Motivation zur psychosomatisch-psychotherapeutischen Bearbeitung von beruflichen Belastungen - Entwicklung und Validierung eines Fragebogens

Background There is a lack of questionnaires assessing the motivation of inpatients to scrutinize occupational stresses and deal with them as part of their psychotherapeutic treatment. Work-related stress contributes significantly to the development of mental disorders. Vocational reintegration is an outcome criterion for the success of vocational rehabilitation. Patients are often not motivated for dealing with occupational stresses during inpatient medical rehabilitation. Therefore it is necessary to assess patient motivation at the beginning of treatment, in order to assign them to specific interventions, e. g. promoting motivation. Method A questionnaire (Fragebogen zur berufsbezogenen …

Domains of Physical Activity in Relation to Stiffness Index in the General Population.

Background Regular exercise training represents an important modifier of arterial stiffness (AS). Therefore, sex‐specific relations between domains of physical activity (PA; commuting, domestic, and leisure‐time PA, including active sport and occupational PA) with AS were investigated. Methods and Results Stiffness index by digital photoplethysmography was investigated in 12 650 subjects from the GHS (Gutenberg Health Study). Self‐reported PA was evaluated by the “Short Questionnaire to Assess Health‐Enhancing Physical Activity” and reported as activity score peer week, being a combined measure of duration, frequency, and intensity of PA. Multivariable linear regression analysis demonstrat…

Reliability, validity and responsiveness of the EQ-5D in assessing and valuing health status in patients with social phobia

Abstract Objective The aim of the study was to analyse the psychometric properties of the EQ-5D in patients with social phobia. Methods We used a sample of 445 patients with social phobia with five measurement points over a 30 month period. The discriminative ability of the EQ-5D was analysed by comparing the patients’ responses with the general population and between different disease severity levels. For test-retest reliability we assessed the level of agreement in patients’ responses over time, when there was no change in the Liebowitz Social Anxiety Scale (LSAS). Construct validity was analysed by identifying correlations of the EQ-5D with more specific instruments. For responsiveness w…

Type-D personality and depersonalization are associated with suicidal ideation in the German general population aged 35–74: Results from the Gutenberg Heart Study

Suicidal ideation (SID) is a major risk factor for suicide attempts. Mental disorders are among the strongest correlates of suicide, with depression and anxiety disorders playing a major role. The present study aims to investigate the contribution of under researched factors contributing to SID such as depersonalization, Type-D personality and cardiovascular risk factors.Factors associated with SID were investigated in a sample of N=5000 participants (aged 35-74 years) of the community-based survey "Gutenberg Heart Study". The factors were assessed by self-report instruments, computer-assisted interviews and medical examination.7.5% of the sample reported SID over the last 2 weeks. In the u…

Auswirkungen von Umweltrisikofaktoren wie Lärm und Luftverschmutzung auf die psychische Gesundheit: Was wissen wir?

ZusammenfassungImmer mehr Studien unterstreichen die Rolle von Lärm und Luftverschmutzung als bedeutsame Umweltrisikofaktoren. Ungeklärt ist, welche Einflüsse Lärm und Luftverschmutzung auf die psychische Gesundheit ausüben. Aktuelle Studienergebnisse zeigen, dass Umgebungslärm (vor allem Verkehrslärm) und verschiedene Bestandteile von Luftverschmutzung (vor allem Feinstaub) das Risiko für psychische Erkrankungen wie Depressionen, Angststörungen, Psychosen und Suizid erhöhen können. Pathophysiologische Mechanismen umfassen sowohl biologische (wie oxidativen Stress und Inflammation) als auch psychosoziale Faktoren (wie mentalen Stress). Umweltrisikofaktoren wie Lärm und Luftverschmutzung kön…

Procrastination, Distress and Life Satisfaction across the Age Range – A German Representative Community Study

Addressing the lack of population-based data the purpose of this representative study was to assess procrastination and its associations with distress and life satisfaction across the life span. A representative German community sample (1,350 women; 1,177 men) between the ages of 14 and 95 years was examined by the short form of the General Procrastination Scale (GPS-K; 1) and standardized scales of perceived stress, depression, anxiety, fatigue and life satisfaction. As hypothesized, procrastination was highest in the youngest cohort (14-29 years). Only in the youngest and most procrastinating cohort (aged 14 to 29 years), men procrastinated more than women. As we had further hypothesized,…

Coagulation and inflammation in long‐term cancer survivors: results from the adult population

Essentials The increase of cancer survival remains curtailed by cardiovascular mortality. We studied a large range of inflammatory and coagulation biomarkers in long-term cancer survivors. Cancer history has an important impact on mortality independent of cardiovascular risk factors. Fibrinogen and von Willebrand factor are potential biomarkers in survivors of increased mortality. Summary Background The advances in cancer treatment and detection of early cancer have resulted in a steady increase in the number of of cancer survivors over the years. However, because of the long-term toxic effects of chemotherapy and radiotherapy, the incidence of cardiovascular disease (CVD) is increasing in …

Changes in quality of life in visually impaired patients after low-vision rehabilitation.

The objective of the study was to assess the impact of low-vision aids on quality of life. Interviews included a modified version of the National Eye Institute Visual Functioning Questionnaire (Modified German NEI VFQ-25), the Hospital Anxiety and Depression Scale, the Mini-Mental State Examination Blind, and Indicators of the Rehabilitation Status. These were conducted before and 5 months after low-vision rehabilitation that involved recommendation of devices and instructing patients on how to use them. Of a total of 88 patients interviewed before low-vision rehabilitation, 50 patients could be reached for the follow-up interview. A huge proportion of the sample reported clinically signifi…

Later-life depressive symptoms and anxiety attacks in displaced and nondisplaced populations

Abstract Background Forced displacement has been suggested as a potential cause for depression and anxiety in later life. Little research has been done on the influence of the host country's socio-political system. Here we examine whether the later-life effects of displacement on mental health (i.e. depressive symptoms and anxiety attacks) differ between socio-political contexts. We hypothesized that between-group differences (displaced vs. nondisplaced) in self-rated depression scores and frequencies of anxiety attacks are more pronounced in East versus West German populations. Methods Datasets from three representative nationwide surveys (2002, 2003, 2007) were analyzed; study participant…

The costs of social anxiety disorder: The role of symptom severity and comorbidities

Abstract Background Social anxiety disorder (SAD) is associated with low direct costs compared to other anxiety disorders while indirect costs tend to be high. Mental comorbidities have been identified to increase costs, but the role of symptom severity is still vague. The objective of this study was to determine the costs of SAD, and to explore the impact of symptoms and comorbidities on direct and indirect costs. Methods Baseline data, collected within the SOPHO-NET multi-centre treatment study ( N =495), were used. Costs were calculated based on health care utilization and lost productivity. Symptom severity was measured with the Liebowitz-Social-Anxiety-Scale; comorbidities were include…

Problema: disfunzione sessuale

La disfunzione erettile (ED) e definita come una rigidita peniena insufficiente a permettere rapporti sessuali. L’assenza di rigidita puo essere completa, parziale o l’erezione puo essere perduta prematuramente. In caso di perdita prematura dell’erezione, il problema e classificato come ED se la perdita dell’erezione si verifica prima dell’eiaculazione. Si puo attribuire un punteggio alla gravita del problema utilizzando l’Indice Internazionale della Funzione Erettile (International Index of Erectile Function, IIEF).

From Bi-Dimensionality to Uni-Dimensionality in Self-Report Questionnaires

Abstract. The common factor model – by far the most widely used model for factor analysis – assumes equal item intercepts across respondents. Due to idiosyncratic ways of understanding and answering items of a questionnaire, this assumption is often violated, leading to an underestimation of model fit. Maydeu-Olivares and Coffman (2006) suggested the introduction of a random intercept into the model to address this concern. The present study applies this method to six established instruments (measuring depression, procrastination, optimism, self-esteem, core self-evaluations, and self-regulation) with ambiguous factor structures, using data from representative general population samples. I…

Neural substrates of the interaction of emotional stimulus processing and motor inhibitory control: an emotional linguistic go/no-go fMRI study.

Neural substrates of behavioral inhibitory control have been probed in a variety of animal model, physiologic, behavioral, and imaging studies, many emphasizing the role of prefrontal circuits. Likewise, the neurocircuitry of emotion has been investigated from a variety of perspectives. Recently, neural mechanisms mediating the interaction of emotion and behavioral regulation have become the focus of intense study. To further define neurocircuitry specifically underlying the interaction between emotional processing and response inhibition, we developed an emotional linguistic go/no-go fMRI paradigm with a factorial block design which joins explicit inhibitory task demand (i.e., go or no-go)…

A clinical evaluation of the DSM-5 criteria for Internet Gaming Disorder and a pilot study on their applicability to further Internet-related disorders.

Background and aims Internet Gaming Disorder (IGD) and other Internet-related disorders (IRDs) have become growing health concerns in our today’s lives. Based on defined diagnostic criteria, IGD has been recognized as a condition for further research in the DSM-5; however, other IRDs have been excluded. Since the release of the DSM-5, representativeness and appropriateness of the nine diagnostic criteria have been debated. Although some first evidence has been published to evaluate these criteria, our knowledge is still limited. Thus, the purpose of this study was to provide data on the clinical validity of the DSM-5 criteria for IGD and other types of IRD. We were also interested in exami…

Short-term cost-effectiveness of psychodynamic therapy and cognitive-behavioral therapy in social anxiety disorder: Results from the SOPHO-NET trial

Abstract Background To investigate the short-term cost-effectiveness of cognitive-behavioral therapy (CBT) and psychodynamic therapy (PDT) compared to waiting list (WL). Methods The analysis was conducted alongside the SOPHO-NET multi-center efficacy trial. Patients were randomly assigned to CBT ( n =209), PDT ( n =207), or WL ( n =79). Resource use was assessed prior and during treatment to determine direct and absenteeism costs. Unadjusted incremental cost-effectiveness ratios (ICERs) were calculated based on remission and response rates. To visualize statistical uncertainty, cost-effectiveness acceptability curves (CEACs) were constructed based on adjusted net-benefit regression. Differe…

Wie wirksam ist psychosomatische Therapie bei somatoformen Störungen? Ergebnisse einer Multicenterstudie

Zusammenfassung Fragestellung: Ziel der Arbeit ist die Beschreibung von Behandlungseffekten bei somatoformen Storungen durch stationare Psychotherapie aufgrund von Patienten- und Therapeutenbeurteilung. Methode: 2 062 Patienten mit der Primardiagnose F45.XX (ICD-10, Somatoforme Storungen) wurden in 17 bayrischen Psychosomatischen Kliniken behandelt. Es wurden vier Subgruppen (F45.0X, F45.3X, F45.4X, sonstige F45.XX) gebildet.Ergebnisse: Die Symptomschwere verringerte sich in allenUntergruppen. Die Pra-Post-Effektstarke betrug d = -.58 beim Global Severity Index der SCL-90-R (GSI) und -1.26 beim Beeintrachtigungs- Schwere-Score (BSS). Untergruppen der somatoformen Storungen unterschieden sic…

Birthweight and its association with retinal vessel equivalents – Results from the population‐based German Gutenberg Health Study

Efficacy of Short-term Treatment of Internet and Computer Game Addiction

Importance Internet and computer game addiction represent a growing mental health concern, acknowledged by the World Health Organization. Objective To determine whether manualized cognitive behavioral therapy (CBT), using short-term treatment for internet and computer game addiction (STICA), is efficient in individuals experiencing internet and computer game addiction. Design, Setting, and Participants A multicenter randomized clinical trial was conducted in 4 outpatient clinics in Germany and Austria from January 24, 2012, to June 14, 2017, including follow-ups. Blinded measurements were conducted. A consecutive sample of 143 men was randomized to the treatment group (STICA; n = 72) or wai…

Persönlichkeitsdiagnostik in der Online-Psychotherapieforschung

Zusammenfassung. Zunehmend wächst das Angebot evidenzbasierter psychotherapeutischer Online-Interventionen. Dies wirft die Frage auf, ob bestimmte Persönlichkeitsmerkmale Nutzung und Erfolg von onlinebasierten Interventionen beeinflussen. Erste Befunde liefern Hinweise, dass sich breite (z.B. Offenheit für neue Erfahrungen, Gewissenhaftigkeit) sowie spezifische Traits (z.B. Einstellung zu psychotherapeutischen Online-Interventionen) als relevante Prädiktoren erwiesen. Trotz der bislang limitierten Datenlage für differentielle Effekte bei klinischen Stichproben stellen Persönlichkeitsmerkmale für die vielen möglichen Varianten der Online-Psychotherapie bei verschiedenen Störungsbildern eine…

Psychoanalytically-Oriented Inpatient Psychotherapy of Somatoform Disorders

Somatoform disorders have been neglected in psychoanalytic publications. Unlike the descriptive approach of DSM-IV and ICD-10, sophisticated psychoanalytical models have been proposed for many years explaining the development of physical symptoms without definable medical cause. Based on a review of the psychoanalytic models of somatization and conversion, this article explores difficulties in the medical and psychotherapeutic treatments of somatoform disorders. The unique tradition of psychosomatic inpatient treatment in Germany is illustrated by the psychoanalytic treatment setting at the University of Mainz. A case report of a somatoform patient shows how childhood trauma is activated an…

Egg donation, surrogate mothering, and cloning: attitudes of men and women in Germany based on a representative survey

Objective To determine opinions and attitudes of the German general population toward the treatment methods of reproductive medicine: egg donation, surrogate mothering, and reproductive cloning. Design Representative survey. Setting German general population: face-to-face interviews at home with 2,110 persons, aged 18–50 years. Patient(s) Patients were not included. Intervention(s) No interventions took place. Main Outcome Measure(s) Approval and disapproval of treatment methods of reproductive medicine and preimplantation genetic diagnosis were assessed by questionnaires regarding medical, age, reasons, or general. Result(s) Overall, the diverse treatment methods of reproductive medicine f…

The role of shame and guilt in social anxiety disorder

Abstract Research suggests that shame and guilt may play a role in anxiety disorders. For social anxiety disorder (SAD), however, only a few studies investigated patients with the primary diagnosis of SAD. Thus, further research on shame and guilt in SAD is required. A secondary analysis of Data from the SOPHO-NET multicenter treatment study was performed. In a large sample of N = 495 patients with the primary diagnosis of SAD the relationship between shame and guilt with symptoms of social anxiety, depression, and interpersonal problems was examined by means of correlation analysis and additionally, a hierarchical linear regression analysis. To assess SAD, the German version of the Structu…

Association of mental distress with smoking status in the community: Results from the Gutenberg Health Study.

Abstract Background Exposition to tobacco smoke is among the major modifiable risk factors in the general population. There is strong evidence for a close association between smoking exposure and mental disorders. Methods Cross-sectional associations of different conditions of smoking status (former, current, and second hand smoking (SHS)) with indicators of mental distress were analyzed in a sample of N =5000 participants (aged 35–74 years) of the population-based survey “Gutenberg Health Study”. Results In the general population clinically significant depression (OR 1.59, 95%CI 1.17–2.17) and a previous diagnosis of depression (OR 1.50, 95%CI 1.16–1.94) were associated with current smokin…

Removing Batch Effects from Longitudinal Gene Expression - Quantile Normalization Plus ComBat as Best Approach for Microarray Transcriptome Data

International audience; Technical variation plays an important role in microarray-based gene expression studies, and batch effects explain a large proportion of this noise. It is therefore mandatory to eliminate technical variation while maintaining biological variability. Several strategies have been proposed for the removal of batch effects, although they have not been evaluated in large-scale longitudinal gene expression data. In this study, we aimed at identifying a suitable method for batch effect removal in a large study of microarray-based longitudinal gene expression. Monocytic gene expression was measured in 1092 participants of the Gutenberg Health Study at baseline and 5-year fol…

Komorbide Internetsucht unter Patienten der stationären Suchtrehabilitation: Eine explorative Erhebung zur klinischen Prävalenz

Anliegen: Die exzessive Nutzung des Internets wird als substanzungebundene Form einer Abhangigkeitserkrankung diskutiert. Laut Pravalenzschatzungen ist 1 % der deutschen Bevolkerung betroffen. Ungeklart ist, inwieweit Internetsucht komorbid unter Patienten der stationaren Suchtrehabilitation auftritt. Methode: In 15 Kliniken wurden alle innerhalb eines halben Jahres aufgenommenen Patienten auf das Vorliegen von Internetsucht gescreent. Ergebnisse: 4,2 % der Patienten erfullten die Kriterien. Diese waren haufiger mannlich mit den Primardiagnosen Cannabisabhangigkeit und pathologisches Glucksspiel. Schlussfolgerungen: Dies verdeutlicht den Bedarf an entsprechenden Routinescreenings innerhalb …

The impact of attachment distress on affect-centered mentalization: An experimental study in psychosomatic patients and healthy adults

Introduction We investigated the impact of attachment distress on affect-centered mentalization in a clinical and a non-clinical sample, comparing mentalization in a baseline condition to mentalization under a condition of attachment distress. Methods The sample consisted of 127 adults who underwent inpatient psychosomatic treatment, and 34 mentally healthy adults. Affect-centered mentalization was assessed by analyzing participants’ narratives on interpersonal situations in a baseline condition with the Levels of Emotional Awareness Scale (LEAS), and an experimental condition inducing attachment distress with the Adult Attachment Projective Picture System (AAP). Unlike the LEAS, the AAP is…

Base rates for depersonalization according to the 2-item version of the Cambridge Depersonalization Scale (CDS-2) and its associations with depression/anxiety in the general population.

