this purpose is the Short Questionnaire for Workplace Analysis (KFZA). Originally, the KFZA was developed and validated for office workers. The aim of the present study was to examine the factorial validity of the KFZA when applied to hospital settings. Therefore, we examined the factorial structure of a questionnaire that contained all the original items plus an extension adding 11 questions specific to hospital workplaces and analyzed both, the original version and the extended version. Methods: We analyzed questionnaire data of a total of 1731 physicians and nurses obtained over a 10-year period. Listwise exclusion of data sets was applied to account for variations in questionnaire versions and yielded 1163 questionnaires (1095 for the extended version) remaining for factor analysis. To examine the factor structure, we conducted a principal component factor analysis. The number of factors was determined using the Kaiser criterion and scree-plot methods. Factor interpretation was based on orthogonal Varimax rotation as well as oblique rotation. Results: The Kaiser criterion revealed a 7-factor solution for the 26 items of the KFZA, accounting for 62.0% of variance. The seven factors were named: “Social Relationships”, “Job Control”, “Opportunities for Participation and Professional Development”, “Quantitative Work Demands”, “Workplace Environment”, “Variability” and “Qualitative Work Demands”. The factor analysis of the 37 items of the extended version yielded a 9-factor solution. The two additional factors were named “Consequences of Strain” and “Emotional Demands”. Cronbach’s α ranged from 0.63 to 0.87 for these scales. Conclusions: Overall, the KFZA turned out to be applicable to hospital workers, and its content-related structure was replicated well with some limitations. However, instead of the 11 factors originally proposed for office workers, a 7-factor solution appeared to be more suitable when employed in hospitals. In particular, the items of the KFZA factor “Completeness of Task” might need adaptation for the use in hospitals. Our study contributes to the assessment of the validity of this popular instrument and should stimulate further psychometric testing. KW - KFZA KW - mental health KW - work-related stress KW - hospital KW - psychosocial workplace risk assessment KW - validation Y1 - 2017 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-157510 VL - 12 IS - 11 ER - TY - THES A1 - Stein, Lisa-Lena T1 - Partizipationsbedürfnis und wahrgenommene Partizipation -Zusammenhang mit psychischem Befinden und Lebensqualität T1 - Participation preferences and experienced participation - correlation with mental health and quality of life N2 - Im Rahmen von Krebserkrankungen müssen zahlreiche medizinische Entscheidungen getroffen werden. Das Bedürfnis der Patienten, an solchen Entscheidungen zu partizipieren, ist individuell unterschiedlich und für Ärzte häufig schwer einschätzbar. Ziel dieser Arbeit ist eine bessere Vorhersage der Partizipationsbedürfnisse von Krebspatienten und die Untersuchung von Effekten des Partizipationsbedürfnisses auf die Lebensqualität. N2 - In an oncological context many medical decisions have to be made. Patient participation preferences concerning these decisions individually differ. For physicians it is often hard to predict them. The aim of this work is a better prediction of oncological patients' participation preferences. Effects of a congruence of preferred and experienced participation on quality of life are investigated. KW - Partizipation KW - Lebensqualität KW - Quality of life KW - Onkologie KW - Partizipative Entscheidungsfindung KW - psychisches Befinden KW - shared decision making KW - mental health KW - participation KW - oncology Y1 - 2013 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-83906 ER -