Abstract Background Recently, the two item version of the Cambridge Depersonalization Scale (CDS-2) has been validated in a clinical sample and has demonstrated that it is a useful tool for the detection of clinically significant depersonalization (DP). In order to provide a framework for the interpretation of the CDS-2 scores the aim of this study was to achieve normative data of a representative sample of the German population and to evaluate the associations with depression, anxiety and sociodemographic characteristics. Methods A nationally representative face-to-face household survey was conducted during the mid of 2009 in Germany. The sample comprised N = 2512 participants. The survey …

Digital Stress over the Life Span: The Effects of Communication Load and Internet Multitasking on Perceived Stress and Psychological Health Impairments in a German Probability Sample

The present study investigated the psychological health effects and motivational origins of digital stress based on a representative survey of 1,557 German Internet users between 14 and 85 years of age. Communication load resulting from private e-mails and social media messages as well as Internet multitasking were positively related to perceived stress and had significant indirect effects on burnout, depression, and anxiety. Perceived social pressure and the fear of missing out on information and social interaction were key drivers of communication load and Internet multitasking. Age significantly moderated the health effects of digital stress as well as the motivational drivers of communi…

Typical symptom change patterns and their predictors in patients with social anxiety disorder: A latent class analysis

Abstract Objectives The use of trajectories and analysis of change patterns is a promising way toward better differentiation of subgroups in psychotherapy studies. Research on change patterns in social anxiety disorder (SAD) are still rare, although SAD is one of the most common mental disorders. In a secondary analysis of data from the SOPHO-NET-trial (ISRCTN53517394) this study aimed to investigate change patterns and their predictors in a sample of SAD patients. Methods Patients with SAD (N = 357) were randomly assigned to cognitive-behavioral or psychodynamic therapy. The Liebowitz Social Anxiety Scale (LSAS) was assessed at 1st session (pre), 8th session, 15th session and at the end of…

An emotion-based online intervention for reducing anxiety and depression in cancer patients: Study protocol for a randomized controlled trial

Abstract Background A cancer diagnosis can cause severe emotional distress and affect quality of life as well as social relationships. The transition from inpatient to outpatient treatment is burdened by stressful uncertainties and a gap of psycho-oncological care. In addition, further barriers, such as information deficits or fear of stigmatization, might hinder cancer patients to use psycho-oncological face-to-face interventions. Online interventions can be a low-threshold adjunct to existing face-to-face services. This study aims to evaluate the effect of the online self-help program epos (emotion-based psycho-oncological online self-help) on improving symptoms of anxiety and depression …

Measurement invariance, validation and normative data of the Jenkins Sleep Scale-4 (JSS-4) in the German general population across the life span.

Abstract Objective As sleep disorders have become a major concern in public health, there is strong need for a brief and sound measure for sleep problems. The purposes of the study were to 1) evaluate factor structure and measurement invariance, 2) validate the scale based on sociodemographic data and distress, and 3) provide norm values for the general population. Methods In a representative survey of the German population N = 2515 participants (14 to 95 years) filled in the 4-item Jenkins Sleep Scale (JSS-4), sociodemographic questions and the Brief Symptom Inventory-18 (anxiety, depression, somatic symptom load). The JSS-4 was analyzed by principal component analysis, confirmatory and mu…

Implementation of a Web-Based Work-Related Psychological Aftercare Program Into Clinical Routine: Results of a Longitudinal Observational Study

Background: As inpatient medical rehabilitation serves to promote work ability, vocational reintegration is a crucial outcome. However, previous Web-based trials on coping with work-related stress have been limited to Web-based recruitment of study participants. Objective: The aim of our study was to evaluate the implementation of an empirically supported transdiagnostic psychodynamic Web-based aftercare program GSA (Gesund und Stressfrei am Arbeitsplatz [Healthy and stress-less at the workplace])-Online plus into the clinical routine of inpatient medical rehabilitation, to identify characteristics of patients who have received the recommendation for GSA-Online plus, and to determine helpfu…

Personality functioning as a mediator of adult mental health following child maltreatment.

Abstract Background The broad range of adverse health outcomes following child maltreatment (child maltreatment) underscores the need to investigate shared trajectories that contribute to associated physical and mental health problems. Previous research focused on different mechanisms, such as emotion regulation or attachment. In the present study, we propose personality functioning, comprising self- and interpersonal regulation and perception, to mediate between child maltreatment and mental and physical health. Methods In a German representative sample (N = 2,508), we assessed remembered child maltreatment, levels of personality functioning, and different health outcomes in adulthood, nam…

Insights Into Aspects Behind Internet-Related Disorders in Adolescents: The Interplay of Personality and Symptoms of Adjustment Disorders

Abstract Purpose Problematic Internet use (PIU) that has recently been referred to as Internet-related disorder is a growing health concern. Yet, it is unclear why some adolescents are developing problematic use, whereas others sustain control. Based on previous research, we hypothesize that personality traits (low conscientiousness and high neuroticism) act as predispositions for PIU. We further hypothesize that PIU can be understood as a maladaptive reaction toward critical life events and that these maladaptive reactions are exacerbated by dysfunctional personality traits. Methods The study investigates the prevalence of distinct subtypes of PIU among a sample of adolescents (n = 1,489; …

Soziale Phobie – eine im psychosomatischen Ambulanz- und Konsildienst unterdiagnostizierte Angsterkrankung?

Social fears are common, whereas Social Phobia is diagnosed infrequently. Therefore, we compared the clinical diagnoses (ICD-10) in an outpatient and CL service of a psychosomatic university hospital to patients' self ratings in social fears on the Liebowitz Social Anxiety Scale (LSAS). Over the course of one year 688 patients could be characterized regarding their clinical diagnoses, LSAS-scores, symptom severity (SCL-90R) and psychosomatic complaints (GBB-24). Patients were assigned to three groups by their levels of social fears (LSAS). Social Phobia was diagnosed rarely by clinicians (5.5%), but generalized social fears (LSAS>60) were commonly reported by patients (14.6%). Patients with…

Association of Low Birth Weight With Altered Corneal Geometry and Axial Length in Adulthood in the German Gutenberg Health Study

IMPORTANCE: Low birth weight is associated with altered ocular organ development in childhood, including the morphology of the eye. However, no population-based data exist about this association in adulthood. OBJECTIVE: To evaluate whether low birth weight has a long-term association with anterior segment anatomy and axial length in adulthood. DESIGN, SETTING, AND PARTICIPANTS: The Gutenberg Health Study is a population-based, observational cohort study in Germany. All participants underwent ocular biometry. Among the participants with follow-up and self-reported birth weight available, associations were assessed between low birth weight and anterior segment anatomy and axial length using m…

Association of ocular, cardiovascular, morphometric and lifestyle parameters with retinal nerve fibre layer thickness.

BACKGROUND Glaucoma is a neurodegenerative disease, leading to thinning of the retinal nerve fibre layer (RNFL). The exact influence of ocular, cardiovascular, morphometric, lifestyle and cognitive factors on RNFL thickness (RNFLT) is unknown and was analysed in a subgroup of the Gutenberg Health Study (GHS). METHODS Global peripapillary RNFLT was measured in 3224 eyes of 1973 subjects (49% female) using spectral-domain optical coherence tomography (SD-OCT). The association of age, sex, ocular, cardiovascular, morphometric, lifestyle and cognitive factors on RNFLT was analysed using Pearson correlation coefficient and fitting a linear mixed model. RESULTS In the univariable analysis highest…

Assessing Planning Ability Across the Adult Life Span in a Large Population-Representative Sample: Reliability Estimates and Normative Data for the Tower of London (TOL-F) Task

AbstractObjectives:The Tower of London (TOL) test has probably become the most often used task to assess planning ability in clinical and experimental settings. Since its implementation, efforts were made to provide a task version with adequate psychometric properties, but extensive normative data are not publicly available until now. The computerized TOL-Freiburg Version (TOL-F) was developed based on theory-grounded task analyses, and its psychometric adequacy has been repeatedly demonstrated in several studies but often with small and selective samples.Method:In the present study, we now report reliability estimates and normative data for the TOL-F stratified for age, sex, and education …

Screening for distress in routine oncological care-a survey in 520 melanoma patients.

Introduction Despite the increasing incidence of melanoma little is known about patients' emotional distress associated with this disease. Supplemented by the problem list (PL), the distress thermometer (DT) is a recommended screening instrument to measure psychosocial distress in cancer patients. Our objective was to explore the acceptance and the feasibility of the DT and PL as a concise screening tool in an ambulatory setting for routine care and to elucidate determinants of distress in melanoma patients with regard to sociodemographic and clinical variables. Methods Consecutive melanoma outpatients were asked to complete the DT with the PL prior to their scheduled consultation. Demograp…

Sexual desire and sexual activity of men and women across their lifespans: results from a representative German community survey

OBJECTIVES To present data on sexual desire and sexual activity from a representative survey of men and women covering the total age range of the adult German population, as previous studies have usually been based on samples selected for gender (either men or women) and age (ageing populations). SUBJECTS AND METHODS A representative sample of 2341 men and women aged 18-93 years were surveyed to determine frequency and intensity of sexual desire and sexual activity, and their social, individual and interpersonal characteristics. RESULTS Sexual desire declined with advancing age; overall, men reported more frequent and stronger sexual desire than women. However, there were important interact…

Free-to-play: About addicted Whales, at risk Dolphins and healthy Minnows. Monetarization design and Internet Gaming Disorder

Abstract Introduction Video games are not only changing due to technical innovation, but also because of new game design and monetization approaches. Moreover, elite gamer groups with financial in-game-investments co-finance all users of free-to-play-games. Besides questions on youth protection, the growing popularity of free-to-play games has fostered discussions on supposed associations to Internet Gaming Disorder (IGD). Method Children and adolescents using free-to-play browser games were examined in a German school-based representative study (N = 3967; age range 12 to 18). Based on a clinical self-report AICA-S (Wolfling et al., 2011), students were categorized into non-problematic, ris…

„Morbus Google“ vs. e-Health: Qualitative Untersuchung zur Akzeptanz und Implementierung von Online-Nachsorge in der stationären Rehabilitation

Zusammenfassung Hintergrund Internet- und mobilbasierte Gesundheitsinterventionen (IMIs) können z. B. in Form von Nachsorgeangeboten das Behandlungsangebot der Rehabilitation erweitern. Für die Implementierung ist jedoch deren Akzeptanz eine wesentliche Voraussetzung, die daher bei Rehabilitanden und Mitarbeitern qualitativ untersucht wurde. Methodik In 3 Rehabilitationskliniken mit verschiedenen Indikationen und Altersgruppen wurden n=15 Rehabilitanden in Einzelinterviews und n=29 Mitarbeiter verschiedener Berufsgruppen in Fokusgruppen nach einem semi-strukturierten Leitfaden auf Basis der “Unified Theory of Acceptance and Use of Technology“ interviewt. Ergebnisse Vorteile einer Online-Nac…

Loneliness predicts suicidal ideation and anxiety symptoms in long-term childhood cancer survivors.

Abstract Background/Objective Long-term childhood cancer survivors (CCS) are at risk for adverse late effects. However, not all of them are well understood. The present study addressed loneliness, a previously under-researched mental health risk in cancer survivor populations. We assessed the prevalence of loneliness and its impact on psychological symptoms over time. Method: A registry-based sample of N = 633 adult long-term CCS underwent medical and psychological assessments and took part in a follow-up survey 2.5 years later. Psychological symptoms (somatic, anxiety, depression symptoms, and suicidal ideation) were measured using the Patient Health Questionnaire. We calculated linear reg…

Psychische Belastung und die Akzeptanz von gewaltlegitimierenden Männlichkeitsnormen bei Jugendlichen

Vor dem Hintergrund der steigenden Anzahl von Jugendlichen mit Migrationshintergrund an der deutschen Bevolkerung war das Ziel der vorliegenden Studie die psychische Belastung bei Jugendlichen mit direktem, indirektem und ohne Migrationshintergrund in einer reprasentativen Schulerbefragung zu beschreiben und zu vergleichen. Die Auspragungen von gewaltlegitimierenden Mannlichkeitsnormen (GLMN) wurden im Zusammenhang mit psychischen Problemen analysiert. Insgesamt wurden 8 518 Schuler und Schulerinnen im Alter von 12 und 19 Jahren aus verschiedenen Schulformen hinsichtlich ihrer selbsteingeschatzten psychischen Belastung in internalisierenden und externalisierenden Problembereichen und ihrer …

A Systematic Review on Sex- and Gender-Sensitive Research in Public Mental Health During the First Wave of the COVID-19 Crisis

Background:Sex and gender are important modifiers of mental health and behavior in normal times and during crises. We investigated whether they were addressed by empirical, international research that explored the mental health and health behavior ramifications after the onset of the COVID-19 pandemic.Methods:We systematically searched the databases PsyArXiv, PubMed, PsycInfo, Psyndex, PubPsych, Cochrane Library, and Web of Science for studies assessing mental health outcomes (main outcomes) as well as potential risk and protective health behavior (additional outcomes) up to July 2, 2020.Findings:Most of the 80 publications fulfilling the selection criteria reflected the static difference p…

Fatigue assessment questionnaire: standardization of a cancer-specific instrument based on the general population.

<i>Objectives:</i> Fatigue has become a major issue of concern in the care of cancer patients, as it has been shown to compromise their quality of life in a significant and lasting way. However, there is a lack of economic and specific measures. The Fatigue Assessment Questionnaire (FAQ) has been developed based on thorough interviews and tested on a large mixed sample of cancer patients. The purposes of this paper are to test the psychometric properties of the FAQ and to provide norms for the German population. <i>Methods:</i> The FAQ was administered to a representative sample of the German population (1,340 female and 1,101 male participants) along with standardiz…

What's past is prologue: Recalled parenting styles are associated with childhood cancer survivors' mental health outcomes more than 25 years after diagnosis

Abstract Background With the increased survival rates of childhood cancer, long-term survivors' well-being over the life span has come into focus. A better understanding of the determinants of childhood cancer survivors' (CCS) mental health outcomes contributes to the identification of vulnerable individuals as well as to the development of evidence-based prevention and intervention efforts. It has been noted that psychosocial factors such as parental rearing behavior shape individual differences in mental health. There is also evidence that parents show altered parenting behavior in the face of childhood cancer, e. g. that they express more emotional support, but also more worries. However…

Mean Platelet Volume and Arterial Stiffness - Clinical Relationship and Common Genetic Variability

AbstractVessel wall stiffening is an important clinical parameter, but it is unknown whether platelets, key elements in the pathogenesis of arterial thrombosis, are associated with arterial stiffness. The present studies sought to determine whether mean platelet volume (MPV), a potential marker of platelet activation, is linked to vascular elasticity as assessed by the augmentation index (AIx), in 15,010 individuals from the population-based Gutenberg Health Study. Multivariable analysis showed that MPV in both males (β 0.776; 95thCI [0.250;1.16]; p = 0.0024) and females (β 0.881[0.328;1.43]; p = 0.0018) is strongly associated with AIx. Individuals with MPV and AIx above the sex-specific me…

Berufsbedingte Einschränkungen und somatische Beschwerden bei Patienten mit Internetbezogenen Störungen im Vergleich zu Pathologischen Glücksspielern

Disturbed glucose metabolism and left ventricular geometry in the general population – results from the Gutenberg health study

Abstract Background Prediabetes and type 2 diabetes mellitus (T2DM) have been demonstrated to alter left ventricular geometry and promote left ventricular (LV) hypertrophy (LVH). However, the impact of impaired glucose metabolism on cardiac structure is still not completely understood and controversially discussed. Purpose To investigate the impact of prediabetes and T2DM on left ventricular geometry and their potential interaction with LVH in the prediction of survival. Methods Data from the Gutenberg Health Study (N=15,010) – a population-based study with highly standardized phenotyping – were analysed. Information was obtained from computer-assisted personal interviews, medical-technical…

The relationship of ocular geometry with refractive error in normal and low birth weight adults

Purpose Low birth weight (BW) individuals have an increased risk for myopic refractive error. However, it is unclear which ocular geometric alterations lead to an increase in myopic refractive error. This study aims to evaluate the impact of ocular biometry in interaction with BW on refractive error. Methods Participants of the prospective, observational, population-based Gutenberg Health Study (GHS) with self-reported BW aged 40–80 years and objective refraction and optical biometry were included. Linear regression analyses were conducted to evaluate associations between spherical equivalent with corneal power, anterior chamber depth, lens thickness and axial length and its interaction wit…

Evaluation des Beratungsaufkommens der Regionalen Fachstellen Glücksspielsucht in Rheinland-Pfalz

Validating the German version of the Quality of Relationship Inventory: confirming the three-factor structure and report of psychometric properties.

Research on psychosocial influences such as relationship characteristics has received increased attention in the clinical as well as social-psychological field. Several studies demonstrated that the quality of relationships, in particular with respect to the perceived support within intimate relationships, profoundly affects individuals' mental and physical health. There is, however, a limited choice of valid and internationally known assessments of relationship quality in Germany. We report the validation of the German version of the Quality of Relationships Inventory (QRI). First, we evaluated its factor structure in a representative German sample of 1.494 participants by means of confirm…

Vocational training integrated into inpatient psychosomatic rehabilitation--short and long-term results from a controlled study.

Purpose. The aim of this study was to determine the impact of a vocational training programme on short- and long-term results after psychosomatic rehabilitation. Method. 1,590 inpatients were screened for vocational integration. A high-risk group of 266 patients was randomly assigned to the vocational training programme plus psychosomatic treatment; treatment- as- usual served as a control condition. An occupational training was conducted at local companies, closely integrated into psychosomatic treatment. Vocational attitudes and adjustment were studied at intake, discharge, three, 12 and 24 month follow-ups. Results. More than half of the study participants were unemployment and/or long-t…

Functional Neuroimaging—Can It Contribute to Our Understanding of Processes of Change?

Preliminary studies have shown that psychotherapeutic and pharmacological treatments of psychiatric disorders lead to measurable changes in the activity of the brain, particularly when they successfully reduce depression, fears, or obsessions. The purpose of this paper is to review the potential of functional neuroimaging in the understanding and evaluation of psychotherapy. Following an overview of basic neuroimaging concepts and procedures, promising neuroimaging paradigms probing mind–brain function are presented together with selected results on psychiatric patients and control subjects. Neuroimaging studies conducted pre- and post-psychotherapy are reviewed. Conclusions are formulated …

Low N-Terminal pro-B-type Natriuretic Peptide (NT-proBNP) longitudinally predicts elevated anxiety in depressed patients with coronary artery disease

MENTAL HEALTH AND SUICIDAL IDEATION AMONG 1ST AND 2ND GENERATION MIGRANTS - Results from the Gutenberg Health Study

Prä-klinische Ansätze der Computerspiel- und Internetsucht: Schulbasierte Präventionsansätze, Medientraining und eine Empfehlung für finanzielle Obergrenzen bei In-Game-Käufen (MIRPPU)

ZusammenfassungAusgewählte Beiträge eines internationalen Reviews zu schulbasierten Präventionsansätzen werden vorgestellt. Aufgrund ihrer Wirksamkeit werden 2 internationale Ansätze dargestellt. Ergänzend werden 5 z.T. evaluierte Ansätze des deutschen Sprachraumes beschrieben.Um einer subklinisch exzessiven Nutzungsgruppe ein benötigtes präventives Angebot zur Verfügung zu stellen, wurde von der Ambulanz für Spielsucht Mainz ein Medientraining konzipiert. Dieser verhaltenstherapeutische Präventionsansatz wird konzeptuell und mit seinen ersten Pilotergebnissen abgebildet. Beim Medientraining handelt es sich um eine gruppentherapeutische Frühintervention für Kinder und Jugendlichen mit probl…

Prevalence of corneal arcus and associated factors in a German population-Results from the Gutenberg Health Study.

Purpose We aimed to determine the prevalence of corneal arcus and to identify associated factors in the general population of Germany. Methods The Gutenberg Health Study (GHS) is a population-based cohort study in Germany, which includes an ophthalmological assessment. Refraction, distance-corrected visual acuity, non-contact tonometry and anterior segment imaging were performed for the five-year follow-up examination. Anterior segment photographs were graded for the presence of corneal arcus. Prevalence estimates were computed, and multivariable logistic regression analysis was applied to determine associated factors for corneal arcus including sex, age, spherical equivalent, central corn…

Comorbid Internet Addiction in Male Clients of Inpatient Addiction Rehabilitation Centers

Addictive Internet use has recently been proposed to be included in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Still, little is known about its nosological features, including comorbidity with other mental disorders and disorder-specific psychopathological symptoms. To investigate whether Internet addiction (IA) is an issue in patients in addiction treatment, 1826 clients were surveyed in 15 inpatient rehabilitation centers. Male patients meeting criteria for comorbid IA (n = 71) were compared with a matched control group of male patients treated for alcohol addiction without addictive Internet use (n = 58). The SCL-90-R, the Patient Health Questionnaire, and …

Standfest? Erste Ergebnisse der Entwicklung eines kognitiv-verhaltenstherapeutischen Gruppenschulungsprogramms zur Behandlung des somatoformen Schwindels

Anhand einer explorativen Fragestellung soll der Einfluss eines Schulungsprogramms fur somatoforme Schwindelpatienten auf dysfunktionale Krankheitsreprasentationen, Symptomstarke und psychische Komorbiditat uberpruft werden. Randomisiertes Wartekontrollgruppen-Design: 10 Patienten wurden der Kontrollgruppe zugewiesen; 14 Patienten der Interventionsgruppe durchliefen die Diagnostik im Pratest, Posttest und eine 3- bzw. 12-Monats-Katamnese. Die Fragebogenbatterie umfasste den Illness Perception Questionnaire, Vertigo Symptom Scale, Vertigo Handicap Questionnaire, Hospital Anxiety and Depression Scale und Physical Health Questionnaire. Hypothesenkonform verbesserte sich die personliche Kontrol…

Zusammenhänge zwischen Anpassungsstörungen und Internetbezogenen Störungen im Jugendalter: Ergebnisse einer Längsschnittuntersuchung

Long-term outcomes of short-term and long-term psychosomatic inpatient treatment and their predictors

Abstract Objectives The Clinic for Psychosomatic Medicine and Psychotherapy at the University Giessen, Germany, offers short-term (STT) and long-term inpatient therapy (LTT). Methods In a prospective, 3-year follow-up study, we examined therapeutic indication, short- and long-term results, outcome predictors, and the utilization of aftercare for both settings. Results STT patients were more frequently acutely ill, suffered from stronger symptomatic manifestations, and were more frequently employed. LTT patients had a greater rate of chronic psychosomatic disorders, personality disorders and somatic comorbidity. In both settings, distress strongly declined during inpatient therapy and remain…

Correlations between hormones, physical, and affective parameters in aging urologic outpatients.

Abstract Objective: To determine the relationship between sex hormones, physical complaints, depression, sexuality, and life satisfaction in aging men. Methods: 263 outpatients aged 40 years and above ( M =56.2; 40–84 years) were recruited from 6 andrological outpatient departments in Germany to evaluate "aging male" symptoms. Subjects were assessed by standardised self-report questionnaires, physical, and endocrinological examination. Results: Total and free testosterone as well as DHEA-S (dehydroepiandrosterone-sulfate) levels decreased significantly with age. SHBG (sex hormone binding globulin) and LH (luteinizing hormone) increased; estradiol remained unchanged. Inactivity, lower urinar…

Bipolar spectrum disorders in a clinical sample of patients with Internet addiction: hidden comorbidity or differential diagnosis?

Background and Aims Behavioral addictions and bipolar disorders have a certain probability of co-occurrence. While the presence of a manic episode has been defined as an exclusion criterion for gambling disorder, no such exclusion has been formulated for Internet addiction. Methods A clinical sample of 368 treatment seekers presenting with excessive to addictive Internet use was screened for bipolar spectrum disorders using the Mood Disorder Questionnaire. Psychopathology was assessed by the Symptom Checklist 90R and a clinical interview was administered to screen for comorbid disorders. Results Comorbid bipolar disorders were more frequent in patients meeting criteria for Internet addictio…

Influence of Thrombotic Thrombocytopenic Purpura on Depressivity, Cognitive Conduction, Quality of Life, and Resilience of Patients

Association of low birth weight with myopic refractive error and lower visual acuity in adulthood: results from the population-based Gutenberg Health Study (GHS).

PurposeLow birth weight (BW) is linked to impaired organ development in childhood, including altered ocular morphological and functional development. The aim of this study was to evaluate whether low BW has long-term effects on visual acuity and refraction in adulthood.MethodsThe Gutenberg Health Study is a population-based, observational cohort study in Germany, including 15 010 participants aged between 35 and 74 years. These participants were divided into three different BW groups (low: <2500 g; normal: between 2500 and 4000 g; and high: >4000 g). Best-corrected visual acuity and objective refraction were examined. We used multivariable linear regression models with adjustment for …

Depersonalization Experiences Are Strongly Associated With Dizziness and Vertigo Symptoms Leading to Increased Health Care Consumption in the German General Population

This study investigated the association of depersonalization (DP) experiences with dizziness and its impact on subjective impairment and health care use. Trained interviewers surveyed a representative sample of 1287 persons using standardized self-rating questionnaires on dizziness, DP, and mental distress. Symptoms of dizziness were reported by 15.8% (n = 201). Thereof, 62.7% endorsed at least one symptom of DP, 40% reported impairment by symptoms of DP, and 8.5% reported clinically significant DP. Regression analyses identified DP as a significant, independent predictor for dizziness symptom severity, health care use, and impairment by dizziness. With regard to the Vertigo Symptom Scale, …

A hidden type of internet addiction? Intense and addictive use of social networking sites in adolescents

Internet Gaming Disorder has been included as a preliminary diagnosis in DSM-5. The question remains, if there are additional internet activities related to addictive use. Especially, use of social networking sites has been discussed to be related to excessive use, but only few empirical studies are available. We wanted to explore, if use of social networking sites is related to addiction symptoms and psychosocial distress and which variables (demography, personality) predict addictive use. A representative sample of n?=?9173 adolescents (12-19 years) was enrolled. Self-report questionnaires assessed demography, frequency of social networking sites use, internet addiction, personality, and …

Adult attachment representation moderates psychotherapy treatment efficacy in clinically depressed inpatients

Abstract Background We explored in a sample of clinically depressed patients the influence of attachment security and unresolved trauma on psychotherapeutic outcome as well as changes in attachment representation through psychotherapeutic intervention. Methods The sample consisted of 85 women (aged 19–52), 43 clinically depressed patients from a psychosomatic inpatient unit, and 42 healthy control subjects matched for age and education. Average length of hospitalization in the patient group was eight weeks. Attachment representations were assessed with the Adult Attachment Interview at the time of admission (baseline) and at discharge. Depressive symptoms were measured using the PHQ-9 at T1…

Persistence of symptoms in primary somatoform vertigo and dizziness: a disorder "lost" in health care?

The aim of this study was to perform a 3-year follow-up of primary somatoform vertigo and dizziness (SVD) regarding health care use and treatment. Ninety-two patients with dizziness underwent detailed vestibular neurophysiological testing and a Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Psychometric assessments comprised the Vertigo Symptom Scale, the Vertigo Handicap Questionnaire, the SCL-90-R, and the Short-Form-36 Health Survey. At the 3-year follow-up, 65 patients with primary SVD (anxiety, n = 29; depression, n = 14; somatoform disorders, n = 22) were reassessed (70.7% response). The patients improved in symptom severity (p…

Gender-Dependent Associations of Anxiety and Depression Symptoms With Eating Disorder Psychopathology in a Representative Population Sample

Background:Evidence shows that anxiety and depressive disorders play an important role in eating disorder behavior. However, given the epidemiology of eating disorders, there is a need to investigate potentially gender-specific connections.Method:This study tested the associations of anxiety and depression symptoms with eating disorder symptoms and behaviors and explored whether they differed between men and women. Within a population-representative survey (N= 2,510; ages 14–94), participants completed measures of depression symptoms (PHQ-2), anxiety symptoms (GAD-2), and eating disorder symptoms (EDE-Q8). We conducted linear regression analyses of the EDE-Q8 sum score and General Linear Mo…

Epidemiologic Analysis of Asteroid Hyalosis and Associations: The Gutenberg Health Study

Thrombin generation in cardiovascular disease and mortality – results from the Gutenberg Health Study

Thrombin generation may be a potential tool to improve risk stratification for cardiovascular diseases. The aim of this study was to explore the relation between thrombin generation and cardiovascular risk factors, cardiovascular diseases, and total mortality. For this study, 5,000 subjects from the population-based Gutenberg Health Study were analyzed in a highly standardized setting. Thrombin generation was assessed by the Calibrated Automated Thrombogram method at 1 and 5 pM tissue factor triggers in platelet-poor plasma. Lag time, endogenous thrombin potential, and peak height were derived from the thrombin generation curve. Sex-specific multivariable linear regression analysis adjusted…

Abstract 13257: FEV1 and FVC predict Mortality in Individuals Without Manifest Lung Disease Independent of Cardiac Performance - Results From the Population-based Gutenberg Health Study

Background: Pulmonary disease has consistently been related to increased mortality. We investigated central spirometry variables in relation to total mortality in individuals from the general population without diagnosed lung disease also accounting for cardiac function. Methods: In 15,010 individuals from the general population (mean age 55±11 years, age range 35-74 years, 50.5% men) in the Gutenberg Health Study we performed spirometry and multimodal transthoracic echocardiography. The biomarkers N-terminal pro-B-type natriuretic peptide (Nt-proBNP) and high-sensitive troponin I (TnI) were measured in the first 5000 individuals using commercially available assays. Multivariable Cox regre…

The Social Phobia Psychotherapy Research Network

This paper presents the Social Phobia Psychotherapy Research Network. The research program encompasses a coordinated group of studies adopting a standard protocol and an agreed-on set of standardized measures for the assessment and treatment of social phobia (SP). In the central project (study A), a multicenter randomized controlled trial, refined models of manualized cognitive-behavioral therapy and manualized short-term psychodynamic psychotherapy are compared in the treatment of SP. A sample of 512 outpatients will be randomized to either cognitive-behavioral therapy, short-term psychodynamic psychotherapy or waiting list. Assessments will be made at baseline, at the end of treatment and…

Developing a prototype for short-term psychodynamic (supportive-expressive) therapy: An empirical study with the psychotherapy process Q-set.

AbstractObjective: A Psychotherapy Process Q-set (PQS) prototype characteristic of short-term psychodynamic therapy (STPP) does not yet exist. Method: Experts in supportive-expressive (SE) therapy used the 100-Item PQS questionnaire to rate an ideal short-term SE therapy. Results: Agreement between raters was high (Cronbach's alpha = 0.94). The prototype for SE therapy showed a significant correlation with the psychoanalytic prototype, but with 28% of variance explained, the majority of variance of the former was not explained by the latter or vice versa. Furthermore, the SE prototype showed significant correlations with the cognitive-behavioral prototype and the prototype of interpersonal …

A contribution to the clinical characterization of Internet addiction in a sample of treatment seekers: validity of assessment, severity of psychopathology and type of co-morbidity.

Abstract Objective Internet addiction becomes a growing health problem worldwide with prevalence rates up to 3%. Still, uncertainties exist regarding its diagnostics and clinical characterization. Especially the lacking clinical evidence regarding self-report measures assessing Internet addiction has been criticized. Methods This study aimed to characterize 290 German treatment seekers and to determine the diagnostic accuracy of a self-report scale for Internet addiction. Patients filled in self-report measures (SCL-90R, PHQ, AICA-S – Scale for the Assessment of Internet and Computer game Addiction) and underwent diagnostic interviews to assess symptoms of Internet addiction and level of fu…

Pursuit of the emerging dialogue between psychoanalysis and neuroscience: clinical and research perspectives.

Einstellungen von Medizinstudierenden zu psychotherapeutischen Behandlungsverfahren und Weiterbildungen

Zusammenfassung Hintergrund und Fragestellung: Vor dem Hintergrund einer arztlichen Unterversorgung von Patienten mit psychischen und psychosomatischen Erkrankungen gewinnt die Frage nach dem Interesse von Studierenden der Medizin fur psychische Erkrankungen und ihren Einstellungen zu psychotherapeutischen Behandlungsverfahren beziehungsweise dem Erwerb des Facharzttitels in diesen Fachgebieten an Bedeutung. Methode: Studierende der Medizin (N = 366) im klinischen Ausbildungsabschnitt wurden mit teilstandardisierten Fragebogen zu ihren Interessen und Einstellungen gegenuber psychotherapeutischen Behandlungsverfahren, zu ihren beruflichen Planen, zu psychischen und sozialen Belastungen sowie…

Visual Impairment Is Associated With Depressive Symptoms—Results From the Nationwide German DEGS1 Study

Introduction: Visual impairment is associated with a variety of co-morbidities including physical and mental health in industrial countries. Our aim is to examine associations between self-reported impairment and depressive symptoms in the German population. Methods: The point prevalence of self-reported visual impairment in Germany was computed using data from the German Health Interview and Examination Survey for adults from 2008 to 2011 (N=7.783, 50.5% female, age range 18-79 years). Visual impairment was surveyed by two questions, one for seeing faces at a distance of 4 meters and one for reading newspapers. Depressive symptoms were evaluated with the PHQ-9 questionnaire and two-week pr…

Somatic symptoms in the Eastern and Western states of Germany 30 years after unification: Population-based survey analyses.

Background Following German reunification, physical health indicators in the formerly separated states (German Democratic Republic- East/ Federal Republic of Germany-West) have converged. However, it remains unclear how these societal changes have impacted somatic complaints, a major indicator of physical and mental health. Therefore, we investigated how somatic symptom reporting in men and women evolved regarding residency. Methods We administered cross-sectional surveys representative of the German population with comparable sample size in 1994 (N = 3047), 2001 (N = 2050), 2013 (N = 2508) and 2019 (N = 2531) following random route procedure. Men and women aged 14-99 reported demographics …

Inanspruchnahme von Selbsthilfegruppen durch Patienten einer psychosomatischen Klinik/ Utilization and Significance of Self-Help Groups in Treatment Careers of Psychosomatic Inpatients

Zusammenfassung Fragestellung: Selbsthilfegruppen wurden in der psychosomatisch-psychotherapeutischen Forschung vernachlassigt. Diese Studie beschaftigt sich daher mit dem Stellenwert von Selbsthilfegruppen in der Behandlungskarriere von Patienten einer psychosomatischen Klinik. Methode: Vorerfahrungen mit Selbsthilfegruppen, Therapeutenempfehlungen und Plane fur kunftige Selbsthilfegruppenteilnahme wurden bei 1.604 Patienten bei Aufnahme und Entlassung aus einer psychosomatischen Behandlung untersucht. Ergebnisse: Patienten mit Selbsthilfegruppen-Erfahrungen (12 % aller Patienten) waren alter, gebildeter und hatten mehr Psychotherapie in Anspruch genommen. Sie berichteten eine langere Kran…

Online Self-Help as an Add-On to Inpatient Psychotherapy: Efficacy of a New Blended Treatment Approach.

<b><i>Background:</i></b> Depression is one of the most frequent and costly mental disorders. While there is increasing evidence for the efficacy of online self-help to improve depression or prevent relapse, there is little evidence in blended care settings, especially combined with inpatient face-to-face psychotherapy. Therefore, we evaluated whether an evidence-based online self-help program improves the efficacy of inpatient psychotherapy. <b><i>Methods:</i></b> A total of 229 depressed patients were randomly allocated either to an online self-help program (intervention group [IG]; Deprexis) or an active control group (CG; weekly online inf…

Distribution of Anterior Chamber Angle Width and Correlation With Age, Refraction, and Anterior Chamber Depth—The Gutenberg Health Study

PURPOSE Scheimpflug imaging allows quantitative analysis of the width of the anterior chamber angle. We report the population-based distribution of the anterior chamber angle width using this noncontact imaging technique and investigate associated factors. METHODS A population-based cross-sectional study was carried out in Germany. A comprehensive ophthalmologic examination including refraction, biometry, and Scheimpflug imaging was performed. Automated measurement of the anterior chamber angle was performed in each anterior chamber quadrant. Exclusion criteria were previous ocular surgery or inadequate image quality. Association analyses were carried out to determine independently associat…

The relationship between trait procrastination, Internet use, and psychological functioning : results from a community sample of German adolescents

Adolescents with a strong tendency for irrational task delay (i.e., high trait procrastination) may be particularly prone to use Internet applications simultaneously to other tasks (e.g., during homework) and in an insufficiently controlled fashion. Both Internet multitasking and insufficiently controlled Internet usage may thus amplify the negative mental health implications that have frequently been associated with trait procrastination. The present study explored this role of Internet multitasking and insufficiently controlled Internet use for the relationship between trait procrastination and impaired psychological functioning in a community sample of N = 818 early and middle adolescent…

Birth weight and its association with optic nerve head morphology - results from the population-based German Gutenberg Health Study.

Symptoms of adjustment disorder and smoking predict long-term functional outcome after ankle and lower leg fracture

Objective To examine the psychological, social, behavioural and injury-related factors impacting functional outcome in patients with ankle or lower limb fracture one year post-operation. Methods In this prospective study 66 patients with ankle or lower leg fracture were recruited and followed up one year post-operation. Possible associations between predictors and functional outcome were explored by regression analyses. Functional outcome was assessed with the American Orthopedic Foot and Ankle Society Ankle-Hindfoot Score. Results Linear regression models revealed that smoking and elevated symptoms of adjustment disorder were associated with lower functional outcome one year post-operation…

Inanspruchnahme von Selbsthilfegruppen und Psychotherapie im Anschluss an eine stationäre psychosomatisch-psychotherapeutische Behandlung

Until now little is known about the role of participation in self-help groups alone or combined with psychotherapy in post-in-patient care. In the present study 2933 patients were questioned about their experience of self-help groups and psychotherapy after discharge from a clinic for psychosomatic medicine and psychotherapy. Nearly 8 % of them utilized self-help groups (mostly combined with out-patient psychotherapy), and altogether 68 % out-patient psychotherapy following in-patient treatment. Patients without out-patient treatment were psychologically less burdened and had better resources than participants of self-help groups or psychotherapy. Self-help group members differed from patie…

The desire for children among adult survivors of childhood cancer: Psychometric evaluation of a cancer-specific questionnaire and relations with sociodemographic and psychological characteristics.

OBJECTIVE Long-term childhood cancer survivors (CCS) are less likely to become parents than their peers of the same age. Previous research has suggested that besides fertility, this outcome is shaped by psychosocial factors such as emotional motives toward having a child. Drawing from a sample of CCS with survival times >25 years, we present the validation of a questionnaire assessing cancer-specific reproductive motives and concerns. METHODS We evaluated the cancer-specific version of the Leipzig Questionnaire of Motives to have a Child (LKM-C) in a register-based sample of adult CCS (N = 632, 31% had children, 44.5% women). We conducted a confirmatory factor analysis and tested associatio…

Association between cingulum bundle structure and cognitive performance: an observational study in major depression.

AbstractBackgroundMajor depression can be regarded as a systemic neurobehavioral disorder resulting from dysfunction of the limbic-cortical networks. The cingulum bundle represents a major association fiber tract of those networks. The aim of our study was to determine the association of brain structural tissue markers of the cingulum bundle and cognitive function in patients with major depression.MethodsRegion-of-interest-based analyses of the middle-anterior and middle-posterior cingulum bundle fractional anisotropy (FA) and mean diffusivity (MD) using color-coded diffusion-tensor imaging and neuropsychological assessment in 14 patients with major depression.ResultsFA of the middle-anteri…

Investigating Risk Factors for Internet Gaming Disorder: A Comparison of Patients with Addictive Gaming, Pathological Gamblers and Healthy Controls regarding the Big Five Personality Traits

Engaging in online games has become increasingly important as a part of leisure activity in adolescents and adults. While the majority of people use these games in a healthy way, epidemiological studies show that some develop excessive use and symptoms that are related to those of substance-related addictions. Despite increasing research concerning the epidemiology of internet gaming disorder (IGD), predisposing factors have been examined to a lesser extent. Knowing about specific risk factors would help clarify the nosological features of IGD and enhance prevention and intervention. This study aimed to evaluate the relationships between personality traits and IGD. A total of 115 patients m…

Depression and cognitive deficits as long-term consequences of thrombotic thrombocytopenic purpura

BACKGROUND Thrombotic thrombocytopenic purpura (TTP) is an acute life-threatening microangiopathy with a tendency of relapse characterized by consumptive thrombocytopenia, microangiopathic hemolytic anemia, and spontaneous von Willebrand factor–induced platelet clumping leading to microthrombi. The brain is frequently affected by microthrombi leading to neurologic abnormalities of varying severity. STUDY DESIGN AND METHODS The aim of this observational cohort study was to investigate the prevalence of depression and cognitive deficits in 104 patients having survived acute TTP. TTP survivors were repeatedly assessed by means of different standardized questionnaires to evaluate depression (ID…

Recovery, relapse, or else? Treatment outcomes in gambling disorder from a multicenter follow-up study

AbstractPurpose:Gambling disorder is associated with various adverse effects. While data on the immediate effectiveness of treatment programs are available, follow-up studies examining long-term effects are scarce and factors contributing to a stable therapy outcome versus relapse are under-researched.Materials and methods:Patients (n = 270) finishing inpatient treatment for gambling disorder regularly participated in a prospective multicenter follow-up study (pre-treatment, post-treatment, 12-month follow-up). Criteria for gambling disorder, psychopathology, functional impairment were defined as endpoints. Changes in personality were defined as an additional parameter.Results:At follow-up,…

Parenting in the face of serious illness: Childhood cancer survivors remember different rearing behavior than the general population

Objective A child's cancer diagnosis and treatment affect the whole family. While it has been recognized that parents are an important resource for their children, little is known about the specifics of parenting in the face of serious illness. Methods We used the Recalled Parental Rearing Behavior Questionnaire in a register-based cohort of adult childhood cancer survivors (CCS) (N = 951) and a representative population sample of the same age range (N = 2042). The questionnaire assesses behavior of mothers and fathers with three scales (emotional warmth, rejection/punishment, and control/overprotection) by querying the (former) child. We compared the two groups using general linear models.…

Depression, Anxiety and Quality of Life in Long-Term Survivors of Malignant Melanoma: A Register-Based Cohort Study

Aim The purpose of the study was to determine anxiety and depression, quality of life, and their determinants in long-term survivors of malignant melanoma. Methods In a state cancer registry a cohort of survivors of malignant melanoma was contacted via the physician registered. Of 1302 contactable patients, 689 (52.2%) completed a questionnaire including the Patient Health Questionnaire with generalized anxiety (GAD-7) and depression (PHQ-9) and the EORTC Quality of Life Questionnaire (EORTC QLQ 30). Based on multiple regression analysis, predictors of quality of life and distress were identified. Comparison data were assessed in two waves of representative face-to-face household surveys of…

Detached and distracted: ERP correlates of altered attentional function in depersonalisation.

Abstract Depersonalisation (DP) is a psychological condition marked by feelings of disembodiment. In everyday life, it is frequently associated with concentration problems. The present study used visual event-related potentials (ERPs) in a Posner-type spatial cueing task with valid, invalid and spatially neutral cues to delineate the potential neurophysiological correlates of these concentration problems. Altered attentional functioning at early, sensory stages was found in DP patients but not in anxiety- and depression-matched psychosomatic patients without DP. Specifically, DP was associated with decreased suppression of stimuli at unattended locations, shown as absent processing costs fo…

Noise annoyance is associated with depression and anxiety in the general population : the contribution of aircraft noise

BACKGROUND: While noise annoyance has become recognized as an important environmental stressor, its association to mental health has hardly been studied. We therefore determined the association of noise annoyance to anxiety and depression and explored the contribution of diverse environmental sources to overall noise annoyance. PATIENTS AND METHODS: We investigated cross-sectional data of n = 15.010 participants of the Gutenberg Health Study (GHS), a population-based, prospective, single-center cohort study in Mid-Germany (age 35 to 74 years). Noise annoyance was assessed separately for road traffic, aircraft, railways, industrial, neighborhood indoor and outdoor noise ("during the day"; "i…

Subclinical impairment of lung function is related to mild cardiac dysfunction and manifest heart failure in the general population.

Lung function impairment has previously been related to heart failure, although no overt cardiovascular or structural heart disease is present. The extent to which pulmonary function is related to subclinical left ventricular impairment in the general population remains to be investigated.15010 individuals from the general population (mean age 55±11years, 50.5% men) in the Gutenberg Health Study underwent spirometry, transthoracic echocardiography and biomarker measurement. Forced expiratory volume in 1s (FEV1) and forced vital capacity (FVC) in percent of the predicted value and FEV1/FVC ratio were associated with echocardiographic measures of cardiac structure, systolic and diastolic func…

Subclinical levels of anxiety but not depression are associated with planning performance in a large population-based sample

BackgroundMajor depression and anxiety disorders are known to negatively influence cognitive performance. Moreover, there is evidence for greater cognitive decline in older adults with generalized anxiety disorder. Except for clinical studies, complex executive planning functions and subclinical levels of anxiety have not been examined in a population-based sample with a broad age range.MethodsPlanning performance was assessed using the Tower of London task in a population-based sample of 4240 participants aged 40–80 years from the Gutenberg Health Study (GHS) and related to self-reported anxiety and depression by means of multiple linear regression analysis.ResultsHigher anxiety ratings we…

Declining Sexual Activity and Desire in Men—Findings From Representative German Surveys, 2005 and 2016

Abstract Background Surveys have indicated an increase of sexual activity in aging men; recently, however, a decrease of sexual activity has been reported in young men. Aim To assess (i) sexual activity and desire and their determinants across the age range in a population-based male sample and (ii) their changes over 11 years. Methods A representative survey of men (N = 1,095) 18 to 93 years old from 2016 was compared with a survey from 2005 (N = 1,106 men) with the same age range. Samples were drawn from the German population at random using standardized sampling procedures. Questions were filled out by participants in the presence of a trained interviewer. Sexual activity was compared us…

Quality of life in melanoma patients during adjuvant treatment with pegylated interferon-α2b: patients’ and doctors’ views

Treatment of malignant melanoma with IFN-α has been associated with significant side-effects. The aim of this retrospective monocentric non-randomized study was first to evaluate the impact on quality of life (QOL) in 30 melanoma patients treated with once weekly 2 μg/kg PEG-IFN-α2b for 18 months, and second to examine whether there is a difference in patients' and physicians' perception of QOL. Data on QOL were collected by means of the EORTC QLQ-C30 questionnaire completed by the patient before consultation at baseline and every three months during treatment. A second questionnaire was filled out independently by the physician, based on the consultation and patient file. All data were rou…

Myopia and Level of Education

Purpose To analyze the association between myopia and educational level in an adult European cohort. Design Population-based cross-sectional study. Participants A cohort of the Gutenberg Health Study, including 4658 eligible enrollees between 35 and 74 years of age. Methods We applied a standardized protocol entailing a comprehensive questionnaire; thorough ophthalmic, general, cardiovascular, and psychological examinations; and laboratory tests, including genetic analyses. We documented achievement levels in school education and post-school professional education. The spherical equivalent (SE) was determined by noncycloplegic autorefractometry. We fitted mixed linear models including age, …

Excess costs of social anxiety disorder in Germany

Abstract Background Social anxiety disorder is one of the most frequent mental disorders. It is often associated with mental comorbidities and causes a high economic burden. The aim of our analysis was to estimate the excess costs of patients with social anxiety disorder compared to persons without anxiety disorder in Germany. Methods Excess costs of social anxiety disorder were determined by comparing two data sets. Patient data came from the SOPHO-NET study A1 (n=495), whereas data of persons without anxiety disorder originated from a representative phone survey (n=3213) of the general German population. Missing data were handled by “Multiple Imputation by Chained Equations”. Both data se…

Life satisfaction, distress, and resiliency across the life span of women.

Objective: This study aimed to determine (1) the relationship between life satisfaction, mental disorders, and aging in the female community and (2) to identify the impact of vulnerability factors, personal (resilience, self-esteem), and social resources on life satisfaction and distress. Methods: A stratified random sample of the German female population (N = 2,540) was investigated using standardized questionnaires of life satisfaction (Questions on Life Satisfaction), depression, anxiety (Patient Health Questionnaire), resilience scale (RS-11), and self-esteem (Rosenberg Self-Esteem Scale). Results: When participants were divided into six age groups (18-30, 31-40, 41-50, 51-60, 61-70, an…

Burden of cardiovascular risk factors and cardiovascular disease in childhood cancer survivors: Data from the German CVSS-study.

Aims: The cardiac and vascular late sequelae in long-term survivors of childhood cancer (CVSS)-study aimed to quantify the prevalence of cardiovascular risk factors (CVRF) and cardiovascular disease (CVD) in German childhood cancer survivors (CCS). Methods and results: In the CVSS-study (NCT02181049), 1002 CCS (age range 23-48 years) diagnosed with neoplasia prior to 15 years of age between 1980 and 1990 prospectively underwent a systematic, standardized clinical and laboratory cardiovascular screening, identical to the population-based Gutenberg Health Study (GHS) cohort. For 951 individuals, prevalences of CVRF and CVD were primarily compared to the GHS sample and to two further German po…

Non-invasive peripheral vascular function, incident cardiovascular disease, and mortality in the general population

AIMS Evidence suggests that peripheral vascular function is related to cardiovascular disease (CVD) and mortality. We evaluated the associations of noninvasive measures of flow-mediated dilatation and peripheral arterial tonometry with incident CVD and mortality. METHODS AND RESULTS In a post-hoc analysis of the community-based Gutenberg Health Study, median age 55 years (25th/75th percentile 46/65) and 49.5% women, we measured brachial artery flow-mediated dilatation (N = 12,599) and fingertip peripheral arterial tonometry (N = 11,125). After a follow-up of up to 11.7 years, we observed 595 incident CVD events, 106 cardiac deaths, and 860 deaths in total. Survival curves showed decreased e…

Weiterbildung CME: Depersonalisation/Derealisation - Krankheitsbild, Diagnostik und Therapie

The present state of knowledge about depersonalization (DP) and derealization (DR) is reviewed with respect to classification, epidemiology, etiology, and therapy. Mild and transient DP-DR are considered to be common phenomena. The prevalence of depersonalization-derealization disorder (DP-DR-D) is estimated to be approx. 1-2% of the general population in the Western hemisphere. DP-DR-D is probably severely underdiagnosed. DP-DR-D is strongly associated with depression and anxiety disorders. It is suggested that symptoms of DP-DR indicate disease severity and negatively predict therapy outcome. Neurobiological and psychological models have shown that a disordered body schema and emotional a…

The Prevalence of Glaucoma in Young People.

BACKGROUND Earlier information on the prevalence of glaucoma among children in Germany was based solely on estimates. Reported values for congenital glaucoma range from 1 in 10 000 to 1 in 68 000 depending on ethnic origin. The estimate for juvenile glaucoma is 1 in 44 000. METHODS The Gutenberg Health Study is a populationbased, prospective, monocentric cohort study with 15 010 participants aged 35 to 74. To determine the history-based prevalence of childhood glaucoma, participants were asked about the diagnosis of glaucoma, any operations for glaucoma that were performed, regular use of drugs for glaucoma, and the age of onset of glaucoma. The affected individuals were classified in four …

Dizziness: Anxiety, health care utilization and health behavior—

Background: Due to the lack of epidemiological data on the relation of dizziness and anxiety, we investigated the prevalence of dizziness and anxiety in a representative sample of the German population. We explored the consequences of comorbid anxiety for emotional distress, functional impairment, health care utilization, and health behavior in dizziness. Methods: By the end of 2006, we surveyed a total of 1287 persons between 14 and 90 years of age in their homes by trained interviewers with standardized self-rating questionnaires on anxiety (Patient Health Questionnaire, Generalized Anxiety Disorder Scale, Mini-Social Phobia Inventory) and dizziness (Vertigo Symptom Scale). The sample was…

No evidence for an association of plasma homocysteine levels and refractive error – Results from the population-based Gutenberg Health Study (GHS)

Purpose There is a strong association between severe hyperhomocysteinemia and myopia. Thus we studied the hypothesis that even moderately increased levels of homocysteine (Hcy) might be a potentially treatable risk factor for myopia. Methods The Gutenberg Health Study (GHS) is a population-based, prospective, observational cohort study in Germany, including 15,010 participants aged between 35 and 74 at recruitment. The baseline examination was conducted from 2007–2012. Refraction was measured using autorefraction (HARK 599, Carl Zeiss AG, Jena, Germany). Hcy was measured by an immunoassay. We included only phakic participants without a history of corneal surgery or corneal laser treatment. …

Symptom course in inpatient and day clinic treatment of depression: Results from the INDDEP-Study.

Abstract Background In major depression (MDD), hospital treatment is an option in more severe cases or if outpatient treatment failed. Psychosomatic hospitals in Germany provide treatment programs with multimodal psychotherapy, either in an inpatient or a day hospital setting. In the context of health care research, this study aimed (1) to compare characteristics of patients treated in psychosomatic day hospitals and inpatient units, (2) to compare the effectiveness of both treatment modalities. Methods A naturalistic design was chosen to achieve external validity. 604 consecutive patients were assessed at admission, discharge and a 3-month follow-up. Primary outcome was defined as a reduct…

Entwicklung einer psychosozialen Online-Selbsthilfe für Krebspatienten: ein patientenorientierter Ansatz

Zusammenfassung Ziel der Studie Der Einbezug potenzieller Endnutzerinnen und -nutzer in den Entwicklungsprozess digitaler Interventionen ermöglicht, dass entwickelte Programme den Bedürfnissen, Anforderungen und Erwartungen der zukünftigen Nutzerinnen und Nutzer entsprechen, was sich wiederum positiv auf die Akzeptanz und Adhärenz auswirkt. In diesem Beitrag wird ein partizipativer Entwicklungsansatz für die patientennahe Gestaltung der psychoonkologischen Online-Selbsthilfe epos vorgestellt, welche Unterstützung im Umgang mit seelischen und körperlichen Beschwerden bieten soll. Methodik Patientinnen und Patienten wurden an 2 Stellen in den Entwicklungsprozess einbezogen. Zu einem frühen Ze…

Noise annoyance predicts symptoms of depression, anxiety and sleep disturbance 5 years later. Findings from the Gutenberg Health Study

Abstract Background Cross-sectional studies have shown that noise annoyance is strongly associated with mental distress, however, its long-term effects on mental health is unknown. We therefore investigated whether noise annoyance predicts depression, anxiety and sleep disturbance in a large, representative sample 5 years later. Methods We investigated longitudinal data of N = 11 905 participants of the Gutenberg Health Study, a population-based, prospective, single-centre cohort study in mid-Germany (age at baseline 35–74 years). Noise annoyance was assessed at baseline and 5-year follow-up (sources: road traffic, aircraft, railways, industrial, neighbourhood indoor and outdoor noise; and …

Preconception sex selection demand and preferences in the United States

Objective Preconception sex selection for nonmedical reasons raises important moral, legal, and social issues. The main concern is based upon the assumption that a widely available service for sex selection will lead to a socially disruptive imbalance of the sexes. For a severe sex ratio distortion to occur, however, at least two conditions have to be met. First, there must be a significant preference for children of a particular sex, and second, there must be a considerable interest in employing sex selection technology. Our objective was to ascertain such demand and preferences among the United States general population. Design Cross-sectional web-based survey. Setting United States gener…

PHQ-2 and GAD-2 scores predict mortality in patients undergoing oral anticoagulation

Treating anxiety disorders by emotion-focused psychodynamic psychotherapy (EFPP)-An integrative, transdiagnostic approach.

Anxiety disorders are characterized by high levels of anxiety and avoidance of anxiety-inducing situations and of negative emotions such as anger. Emotion-focused therapy (EFT) and psychodynamic psychotherapy (PP) have underscored the therapeutic significance of processing and transforming repressed or disowned conflicted or painful emotions. Although PP provides sophisticated means of processing intrapsychic and interpersonal conflict, EFT has empirically tested a set of techniques to access, deepen, symbolize, and transform emotions consistent with current conceptualizations of emotions and memory. Based on our clinical experience, we propose that an integrative emotion-focused and psycho…

Epidemiology of sexual dysfunction in the male population.

Sexual dysfunctions have found an increasing attention in recent epidemiological studies of the ageing male. The purpose of this paper is to review the prevalence of sexual dysfunctions and risk factors based on community samples. Studies have not only demonstrated a strong age-related incline of erectile dysfunction (ED), but also of ejaculatory and orgasmic disorders (particularly a reduced or absent ejaculation). Despite a declining sexual desire, sexual interest remains present in old age. Lower urinary tract symptoms have been identified as strong risk factors for ED along with cardiovascular, metabolic, psychiatric disorders and lifestyle factors. The wide range of prevalence rate est…

Stationäre integrative Psychotherapie

Anfange der psychosomatisch-psychotherapeutischen Behandlung gehen in Deutschland bis in die 20er und 30er Jahre des vergangenen Jahrhunderts zuruck (Hartkamp u. Hildenbrand 2009, Tress 2005): Ansatze zur integrierten psychosomatischen Medizin wurden von Internisten und Neurologen u. a. in Heidelberg (Ludolf von Krehl, Richard Siebeck, Viktor von Weizsacker) und Berlin (Ernst von Bergmann, Kurt Goldstein) eingefuhrt, gepragt durch die Psychoanalyse; stationare psychotherapeutische Einrichtungen wurden von Ernst Simmel in Berlin-Tegel, Georg Groddeck in Baden-Baden und Frieda Fromm-Reichmann in Heidelberg begrundet. Nach deren Zerstorung im Nationalsozialismus wurden neue Ansatze nach dem Zw…

Altered orientation of spatial attention in depersonalization disorder

Difficulties with concentration are frequent complaints of patients with depersonalization disorder (DPD). Standard neuropsychological tests suggested alterations of the attentional and perceptual systems. To investigate this, the well-validated Spatial Cueing paradigm was used with two different tasks, consisting either in the detection or in the discrimination of visual stimuli. At the start of each trial a cue indicated either the correct (valid) or the incorrect (invalid) position of the upcoming stimulus or was uninformative (neutral). Only under the condition of increased task difficulty (discrimination task) differences between DPD patients and controls were observed. DPD patients sh…

Psychosomatische Medizin in der Gutenberg- Gesundheitsstudie (GHS) – Fragestellungen, Messverfahren, ausgewählte Ergebnisse

Psychosomatic medicine in the Gutenberg Health Study (GHS) - research questions, measurement instruments, selected results Goal: Main questions from the Gutenberg Health Study (GHS) related to psychosomatic medicine are presented: (1) Prevalence and incidence of mental illnesses, (2) Sex-specific risk- and protective factors for mental health, (3) Interplay between psychological and somatic diseases and (4) methodical-psychometric developments. Methods: The GHS is an ongoing, prospective and interdisciplinary cohort study in Mainz. The comprehensive examinations include psychological characteristics and clinical and laboratory tests. 15010 respondents were selected in the baseline study fro…

Symptome einer Anpassungsstörung nach einer Unfallverletzung: Risiko- und Schutzfaktoren

Symptoms of Adjustment Disorder after an accidental injury: risk and protective factors Objectives: The identification of protective and risk factors for symptoms of adjustment disorder (AD) after an accident injury. Methods: In this prospective long-term study, data from 73 patients with ankle and lower leg fractures were analyzed. Symptoms of AD were assessed at enrollment (T0), 1 month (T1) and 12 months (T2) after injury. In addition, questionnaires regarding adverse childhood experiences, coping strategies and the number of stressors during the last year were obtained. The Structured Clinical Interview for DSM-IV (SCID) was conducted at T1 and T2. Results: 4.1 % of patients met the cri…

Changes of attachment characteristics during psychotherapy of patients with social anxiety disorder : results from the SOPHO-Net trial

Objectives Within a randomized controlled trial contrasting the outcome of manualized cognitive-behavioral (CBT) and short term psychodynamic therapy (PDT) compared to a waiting list condition (the SOPHO-Net trial), we set out to test whether self-reported attachment characteristics change during the treatments and if these changes differ between treatments. Research design and methods 495 patients from the SOPHO-Net trial (54.5% female, mean age 35.2 years) who were randomized to either CBT, PDT or waiting list (WL) completed the partner-related revised Experiences in Close Relationships Questionnaire (ECR-R) before and after treatment and at 6 and 12 months follow-up. The Liebowitz Social…

Affective Change in Psychodynamic Psychotherapy: Theoretical Models and Clinical Approaches to Changing Emotions.

Affective change has been considered the hallmark of therapeutic change in psychoanalysis. Psychoanalytic writers have begun to incorporate theoretically the advanced understanding of emotional processing and transformation of the affective neurosciences. We ask if this theoretical advancement is reflected in treatment techniques addressing the processing of emotion.We review psychoanalytic models and treatment recommendations of maladaptive affect processing in the light of a neuroscientifically informed model of achieving psychotherapeutic change by activation and reconsolidation of emotional memory.Emotions tend to be treated as other mental contents, resulting in a lack of specific psyc…

Suchtartige Internetnutzung als komorbide Störung im jugendpsychiatrischen Setting

Einleitung: Die exzessiv suchtartige Internetnutzung bei Kindern und Jugendlichen, welche sich in ähnlichen Symptomen äußern kann wie klassische Abhängigkeitserkrankungen, ist ein Phänomen, dem Wissenschaft und Praxis immer mehr Beachtung schenken. Prävalenzen von 3 % unter Kindern und Jugendlichen deuten auf ein häufig vorkommendes Problem hin, das bei Betroffenen zu Funktionseinschränkungen führt und mit hohem Leidensdruck einhergeht. Ungeklärt ist, wie häufig Internetsucht unter Patienten jugendpsychiatrischer Einrichtungen auftritt. Methodik: Zur erstmaligen Bestimmung der Prävalenz von Internetsucht unter psychiatrisch behandelten Jugendlichen wurde ein standardisiertes Screening-Inst…

Sex differences in correlates of intermediate phenotypes and prevalent cardiovascular disease in the general population

Background: There are marked sex differences in cardiovascular disease (CVD) manifestation. It is largely unknown how the distribution of CVD risk factors or intermediate phenotypes explain sex-specific differences. Methods and Results: In 5000 individuals of the population-based Gutenberg Health Study, mean age 55 ± 11 years, 51% males, we examined sex-specific associations of classical CVD risk factors with intima-media thickness, ankle-brachial index, flow-mediated dilation, peripheral arterial tonometry, echocardiographic, and electrocardiographic variables. Intermediate cardiovascular phenotypes were related to prevalent CVD [coronary artery disease, heart failure, stroke, myocardial i…

Telefonische Beratung für Glücksspielsüchtige – der heiße Draht ins Hilfesystem? Akzeptanz und Nutzung der Mainzer Hotline Verhaltenssucht

Zusammenfassung Ziel Trotz erheblicher psychosozialer Folgen findet nur ein geringer Anteil der pathologischen Glücksspieler den Weg in die Beratung und Behandlung. Telefonische Beratungsangebote (Hotlines) sollen Betroffenen den Weg in das Suchthilfesystem erleichtern. In Deutschland fehlt es an Forschung zur Inanspruchnahme und den Effekten von Hotlines. Es soll die Frage beantwortet werden, ob telefonische Beratungsangebote dazu beitragen, Glücksspielsüchtigen den Weg in das Suchthilfesystem zu bahnen. Methodik Alle Erstanrufe, die auf der Hotline Verhaltenssucht der Universitätsmedizin Mainz zwischen 2013 und 2016 aufgrund eines problematischen Glücksspielverhaltens eingingen, wurden mi…

2861Role of glycemic state for the relationship between abdominal obesity and markers of inflammation and hemostasis in the population

Depersonalisation, soziale Ängste und Scham

Associations between depersonalization (DP) and social phobia (SP) were described in the early scientific literature. This connection, however, has not yet been considered in the recent empirical literature and clinical trials on SP. The aim of this study is to examine these associations. In a sample of 100 consecutive inpatients we compare 45 patients with pathological DP to 55 patients without pathological DP with respect to comorbidity and the degree of social anxieties assessed with the SOCIAL INTERACTION ANXIETY SCALE (SIAS) and with the SOCIAL PHOBIA SCALE (SPS) and the extent of shame assessed with the INTERNALIZED SHAME SCALE (ISS). Social phobia was significantly more prevalent in …

Permanently online and permanently procrastinating? The mediating role of Internet use for the effects of trait procrastination on psychological health and well-being

A growing number of studies suggest that Internet users frequently utilize online media as “tools for procrastination.” This study thus investigated the relationship between trait procrastination, Internet use, and psychological well-being in a representative sample of N = 1,577 German Internet users. The results revealed that trait procrastination was associated with an increased use of leisure-related online content and impaired control over Internet use. As a result, Internet users high in trait procrastination showed a higher risk of experiencing negative consequence of Internet use in other life domains. These negative repercussions of insufficiently self-regulated Internet use partia…

Suicide attempts in chronically depressed individuals: What are the risk factors?

Abstract Chronically depressed individuals have a high suicide risk. However, it is an open question whether previously observed risk factors for suicide attempts also apply to chronic depression or whether there are specific risk factors related to chronic-recurrent illness. We drew from a large group of chronically depressed individuals seeking psychotherapy to investigate demographic and psychological factors related to previous suicide attempts. Participants took part in the SCID and filled out established questionnaires. Among 368 chronically depressed individuals (68.7% women; Mage = 40.95 years), 75 participants (19.4%) reported previous suicide attempts. Men were more likely to have…

Distribution of HOMA-IR in a population-based cohort and proposal for reference intervals

Abstract Objectives Insulin resistance (IR) is a hallmark of type 2 diabetes mellitus (DM). The homeostatic model assessment of insulin resistance (HOMA-IR) provides an estimate for IR from fasting glucose and insulin serum concentrations. The aim of this study was to obtain a reference interval for HOMA-IR for a specific insulin immunoassay. Methods The Gutenberg Health Study (GHS) is a population-based, prospective, single-center cohort study in Germany with 15,030 participants aged 35–74 years. Fasting glucose, insulin, and C-peptide were available in 10,340 participants. HOMA-IR was calculated in this group and three reference subgroups with increasingly more stringent inclusion criteri…

Cross-Sectional Associations between Homoarginine, Intermediate Phenotypes, and Atrial Fibrillation in the Community—The Gutenberg Health Study

Homoarginine has come into the focus of interest as a biomarker for cardiovascular disease. Atrial fibrillation (AF) causes a substantial increase in morbidity and mortality. Whether circulating homoarginine is associated with occurrence or persistence of AF and may serve as a new predictive biomarker remains unknown. We measured plasma levels of homoarginine in the population-based Gutenberg health study (3761 patients included, of them 51.7% males), mean age 55.6 &plusmn

Relevance of depression for anticoagulation management in a routine medical care setting: results from the ThrombEVAL study program

Summary Background Depressive symptoms have detrimental effects on quality of life and mortality. Poor adherence to a treatment regimen is a potential mechanism for the increased risk of adverse medical events associated with depression. Regarding oral anticoagulation with vitamin K antagonists, adherence is crucial for the outcome. Little is known about the clinical relevance of current depressiveness for anticoagulation treatment. Objectives To examine the impact of current depressiveness on anticoagulation treatment in regular medical care. Patients/Methods We examined the association between clinically significant depressiveness as assessed by the Patient Health Questionnaire-2 ≥ 2 (PHQ…

„Eine Medizin der menschlichen Beziehungen” revisited - Aktuelle neurobiologische und psychosomatische Entwicklungen

In his programmatic paper published 1989 in this journal, Herbert Weiner held the view that psychosomatic medicine has become a medicine of human relations. The aim of this review is TO reflect if current scientific evidence supports his view. Evidence from animal studies suggests that early infant-mother separation or neglect not only has a lasting influence on attachment behaviour, but also on brain development and the ability for stress regulation mediated by environmental as well as genetic factors. Neuronal networks processing affective components of physical pain play a role in signalling painful emotional experiences due to social isolation and separation. A consistent finding across…

Adding Clinical Validity to the Statistical Power of Large-Scale Epidemiological Surveys on Internet Addiction in Adolescence

OBJECTIVE Research has indicated that internet addiction is associated with psychosocial maladjustment in adolescence. Many epidemiologic surveys are lacking representativeness, and knowledge on disorder-specific risk factors is scarce. One weakness of epidemiologic studies often regards their lack of generalizability to clinical reality. The aim of this study was to provide a detailed description of internet addiction among adolescents, focusing on its prevalence in a population-based context, psychopathological correlates, and predisposing factors. METHODS The main analyses were based on 2 large representative samples of German adolescents (N = 9,293; 12-19 years) collected in 2012, and t…

Characteristics and pathologies of the vitreo‐macular interface—results from the Gutenberg Health Study

Purpose We aimed to determine the prevalence of characteristics and pathologies of the vitreo-macular interface within the general population. Methods The Gutenberg Health Study is a population-based study in Germany, including an ophthalmological examination with refraction, biometry and optical coherence tomography (OCT) imaging. Characteristics of the vitreo-macular interface were graded on volume scans including visibility of an epiretinal membrane, full-thickness macular hole, lamellar hole and pseudohole. Overall and age-specific prevalences including 95% confidence intervals [95%-CI] were calculated. Association analyses were conducted to determine systemic and ocular factors that ar…

Assessing Procrastination

Abstract. The short form of the General Procrastination Scale (GPS-K; Klingsieck & Fries, 2012 ; Lay, 1986 ) is a reliable self-report scale measuring general procrastination. The presumed one-dimensional factor structure of the scale, however, has never been examined. Thus, the purposes of this representative study were to examine its dimensionality and factorial invariance across age and sex, and to provide norm values of the German general population. The GPS-K was administered to a representative community sample ( N = 2,527; age range 14–95 years). A confirmatory factor analysis (CFA) was conducted. To explore convergent validity, standardized scales of distress and life satisfact…

Does unresolved attachment predict functional cognitive impairments after the activation of attachment related anxiety?

Emotion regulation strategies moderate the relationship of fatigue with depersonalization and derealization symptoms.

Abstract Background The aim of the present study was to investigate the relationships of common emotion regulation strategies (suppression and reappraisal) to self-reported fatigue and depersonalization/derealization symptoms. Specifically, we tested the moderating effect of suppression and reappraisal on the link of fatigue with depersonalization and derealization symptoms. Opposite effects were expected for both emotion regulation strategies assuming that cognitive reappraisal has an adaptive buffering effect, while suppression intensifies the association of fatigue and depersonalization/derealization experiences. Methods In a representative study (N = 2524) we assessed emotion regulation…

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The Prevalence of Visual Impairment in the Adult Population

Background The distribution of visual impairment is an indicator of the health status of the population and for the frequency of diseases of the eye. Methods The Gutenberg Health Study (GHS) is a population-based cohort study in Germany concerning adults aged 35 to 74. 15 010 subjects from the Mainz-Bingen region underwent general medical and ophthalmological examination, with measurement of the distance-corrected visual acuity in each eye separately. As per the World Health Organization criteria, visual impairment was defined as an acuity below 0.3 in the better eye, and blindness as an acuity below 0.05. All patients who were found to be visually impaired or blind underwent further indivi…

Childhood adversities and distress - The role of resilience in a representative sample.

While adverse childhood experiences have been shown to contribute to adverse health outcomes in adulthood, specifically distress and somatic symptoms, few studies have examined their joint effects with resilient coping style on adult adjustment. Hence, we aim to determine the association between resilient coping and distress in participants with and without reported childhood adversities. A representative German community sample (N = 2508) between 14-92 years (1334 women; 1174 men) was examined by the short form of the Childhood Trauma Questionnaire, the Brief Resilience Coping Scale, standardized scales of distress and somatoform symptoms. Childhood adversity was associated with reduced ad…

Atrial Fibrillation Manifestations Risk Factors and Sex Differences in a Population-Based Cohort (From the Gutenberg Health Study)

Sex differences in cardiovascular risk factors, cardiac structure and function, and disease and symptom burden in the common arrhythmia atrial fibrillation (AF) have not been investigated systematically at the population level. Cross-sectional data of 14,796 subjects (age range 35 to 74 years, 50.5% men) from the population-based Gutenberg Health Study were examined to show the distribution of cardiovascular risk factors by AF status and sex, and to determine sex-specific predictors for AF. The prevalence of AF was higher in men (4.3%) than in women (1.9%). Men had a worse cardiovascular risk factor profile, a higher prevalence of cardiovascular disease, but fewer symptoms than women. Age-a…

Ready for eHealth? Health Professionals' Acceptance and Adoption of eHealth Interventions in Inpatient Routine Care.

eHealth interventions can be effective in treating health problems. However, adoption in inpatient routine care seems limited. The present study therefore aimed to investigate barriers and facilitators to acceptance of eHealth interventions and of online aftercare in particular in health professionals of inpatient treatment. A total of 152 out of 287 health professionals of various professional groups in four inpatient rehabilitation facilities filled out a self-administered web-based questionnaire (response rate: 53%); 128 individuals were eligible for further data analysis. Acceptance and possible predictors were investigated with a complex research model based on the Unified Theory of Ac…

Association of Type D personality with cognitive functioning in individuals with and without cardiovascular disease: The Gutenberg health study

ObjectiveDistressed (‘Type D’) personality is associated with adverse health outcomes in patients with cardiovascular disease (CVD). While personality traits from the Five-Factor Model are related to cognitive functioning, neither Type D personality nor its underlying traits negative affectivity (NA) and social inhibition (SI) have been investigated regarding cognition. We therefore compared the predictive value of Type D classification and its subcomponents NA and SI on planning performance in individuals with and without CVD.MethodsType D personality traits (DS14) were determined in a population-based sample of 4026 participants (including 549 with CVD) aged 40–80 years from the Gutenberg…

Linking cancer and mental health in men and women in a representative community sample

Abstract Objective In aging populations, a growing number of individuals are affected by cancer. However, the relevance of the disease for mental health is still controversial, especially after treatment. We drew from a representative community sample to explore the link of cancer with mental health assessing different dimensions and different periods of time. Methods A cohort of 14,375 men and women (35–74 years) underwent medical assessments and was queried about cancer history, previous diagnoses of mental disorders, current mental distress symptoms, and current subjective health appraisal. Results 1066 participants (7.4%) reported a diagnosis of cancer (survival time M = 9.79 (SD = 9.07…

Prevalence and determinants of online-sex use in the German population.

Introduction The unlimited access to sexual features in the World Wide Web has raised concerns about excessive and problematic online-sex use. However, little is known about antecedents of internet-sex use of different intensity. Based on a representative German sample of 2,522 participants between the ages of 14 and 97 years, the aims of the present study were (1) to determine the prevalence rates of online-sex users with the short version (ISSTGSV) of the Internet Sex Screening Test and (2) to associate online-sex use with anxious vs. avoidant partner attachment patterns and “Big Five” personality traits as potential antecedents. Results The ISST is a brief, one-dimensional and reliable m…

Long-term weight loss maintenance after inpatient psychotherapy of severely obese patients based on a randomized study: predictors and maintaining factors of health behavior.

Abstract Objective The objective of this study was to identify predictors of long-term weight loss after inpatient psychodynamic or behavioral psychotherapy of severely obese patients. Methods In a longitudinal study, obese patients [body mass index (BMI)≥35 kg/m2] were randomly assigned to behavioral or psychodynamic inpatient treatment. The average treatment duration was 7 weeks. Two hundred sixty-seven obese patients, mostly female (85%), with psychiatric and somatic comorbidity (age, 20–64 years; BMI=35–74 kg/m2) were examined with standardized self-report scales at intake, discharge, 1-year follow-up, and 3-year follow-up. Results Overall, 3 years after inpatient psychotherapy, irrespe…

Sex-specific differences in genetic and nongenetic determinants of mean platelet volume: results from the Gutenberg Health Study.

Mean platelet volume (MPV), a measure of platelet size, is a potential biological marker of platelet function. To date, a comprehensive analysis including known genetic and nongenetic factors that determine MPV is still lacking. MPV has been evaluated in 15 010 individuals from the population-based Gutenberg Health Study. Genetic information was available for 4175 individuals. Our results showed that age (β, 0.0346; 95% confidence interval [CI], 0.0255 to 0.0436), cardiovascular risk factors (CVRFs) such as smoking (β, 0.178; 95% CI, 0.128 to 0.229), hypertension (β, 0.05; 95% CI, 0.00289 to .0981), and high glucose level (β, 0.00179; 95% CI, 0.0006 to 0.00299) were linked with higher MPV i…

SOPHO-NET – Forschungsverbund zur Psychotherapie der Sozialen Phobie

This paper presents the Social Phobia Psychotherapy Research Network (SOPHO-NET). SOPHO-NET is among the five research networks on psychotherapy funded by "Bundesministerium fur Bildung und Forschung". The research program encompasses a coordinated group of studies of social phobia. In the central project (Study A), a multi-center randomized controlled trial, refined models of manualized cognitive-behavioral therapy (CBT) and manualized short-term psychodynamic psychotherapy (STPP) are compared in the treatment of social phobia. A sample of n=512 outpatients will be randomized to either CBT, STPP or wait list. For quality assurance and treatment integrity, a specific project has been establ…

Menopausal syndrome limited to hot flushes and sweating a representative survey study.

The menopausal syndrome is described as a series of various physical and nonphysical symptoms attributed to perimenopausal changes in hormone levels. However, evidence is biased by focusing research on the target group of middle aged women only. To overcome this bias, we examined the occurrence of menopausal symptoms during the entire life span in both women and men.Therefore, we studied the occurrence of menopausal symptoms with the widely used Menopause Rating Scale (MRS) across the entire life span in both women and men. To this end, we performed a nationwide cross-sectional survey study in Germany in which we examined a representative sample of 2527 persons aged from 14 to 95 years. Add…

Hypogonadism-related symptoms: development and evaluation of an empirically derived self-rating instrument (HRS ‘Hypogonadism Related Symptom Scale’)

While self-report screening instruments are highly sensitive to hypogonadism in the ageing male, they have lacked specificity as evidenced by low or absent correlations with testosterone. The purpose of this paper was to develop an economical and specific screening instrument for identifying hypogonadal ageing men. Based on a comprehensive study of physical, somatoform and affective complaints, sexual behaviour and function and hormonal parameters of 263 outpatients aged 40 years and above (M = 56.2; 40-84 years) recruited from six andrological outpatient departments in Germany, we identified those items correlating significantly with testosterone. By factor analyses, five factors were iden…

Schirmer test results: are they associated with topical or systemic medication?

To test whether Schirmer test (ST) results are associated with topical or systemic medication and to evaluate the distribution of tear fluid quantity in a 3-min and 5-min ST.The Gutenberg Health Study is a population-based, prospective, observational cohort study in Germany. ST was assessed in a sub-cohort of 1,999 participants. ST was performed under topical anesthesia for 5 min (ST-5) or of 3 min (ST-3). Anthropometric factors, systemic diseases, use of systemic and eye medications were recorded. We used multivariable quantile regression analysis to assess the influence on ST measurements.The length of wetting of the Schirmer strips for ST-5 was 23.2 ± 9.31 mm for right and 22.9 ± 9.0 mm …

Symptoms of depression and anxiety predict mortality in patients undergoing oral anticoagulation: Results from the thrombEVAL study program

Abstract Background/objectives Depression and anxiety are highly prevalent in cardiovascular patients. Therefore, we examined whether the 4-item Patient Health Questionnaire (PHQ-4, measuring symptoms of depression and anxiety) predicts all-cause mortality in outpatients with long-term oral anticoagulation (OAC). Methods The sample comprised n=1384 outpatients from a regular medical care setting receiving long-term OAC with vitamin K antagonists. At baseline, symptoms of anxiety and depression were assessed with the PHQ-4 and the past medical history was taken. The outcome was all-cause mortality in the 24month observation period. The median follow-up time was 13.3months. Results N=191 pati…

Maladaptive Personality Traits and Their Interaction with Outcome Expectancies in Gaming Disorder and Internet-Related Disorders

Gambling disorder and gaming disorder have recently been recognized as behavioral addictions in the ICD-11 (International Classification of Diseases, 11th edition). The association between behavioral addictions and personality has been examined before, yet there is a lack of studies on maladaptive traits and their relationship to specific outcome expectancies. In study 1, we recruited a community sample (n = 365)

Lipid-Mediated Relation between Tissue Factor Pathway Inhibitor Activity and Cardiovascular Risk Factors and Diseases in a Large Population Sample

Abstract Background: Tissue factor pathway inhibitor (TFPI), a Kunitz-type serine protease, is a potent anticoagulant protein in the extrinsic coagulation pathway and acts by inhibiting both the FXa and the Tissue Factor-FVIIa complex. In contrast to total and free TFPI antigen levels, the reference values and clinical determinants of total TFPI activity have not yet been studied in detail in the general population. In the present study, we aim to identify the cardiovascular determinants for total TFPI activity and investigate its association with cardiovascular disease (CVD) and total mortality, in a population at large. Methods: For this study, the first 4779 subjects of the population-ba…

Prevalence, correlates, and predictors of depersonalization experiences in the German general population.

The survey aimed to investigate the prevalence of depersonalization (DP) experiences, its sociodemographic characteristics and its associations with medical conditions, illness behavior, and potential etiologic factors. A representative face-to-face household survey was conducted. The sample consists of n = 1,287 participants aged 14 to 90 years. Sociodemographic variables, medical conditions, current mental disorders, health care utilization, and childhood adversities were assessed. A total of 1.9% participants scored in the range of clinically significant DP (DP-C) and 9.7% reported at least some impairment through DP (DP-I). DP-C/DP-I were strongly associated with depression and anxiety.…

Experienced Childhood Maltreatment in a Sample of Pedophiles: Comparisons With Patients of a Psychosomatic Outpatient Clinic and the General Population.

Abstract Background Adverse childhood events have a lasting impact on mental health. Studies on patients with pedophilia focus on traumatic events as sexual abuse in their childhood, in which further childhood maltreatment is rarely described. Aim In addition to previous studies on patients with pedophilia that focus on traumatic events as sexual abuse, we further investigate different types of childhood maltreatment. Methods We compared 3 samples using the Childhood Trauma Questionnaire: patients with pedophilia, psychotherapy outpatients, and general population (GP). Descriptive analyses were conducted for prevalence rates. To assess statistical differences between the samples concerning …

Psychodynamic Online Treatment Following Supportive Expressive Therapy (SET):Therapeutic Rationale, Interventions and Treatment Process.

The feasibility of psychodynamic online treatments has remained an issue of debate. The paper presents rationale and technique of a psychodynamic online intervention discussing therapeutic process and alliance based on two case examples from an RCT.A weekly writing task is followed by individual feedback from the online therapist. Treatment focuses on a 'Core Conflict Relationship Theme' based on relationship episodes according to the wish of the patient, reactions of the others and reactions of the self. Maladaptive interpersonal interactions are worked through by supportive and expressive therapeutic interventions.Case reports from our study illustrate a productive therapeutic process wit…

Cardiac modulation of startle is altered in depersonalization-/derealization disorder: Evidence for impaired brainstem representation of baro-afferent neural traffic.

Patients with depersonalization-/derealization disorder (DPD) show altered heartbeat-evoked brain potentials, which are considered psychophysiological indicators of cortical representation of visceral-afferent neural signals. The aim of the current investigation was to clarify whether the impaired CNS representation of visceral-afferent neural signals in DPD is restricted to the cortical level or is also present in sub-cortical structures. We used cardiac modulation of startle (CMS) to assess baro-afferent signal transmission at brainstem level in 22 DPD and 23 healthy control individuals. The CMS paradigm involved acoustic startle stimuli (105dB(A), 50ms) elicited 0, 100, 200, 300, 400 and…

Konsiliar-Liaisondienst und Ambulanz einer Psychosomatischen Universitätsklinik: Patientenzuweisung, Anlass der Vorstellung, Empfehlungen

Zusammenfassung {! Fragestellung:} Obgleich psychosomatische Kliniken an Krankenhausern in der Regel sowohl einen Konsiliar-Liaisondienst (CL-Dienst) als auch eine Ambulanz vorhalten, fehlen bislang direkte Vergleiche der beiden Versorgungsansatze. {! Methode:} Im Vergleich zwischen 750 Patienten eines Jahrgangs aus dem CL-Dienst und 617 Patienten aus der Ambulanz einer psychosomatischen Universitatsklinik werden Unterschiede zwischen den beiden Patientenkollektiven, Hintergrunde der Patientenvorstellung und Empfehlungen zur psychotherapeutischen Behandlung erhoben. {! Ergebnisse:} CL-Patienten waren mit ca. 50 Jahren alter als Patienten der Ambulanz (43 Jahre). Es zeigte sich im CL-Dienst …

Prävalenz von Internetsucht vor und während der COVID-19 Pandemie unter Studierenden der Johannes Gutenberg-Universität Mainz

Zusammenfassung Ziel der Studie Internetsucht ist eine Verhaltensstörung, von welcher v. a. Jugendliche und junge Erwachsene, unter ihnen auch Studierende an Hochschulen betroffen sind. Die COVID-19 Pandemie führte aufgrund der Maßnahmen zu ihrer Eindämmung zu starken Einbußen sozialer Beziehungen, Studium und Freizeitaktivitäten der Studierenden. Diese Studie untersuchte, wie hoch die Prävalenz der Internetsucht unter Studierenden vor und während der COVID-19 Pandemie ausfällt und welche soziodemografischen (Geschlecht, Fachgruppe) und Gesundheitsfaktoren (Depressionssymptome, Einsamkeit, Ängste, Impulsivität) mit Internetsuchtsymptomen assoziiert sind. Methodik In der vorliegenden Studie …

Type D personality is independently associated with major psychosocial stressors and increased health care utilization in the general population

Abstract Background Type D is considered as a non pathological personality trait and propensity for mental distress. Its relationship with mental distress has been mainly studied in cardiovascular patients and with respect to depression. The knowledge about the relationship of Type D with mental disorders, psychosocial stressors and health care utilization in the general population is insufficient. Therefore the present study sought to determine the associations of Type D with mental distress, major psychosocial stressors, health status, and health care utilization in the general population. Methods Cross-sectional analysis in a representative population based sample of n = 2495 subjects (m…

Relation between Tissue Factor Pathway Inhibitor Activity and Cardiovascular Risk Factors and Diseases in a Large Population Sample.

Abstract Objective Tissue factor pathway inhibitor (TFPI) is a potent anticoagulant protein in the extrinsic coagulation pathway. In the present study, we aim to identify the cardiovascular determinants for total TFPI activity and its association with cardiovascular disease (CVD) and total mortality. Methods Total TFPI activity was assessed in a selection of the population-based Gutenberg Health Study (n = 5,000). Statistical analysis was performed to identify the determinants for total TFPI activity as well as the associations with CVD and mortality. Results Multivariable linear regression analysis identified smoking (β 0.095 [0.054–0.136]) as a positive determinant for total TFPI activity…

Life satisfaction, anxiety, depression and resilience across the life span of men

To determine (a) the relationship between life satisfaction, anxiety, depression and ageing in the male community and (b) to identify the impact of vulnerability factors, personal and social resources on life satisfaction and distress.A stratified random sample of the German male population (N = 2144) was investigated by standardized questionnaires of life satisfaction (FLZ(M)), depression, anxiety (PHQ), resilience (RS-11) and self-esteem (RSS).No age-related change was found regarding overall life satisfaction. Satisfaction with health decreased in midlife (51-60 years), while the importance of health increased. Importance of and satisfaction with partnership and sexuality were only reduc…

Assessing Somatic, Psychosocial, and Spiritual Distress of Patients with Advanced Cancer

Objective: For adequate distress assessment in palliative care, we developed a screening evaluation tool. Methods: Proven methods of scale construction led to a 53-item pilot form of the Advanced Cancer Patients’ Distress Scale (ACPDS). We used Hornheide Questionnaire (HQ), Palliative Outcome Scale (POS), and Minimal Documentation System (MIDOS) for validation. Advanced cancer patients (N = 168) from 3 centers for palliative medicine (aged 23-89, 51% female) filled out the questionnaire. Results: With a principal component analysis (PCA), we extracted 5 distress scales (emotional reactions/physical restrictions, communication deficits, negative social reactions, pain, and gastrointestinal s…

Vom Sinn des Verfahrenskonzepts und der Verfahrensvielfalt – und warum das Baukasten-System in der Psychotherapie nicht funktioniert

Why the concept of distinct psychotherapeutic approaches is indispensable - and why the tool box concept of psychotherapy cannot work Background: In Germany, the official psychotherapy guidelines are oriented towards the model of distinct psychotherapeutic approaches. Within the German health care system this also applies to the training in psychotherapy. Some critics, however, are presently pleading in favour of abolishing the model of distinct psychotherapeutic approaches, which also implies to abolish the concept of the so called "Richtlinienverfahren" in Germany - approaches of psychotherapy which proved to be efficacious and whose costs are reimbursed by the insurance companies. Object…

Welche Auswirkungen haben Flucht und Vertreibung auf Lebensqualität und Befindlichkeit? Repräsentative Erhebung mit den vor 1946 Geborenen in Deutschland

Zusammenfassung Fragestellung: Zum Ende des Zweiten Weltkrieges war ein groser Teil der deutschen Bevolkerung Flucht und Vertreibung ausgesetzt. Massive Belastungen und Traumatisierungen wurden in zahlreichen Einzelfallschilderungen beschrieben. Erste systematische Untersuchungen an ausgewahlten Stichproben ergaben Hinweise auf nachhaltige psychische Langzeitfolgen der Vertreibung; reprasentative Erhebungen in der deutschen Bevolkerung fehlen aber bisher. Ziele der vorliegenden Studie waren daher zu bestimmen, wie sich Lebensqualitat, psychisches und korperliches Befinden von Vertriebenen aus den ostlichen Siedlungsgebieten im hoheren Lebensalter entwickelt haben im Vergleich zu Nichtvertri…

Temperament and personality: the German version of the Adult Temperament Questionnaire (ATQ)

The psychobiological orientation inherent in temperament concepts permits a close tie between temperament and the rapidly proliferating research areas of neurosciences and behavioural genetics. Based on developmental and psychobiological studies, the Adult Temperament Questionnaire (ATQ) by Rothbart measures self-regulatory processes in addition to constitutionally based individual reactivity. The purpose of this paper is to validate a German version of the short form of the ATQ with 77 items. 213 psychosomatic inpatients and outpatients and 116 control subjects took part in this study. The study included standardized measures of personality and symptoms. The German version reliably measure…

P5361The diabetic continuum and its relation with cardiovascular disease: results from the population-based Gutenberg health study

Theory of Mind and Emotional Awareness Deficits in Patients With Somatoform Disorders

To explore whether deficits are present in the mental representation of emotion signals and whether these are related to more general deficits in Theory of Mind (ToM) functioning test. To test this hypothesis in patients suffering from somatoform disorders, we used the Frith-Happé-Animations Task (AT)-an established ToM measure. We previously demonstrated that somatization in psychiatric patients is associated with decreased emotional awareness as measured by the Levels of Emotional Awareness Scale (LEAS). These findings suggest that individuals with decreased emotional awareness often fail to experience affective arousal as feelings and instead experience emotional distress somatically.We …

Wie oft wird die Depersonalisations-Derealisationsstörung (ICD-10: F48.1) in der ambulanten Versorgung diagnostiziert?

Zusammenfassung Fragestellung: Untersucht wird erstmalig, wie haufig die Depersonalisations-Derealisationsstorung (ICD-10: F48.1) in der Allgemeinbevolkerung unter Alltagsbedingungen diagnostiziert wird und mit welchen weiteren Krankheitsgruppen sie assoziiert ist. Methode: Die Untersuchungspopulation umfasst 1.567 Millionen Versicherte einer gesetzlichen Krankenkasse (Gmunder Ersatzkasse). Analysiert wird die Einjahrespravalenz der Diagnose F48.1 sowie deren Assoziation mit anderen ICD-10-Diagnosenschlusseln. Ergebnis: Es fand sich eine Einjahrespravalenz fur die Diagnose F48.1 von 0.007 %. Nach Adjustierung fur Alter, Geschlecht, Depression und Angst waren unter anderem folgende somatisch…

Improved Postural Control after Behavioural Short Term Intervention in Patients with Psychiatric Dizziness

Background:Patients with psychiatric dizziness often report subjective instability of stance and gait and fear of falls. They showed increased activity of their body sway in static posturography compared to normals (1, 2). Aim of the present study was to evaluate the efficiency of a behavioural therapy by static posturography.Methods:14 patients with psychiatric dizziness were included in the prospective study on static posturography to quantify the postural sway (sway path) during upright stance under different conditions. the psychosomatic examination comprised of standardized interviews (SCID-Interview) and a psychometric examination battery (SCL-90, VSS, VHQ). Results of static posturog…

Mid-Term Effectiveness of Behavioral and Psychodynamic Inpatient Treatments of Severe Obesity Based on a Randomized Study

<i>Background:</i> The objective of this study was to compare the effectiveness of psychodynamic and behavioral inpatient treatments of severely obese patients regarding weight and distress. <i>Methods:</i> In a longitudinal study obese patients (body mass index, BMI ≧35) were randomly assigned to behavioral or to psychodynamic inpatient treatment. Mostly female (n = 267; 85%) obese patients with psychiatric and somatic comorbidity (age 20–64 years, BMI 35–74) were examined with standardized self-report scales on distress (SCL-90R), interpersonal problems (Inventory of Interpersonal Problems), eating behavior (Fragebogen zum Essverhalten) and body image (Fragebogen z…

Chronic venous insufficiency, cardiovascular disease, and mortality: a population study

Abstract Aims  Evidence regarding the health burden of chronic venous insufficiency (CVI), its clinical determinants, and impact on outcome is scarce. Methods and results  Systematic phenotyping of CVI according to established CEAP (Clinical-Etiologic-Anatomic-Pathophysiologic) classification was performed in 12 423 participants (age range: 40–80 years) of the Gutenberg Health Study from April 2012 to April 2017. Prevalence was calculated age- and sex-specifically. Multivariable Poisson regression models were calculated to evaluate the relation of CVI with cardiovascular comorbidities. Survival analyses were carried out to assess the CVI-associated risk of death. Replication of findings was…

FEV1 and FVC predict all-cause mortality independent of cardiac function - Results from the population-based Gutenberg Health Study.

Abstract Background Lung function has previously been related to increased mortality. Whether pulmonary impairment is associated with an increased mortality independent of cardiac dysfunction remains unclear. Methods In 15010 individuals from the general population (age range 35–74years, 51% men) in the Gutenberg Health Study we performed spirometry and transthoracic echocardiography. N-terminal pro-B-type natriuretic peptide (Nt-proBNP) and high-sensitive troponin I (hsTnI) were measured in all individuals. 1819 individuals with pulmonary diseases were excluded from further analysis. Results The median for forced expiratory volume in 1s (FEV1) was 94.2% and for forced vital capacity (FVC) …

Is assessment of depression equivalent for migrants of different cultural backgrounds? Results from the German population-based Gutenberg Health Study (GHS)

BACKGROUND Bearing in mind the multicultural background of a national population, little is known about the measurement invariance across different cultures or ethnicities of frequently used screeners for depression. For this reason, the main objective of the current study is to assess the measurement invariance of the Patient Health Questionnaire (PHQ-9) across groups with different migration backgrounds. METHODS We provided psychometric analyses (descriptive statistics at item and scale level, reliability analysis, exploratory [EFA] and confirmatory factor analyses [CFA]) comparing a native population with first- and second-generation migrants of the German population-based Gutenberg Heal…

Five-year change in refractive error and its risk factors: results from the Gutenberg Health Study.

Background/AimsTo examine the 5-year change in refractive error in phakic eyes and its risk factors in the general population.MethodsThe Gutenberg Health Study (GHS) is a population-based cohort study including 15 010 participants from Germany aged 35–74 years at baseline examination (2007–2012). After 5 years, a follow-up examination was carried out (83% participation). 5-year change of spherical equivalent (SE) was computed as difference between follow-up and baseline objective refraction. Linear and logistic regression analysis were conducted analysing potential risk factors. Only phakic eyes at follow-up examination were included.ResultsRight eyes of 10 175 subjects were included. An ag…

Deutschsprachige Validierung des Vertigo Handicap Questionnaire (VHQ) anhand einer Patientenstichprobe mit vestibulärem und somatoformem Schwindel

The Vertigo Handicap Questionnaire (VHQ) by Yardley (1992) assesses physical and psychosocial impairments of vertigo or dizziness. Our study examines the structure, reliability, and aspects of validity of the German version of the VHQ. 98 vestibular vertigo syndromes vs. 90 patients with somatoform vertigo and dizziness were evaluated with the VHQ, symptom severity (VSS), distress (GSI), anxiety and depression (HADS), catastrophizing beliefs (ACQ), fear of body sensations (BSQ), and quality of life (SF-36). For diagnostic classification detailed clinical neurological, neuro-otological and psychosomatic testing were conducted. Principal components analysis identified two factors, which could…

Annoyance to different noise sources is associated with atrial fibrillation in the Gutenberg Health Study

Abstract Background Annoyance is a common reaction in populations exposed to environmental noise and is associated with cardiovascular diseases. We investigated for the first time the existence of an association between noise annoyance and atrial fibrillation (AF). Methods and results Cross-sectional data from 14,639 participants of the Gutenberg Health Study were collected between 2007 and 2012. Annoyance from road traffic, aircraft, railways, industrial/construction and neighbourhood noise during daytime and sleep were collected from all participants through questionnaires using a 5-point scale. AF was assessed via self-reported medical history and/or documentation of AF on the study elec…

The distribution of whole blood viscosity, its determinants and relationship with arterial blood pressure in the community: cross-sectional analysis from the Gutenberg Health Study.

Background: Blood viscosity has a role in modulating cardiovascular homeostasis; changes in this parameter have been associated with cardiovascular mortality and morbidity. However, it remains unclear whether these changes are (1) involved in the pathophysiology of disease, (2) an epiphenomenon, or (3) the expression of counterregulatory mechanisms. We report data on the normal values of blood viscosity and its association with cardiovascular risk factors, prevalent cardiovascular disease, and blood pressure in a large population-based cohort study. Methods and results: Viscosity was calculated using validated formulae and its associations were explored in 15,010 participants (mean 55.0, mi…

Emotionale Befindlichkeit und dysfunktionale Stressverarbeitung bei Personen mit Internetsucht

Ziele: Die suchtartige Nutzung des Internet ist ein Phänomen, das immer stärker in das öffentliche Bewusstsein vordringt. Eine hinreichende klinische Charakterisierung, wie auch Befunde zu ätiopathologischen Faktoren fehlen bislang jedoch. In der vorliegenden Studie wurden zwei verschiedene Klientengruppen hinsichtlich Symptombelastung, Coping und Affektivität mit gesunden Kontrollprobanden verglichen. Methodik: Es nahmen insgesamt 45 Personen an der Studie teil; jeweils zu gleichen Teilen Personen, die wegen des Verdachts auf Internetsucht regionale Beratungsstellen aufsuchten bzw. Personen, die in einer spezialisierten Spielsuchtambulanz vorstellig wurden, sowie gesunde Kontrollpersonen.…

Discounting delayed monetary rewards and decision making in behavioral addictions - A comparison between patients with gambling disorder and internet gaming disorder.

Abstract Behavior addictions, such as Gambling Disorder and Internet Gaming Disorder, have been demonstrated to have severe negative impact. Heightened impulsivity, deficits in decision making, and cognitive biases in the preference of immediate rewards have been shown to be crucial aspects in addictive disorders. While for Gambling Disorder (GD), dysfunctional decision making has been documented before, data for Internet Gaming Disorder (IGD) are still underrepresented. In order to allow for a direct comparison of both disorders, we assessed different measures of impulsivity (trait, impulsive choice, and decision making) in a clinical sample. N = 31 patients meeting criteria for GD and n =…

Methylation of the oxytocin receptor gene in clinically depressed patients compared to controls: The role of OXTR rs53576 genotype

The emerging field of epigenetics provides a biological basis for gene-environment interactions relevant to depression. We focus on DNA methylation of exon 1 and 2 of the oxytocin receptor gene (OXTR) promoter. The research aims of the current study were to compare OXTR DNA methylation of depressed patients with healthy control subjects and to investigate possible influences of the OXTR rs53576 genotype. The sample of the present study consisted of 43 clinically depressed women recruited from a psychosomatic inpatient unit and 42 healthy, female control subjects - mean age 30 years (SD = 9). DNA methylation profiles of the OXTR gene were assessed from leukocyte DNA by means of bisulfite seq…

Incidence of Retinal Detachment in Germany: Results from the Gutenberg Health Study

<b><i>Purpose:</i></b> To investigate the incidence of retinal detachment in the German population and to assess potential risk factors. <b><i>Methods:</i></b> The Gutenberg Health Study is a population-based cohort study in Mainz, Germany, including subjects (<i>n</i> = 15,010) with an age range from 35 to 74 years at baseline examination. Study participants underwent a comprehensive ophthalmological examination including distant-corrected visual acuity, refraction and slit-lamp examination at baseline examination. A computer-assisted telephone interview was conducted after 2.5 and 5 years, and health events were recorded. The 5-y…

Symptoms of depersonalization/derealization are independent risk factors for the development or persistence of psychological distress in the general population: Results from the Gutenberg health study

Abstract Background Symptoms of depersonalization (DP) and derealization (DR) have a high prevalence in patient and community samples. Previous studies suggested that DP/DR symptoms might represent a marker of disease severity and poor prognosis. However, population-based studies investigating the impact of DP/DR symptoms on the course of depression and anxiety are sparse. Therefore, we aimed to analyze whether symptoms of DP/DR are longitudinally associated with the persistence or incidence of elevated symptoms of depression/anxiety. Methods We analyzed observational data from a sample of 13.182 participants of the Gutenberg Health Study. The outcomes were elevated symptoms of depression/a…

Efficacy and predictors of outcome of short-term psychodynamic psychotherapy (stpp) in depressed breast cancer patients: A randomised controlled trial

Results: 34 people made up the data set. 25/34 (74%) answered the questionnaire. 11/25(44%) had suicidal thoughts in the previous 72 hours. 3/34 (9%) had deliberately self-harmed in the previous 72 hours. 29/34 (85%) stated that the needle exchange would be their first contact point in health care if they had concerns over theirmental health. Qualitative data revealed drug workers are providing mental health support to service users, but haven’t received formal training. Discussion: This is a small study limited by questionnaire design and sample size. However, it does highlight some important points. Namely, drug users remain at higher risk of suicide ideation and selfharm than general pop…

Between commodification and altruism: gender imbalance and attitudes towards organ donation. A representative survey of the German community

The German transplant law (TGP) of 1997 only recognises organ donation if the donor agrees (‘extended consent’) and if done for altruistic reasons. Several alternatives will be discussed here, including incentives and passive agreement. Based upon a representative survey, the authors examined the attitudes of Germans towards several European models of organ donation and their attitude towards organ donation in general whilst living and after death. The acceptance of possible compensation systems was also explored. In Germany the majority do not favour compensation systems, but rather passive agreement. There is evidence of gender difference with respect to this attitude. Men tend to favour …

Comorbidity, family history and personality traits in pathological gamblers compared with healthy controls.

AbstractBackgroundWhile DSM-5 classified pathological gambling as an addictive disorder, there is debate as to whether ICD-11 should follow suit. The debate hinges on scientific evidence such as neurobiological findings, family history of psychiatric disorders, psychiatric comorbidity, and personality variables.MethodsIn the “Baden-Württemberg Study of Pathological Gambling”, we compared a group of 515 male pathological gamblers receiving treatment with 269 matched healthy controls. We studied differences in sociodemographic characteristics, gambling-related variables, psychiatric comorbidity (lifetime), family history of psychiatric conditions, as well as personality traits such as impulsi…

Type D personality as a cardiovascular risk marker in the general population: results from the Gutenberg health study.

<i>Background:</i> Type D personality is considered as an independent risk factor for morbidity and mortality in cardiovascular patients and a vulnerability factor for distress in the general population. Because representative community studies are rare, we sought to determine the prevalence of type D personality and its relationship with demographic characteristics, different features of mental disorders, cardiovascular risk factors, health behavior, endothelial function and cardiovascular biomarkers in the general population. <i>Methods:</i> The prevalence of type D personality and its correlates were analyzed cross-sectionally in a population-based sample of 5,000…

Psychische Komorbidität, Inanspruchnahme- und Gesundheitsverhalten bei Übergewichtigen und Adipösen - am Beispiel einer repräsentativen Stichprobe der deutschen Allgemeinbevölkerung

Obesity is associated with an increased somatic morbidity and mortality. This paper focuses on the controversial issue of mental co-morbidity in various populations of overweight and obese persons and the relationship to the utilization of medical care and health behaviour. Therefore, this paper focuses on health care utilization and health behaviour in overweight/obese with mental co-morbidity. In a representative German community sample with n = 1281 we administered valid self-rating scales on depression and anxiety. Using established cut-off scores we identified 61 subjects with both overweight/obesity and at least one mental disorder. Compared to the overweight/obese without mental co-m…

Das Adult Attachment Interview - Grundlagen, Anwendung und Einsatzmöglichkeiten im klinischen Alltag

The present paper looks at the potential of the Adult Attachment Interview (AAI) and its underlying basis in attachment theory for use in psychotherapeutic work. We summarize the basic tenets of attachment theory, detail the content and structure of the AAI, provide instructions for conducting the AAI, and introduce the Main et al. (2002) coding system. We then report on associations between AAI-Attachment groups and psychosomatic diseases and, finally, demonstrate applications of the AAI in clinical work and research.

Gender-specific associations of loneliness and suicidal ideation in a representative population sample: Young, lonely men are particularly at risk

Loneliness has been related to negative physical and mental health outcomes including suicidal ideation (SI). However, it is not clear whether loneliness is equally important for SI in women and men and in individuals of all age groups.Participants were a representative population sample (N=2,450) comprising the entire adult age range (18-95 years). Participants filled out established questionnaires (UCLA Three-Item Loneliness Scale, Beck Scale for Suicide Ideation, Patient Health Questionnaire-4). We tested a multiple linear regression model of SI (controlling for income, living alone, and mental distress) with interaction terms (loneliness x gender, loneliness x age, gender x age, lonelin…

Long-term cost-effectiveness of cognitive behavioral therapy versus psychodynamic therapy in social anxiety disorder.

Background To determine the cost-effectiveness of cognitive behavioral therapy (CBT) versus psychodynamic therapy (PDT) in the treatment of social anxiety disorder after a follow-up of 30 months from a societal perspective. Methods This analysis was conducted alongside the multicenter SOPHO-NET trial; adults with a primary diagnosis of social anxiety disorder received CBT (n = 209) or PDT (n = 207). Data on health care utilization and productivity loss were collected at baseline, after 6 months (posttreatment), and three further follow-ups to calculate direct and indirect costs. Anxiety-free days (AFDs) calculated based on remission and response were used as measure of effect. The increment…

Relative Telomere Length and Cardiovascular Risk Factors

(1) Background: Telomeres are repetitive DNA sequences located at the extremities of chromosomes that maintain genetic stability. Telomere biology is relevant to several human disorders and diseases, specifically cardiovascular disease. To better understand the link between cardiovascular disease and telomere length, we studied the effect of relative telomere length (RTL) on cardiovascular risk factors in a large population-based sample. (2) Methods: RTL was measured by a real-time quantitative polymerase chain reaction in subjects of the population-based Gutenberg Health Study (n = 4944). We then performed an association study of RTL with known cardiovascular risk factors of smoking status…

Loneliness and its relation to mental health in the general population: Validation and norm values of a brief measure

Abstract Background Loneliness has been increasingly recognized as an important determinant of mental health. The purposes of this study were to (1) determine the degree of loneliness of women and men across different age groups, (2) explore its association with distress, (3) psychometrically evaluate the Three-Item Loneliness Scale, (4) provide norm values. Methods The Three-Item Loneliness Scale was applied in a representative survey of the German population (N=2527; 14–95 years). Standardized scales were used measuring distress (depression and anxiety symptoms, perceived stress, hopelessness, suicidal ideation, fatigue, life satisfaction). Factor structure and measurement invariance acro…

Is that me in the mirror? Depersonalisation modulates tactile mirroring mechanisms

Our sense of self is thought to develop through sensory-motor contingencies provided, not only by observing one's own body, but also by mirroring interactions with others. This suggests that there is a strong link between mirroring mechanisms and the bodily self. The present study tested whether this link is expressed at early, implicit stages of the mirroring process or at later, more cognitive stages. We also provide, to the best of our knowledge, the first demonstration of how inter-individual differences in our sense of bodily self may affect mirroring mechanisms. We used somatosensory event-related potentials (SEPs) to investigate the temporal dynamics of mirroring highly self-related …

Abstract 147: The Role of Thrombin Generation in Cardiovascular Disease and Mortality - Results from the Population-based Gutenberg Health Study

Background: Thrombin formation is one of the key enzymatic processes that direct the activity of the hemostatic system. Thrombin generation (TG), a method addressing the overall potential of a given plasma sample to form thrombin, may be a potential tool to improve risk stratification for cardiovascular diseases (CVD). This study aims to explore the relation between TG and cardiovascular risk factors (CVRFs), CVD, and total mortality. Methods: For this study, N=5000 subjects from the population-based Gutenberg Health Study were analyzed in a highly standardized setting. TG was measured by the Calibrated Automated Thrombogram method at 1 and 5 pM tissue factor (TF) trigger in platelet poor …

New onset of depression in aging women and men: contributions of social, psychological, behavioral, and somatic predictors in the community.

AbstractBackgroundBased on the vulnerability–stress model, we aimed to (1) determine new onset of depression in individuals who had not shown evidence of depression at baseline (5 years earlier) and (2) identify social, psychological, behavioral, and somatic predictors.MethodsLongitudinal data ofN= 10 036 participants (40–79 years) were evaluated who had no evidence of depression at baseline based on Patient Health Questionnaire (PHQ-9), no history of depression, or intake of antidepressants. Multivariate logistic regression models were used to predict the onset of depression.ResultsPrevalence of new cases of depression was 4.4%. Higher rates of women (5.1%) than men (3.8%) were due to thei…

Problème : dysfonction sexuelle

L’angoisse de performance est une cause contributive chez presque tous les hommes qui ont une dysfonction erectile (DE). Les inhibiteurs de la phosphodiesterase de type 5 (PDE5) sont sans risque et peuvent etre utilises en premiere intention chez presque tous les hommes qui ont une DE. Chez les hommes ages des pays developpes, la maladie vasculaire est le facteur etiologique le plus courant. Tout homme se plaignant d’une DE doit avoir une recherche du diabete. On doit rechercher une atteinte coronarienne chez les hommes ages ayant une DE, et les modifications appropriees du mode de vie doivent etre recommandees en plus de tout autre traitement.

Assessing Planning Ability Across the Adult Life Span: Population-Representative and Age-Adjusted Reliability Estimates for the Tower of London (TOL-F).

Planning ahead the consequences of future actions is a prototypical executive function. In clinical and experimental neuropsychology, disc-transfer tasks like the Tower of London (TOL) are commonly used for the assessment of planning ability. Previous psychometric evaluations have, however, yielded a poor reliability of measuring planning performance with the TOL. Based on theory-grounded task analyses and a systematic problem selection, the computerized TOL-Freiburg version (TOL-F) was developed to improve the task's psychometric properties for diagnostic applications. Here, we report reliability estimates for the TOL-F from two large samples collected in Mainz, Germany (n = 3,770; 40-80 y…

Challenge Accepted! a Critical Reflection on How to Perform a Health Survey Among University Students—An Example of the Healthy Campus Mainz Project

Background: Universities represent an important setting of everyday life for health promotion. The Healthy Campus Mainz project aims to develop an evidence-based and comprehensive student health management program covering physical, mental, and social health promotion. Hence, an initial health survey was performed in order to identify the students' health concerns and resources. Up until now, it remains unclear which topics to choose in a health survey among university students and which strategies can be recommended to receive an acceptable response rate or representative student sample within a university setting. The present paper contributes to the call for the present research topic “P…

History of depression but not current depression is associated with signs of atherosclerosis: data from the Gutenberg Health Study.

ObjectivesTo test the vascular depression hypothesis in the general population, we analyzed the association between current depression, medical history of depression, cognitive and somatic depressive symptom dimensions and measures of atherosclerosis [intima–media thickness (IMT) and carotid plaques].MethodWe included a representative sample of 5000 participants from the Gutenberg Health Study (GHS). Depression was assessed by the nine-item Patient Health Questionnaire (PHQ-9), and IMT and carotid plaques were measured at both common carotid arteries using an edge detection system. Regression analyses were performed separately for participants with and without cardiovascular disease, adjust…

Prevalence of distress, comorbid conditions and well being in the general population.

Abstract Background The purposes of this paper are to determine the prevalence of distress in the community, to identify its determinants and to assess its relationship to somatic conditions and subjective well being. Methods Distress and associated factors were investigated in a random sample of 5000 participants (35–74 years) of a community-based, prospective, observational cohort study in western Mid-Germany (“Gutenberg Heart Study”) between 04/2007 and 10/2008. The sample was stratified 1:1 for gender and residence and in equal strata for decades of age. Data were assessed by self-report instruments, interviews and medical examination. Results We found a prevalence rate for depression o…

East vs. West: Differences in the prevalence of child maltreatment in Germany before the reunification

The relevance of depressive symptoms for the outcome of patients receiving vitamin K antagonists: results from the thrombEVAL cohort study.

Abstract Aims Although depressive symptoms are highly prevalent in patients receiving oral anticoagulation (OAC), the relevance of depression for the outcome of anticoagulated individuals is unknown. Methods and results We analysed data from the multicentre cohort study thrombEVAL (NCT01809015) investigating the efficacy of OAC with vitamin K antagonists. There was an independent study monitoring, and an independent review panel assessed the endpoints. Out of n = 1558 participants, information about depressive symptoms, as measured by the two-item screener of the patient health questionnaire (PHQ-2), was available in n = 1405 individuals. The mean follow-up period was 28.04 months, with a s…

Psychodynamic focal group treatment for psychosomatic inpatients--with an emphasis on work-related conflicts.

Conflicts arising from the work setting have remained a neglected issue in psychotherapy. To address this, the present study investigated the effectiveness of a manualized focal group treatment for psychotherapeutic inpatients suffering from vocational strains and conflicts and identified predictors of outcome. Cohorts of patients were assigned either to a treatment (N=144) or control condition (N=135). The group therapy intervention was found to be highly accepted by participants who were also more optimistic about returning to work and more favorable in their evaluations of treatment than patients in the treatment-as-usual condition. Group climate was found to be a predictor of favorable …

Efficacy of short-term psychodynamic psychotherapy (STPP) with depressed breast cancer patients: results of a randomized controlled multicenter trial.

BACKGROUND There is a lack of trials of psychodynamic treatments of depression in breast cancer patients. The purpose of this trial was to determine the efficacy of short-term psychodynamic psychotherapy (STPP) in non-metastatic breast cancer patients diagnosed with depression, one of the most frequent mental comorbidities of breast cancer. PATIENTS AND METHODS In a multicenter prospective trial, 157 breast cancer patients with comorbid depression were randomized to either individual STPP (intervention group, N=78) or 'treatment as usual' (control group, TAU, N=79). As our primary outcome measure, we hypothesized a higher rate of remission defined as no diagnosis of depression (Structured C…

Smoking and Neuropsychiatric Disease-Associations and Underlying Mechanisms.

Despite extensive efforts to combat cigarette smoking/tobacco use, it still remains a leading cause of global morbidity and mortality, killing more than eight million people each year. While tobacco smoking is a major risk factor for non-communicable diseases related to the four main groups—cardiovascular disease, cancer, chronic lung disease, and diabetes—its impact on neuropsychiatric risk is rather elusive. The aim of this review article is to emphasize the importance of smoking as a potential risk factor for neuropsychiatric disease and to identify central pathophysiological mechanisms that may contribute to this relationship. There is strong evidence from epidemiological and experiment…

Children and Employment - Resource or Stressors after Breast Cancer?

Introduction: Breast cancer patients suffer clinically relevant levels of psychological stress because of their disease. Various factors can affect the level of stress experienced. This study aimed to investigate the relationship between the level of psychological stress and employment and children, including time since diagnosis. Material and Methods: A randomised clinical study was done of 724 breast cancer patients aged between 18 and 65 years; all were in the curative stage of disease and had been diagnosed 0–12 months previously. Patients were investigated for their levels of psychological stress (anxiety and depression) using the Hospital Anxiety and Depression Scale (HADS). The relat…

Brief assessment of subjective health complaints: Development, validation and population norms of a brief form of the Giessen Subjective Complaints List (GBB-8).

Abstract Objective Although there is no causal relationship to medical morbidity, routine clinical assessment of somatic symptoms aids medical diagnosis and assessment of treatment effectiveness. Regardless of their causes, somatic symptoms indicate suffering, distress, and help-seeking behavior. The aim of the present study was to develop and validate a brief self-report questionnaire to assess somatic symptom strain. Methods A brief form of the Giessen Subjective Complaints List (GBB-8) was developed and validated in a large population sample representative of the Federal Republic of Germany ( N  = 2008). Psychometric analyses included confirmation of factor structure, classical item anal…

818 – The neuroscience of internet and computer game addiction - what do we know about what is going on inside our patients brains?

Internet and Computer Game Addiction will in the future be included in the diagnostic manuals for mental disorders (Internet Use Disorder, www.dsm5.org ). During the past decades research in the epidemiology, risk factors and the clinical picture of IUD has emerged and convincingly contributed to the development of sound diagnostic criteria. However, there are two major areas where evidence of high quality is sparse. These are on the one hand the effectiveness and efficacy of tailored therapeutic interventions and on the other hand the neuroscientific underpinnings of Internet and Computer Game Addiction. The latter is strongly represented in the Asian Countries, where prevalence rates for …

Is Sensation Seeking a correlate of excessive behaviors and behavioral addictions? A detailed examination of patients with Gambling Disorder and Internet Addiction

Sensation Seeking has repeatedly been related to substance use. Also, its role as a correlate of Gambling Disorder has been discussed although research has led to heterogeneous results. Likewise, first studies on Internet Addiction have indicated increased Sensation Seeking, to some extent contradicting clinical impression of patients suffering from internet addiction. We assessed Sensation Seeking in a clinical sample of n=251 patients with Gambling Disorder, n=243 patients with internet addiction, n=103 clients with excessive but not addictive internet use, and n=142 healthy controls. The clinical groups were further sub-divided according to the preferred type of addictive behavior (slot-…

Erwartungen und Informationsbedarf von Rehabilitanden bezüglich stationärer psychosomatischer Rehabilitation

Zusammenfassung Ziel der Studie Um ein Online-Portal zur Vorbereitung auf die stationäre psychosomatische Rehabilitation zu entwickeln, wurden Informationsbedarf und Online-Nutzungsverhalten von Rehabilitanden untersucht. Methodik Vier Fokusgruppen mit Rehabilitanden (N=31) sowie zwei mit Behandlern (N=18) wurden durchgeführt und qualitativ-inhaltsanalytisch ausgewertet. Ergebnisse Insgesamt wurden 419 Aussagen von Rehabilitanden und 333 Aussagen von Behandlern kodiert und kategorisiert. Aktuelle Informationsmaterialien zur Rehabilitation wurden von Rehabilitanden als zu ausführlich und schwer verständlich eingeschätzt. Unsicherheit bestand vor allem hinsichtlich der Wirksamkeit und Nachhal…

Association of Birth Weight with Central and Peripheral Corneal Thickness in Adulthood-Results from the Population-Based German Gutenberg Health Study.

Low birth weight (BW) is associated with altered ocular geometry such as a steeper corneal shape in adulthood. However, it is unclear whether low birth weight affects corneal thickness development in the center or periphery in adulthood which may contribute to ocular disease. The purpose of this study was to investigate corneal thickness in former low birth weight individuals in adulthood. Methods: The German Gutenberg Health Study is a prospective, population-based study in which every participant (age range 40–80 years) was measured with Scheimpflug imaging (Pentacam HR, Oculus Optikgeräte GmbH, Wetzlar, Germany). BW was collected by self-reports. The relationship between birth weight and…

Risk factors for suicidal ideation in a large, registry-based sample of adult long-term childhood cancer survivors

Abstract Introduction Long-term childhood cancer survivors (CCS) are at risk for physical and psychosocial late effects. Previous research has attested to increased rates of suicidal ideation (SI) in CCS, an especially dangerous indicator of distress. However, little was known about risk factors of SI among CCS which go beyond illness- and treatment related variables. Methods A registry-based sample of 916 adult long-term CCS (Mage=34.58 years [SD=5.53], Mage at diagnosis=6.15 years [SD=4.28]) underwent medical assessments and filled out questionnaires. We conducted a linear regression analysis on SI, testing predictors of different areas: sociodemographic, social, physical health and healt…

Repressive Coping Style and Its Relation to Psychosocial Distress in Males With Erectile Dysfunction

ABSTRACT Introduction There is evidence that repressive coping adversely affects medical conditions such as coronary heart disease, hypertension, and bronchial asthma. Erectile dysfunction (ED) is known to have a severe and lasting negative impact on health, quality of life, and partnership. Although ED may be eminently threatening for the self-image of affected men, a repressive coping style and its consequences for their mental health and partnership has not yet been investigated. Aim Based on the presumption that the male self-image is threatened by ED, we expected men with repressive coping strategies—although reporting the same degree of impairments regarding their sexual function—to d…

How can we support COVID-19 survivors? Five lessons from long-term cancer survival.

Clinical Determinants of Thrombin Generation Measured in Presence and Absence of Platelets-Results from the Gutenberg Health Study.

AbstractThe tendency of a plasma sample to generate thrombin, a central enzyme in blood coagulation, might be an important indicator of prothrombotic risk linked to cardiovascular disease (CVD), but the presence of platelets may be a critical determinant. Clinical data, laboratory markers and thrombin generation (TG), investigated in both platelet-rich plasma (PRP) and platelet-free plasma (PFP) at 1 pM TF, were available in 407 individuals from the Gutenberg Health Study. Given the well-known effect of anticoagulants on TG, subjects taking anticoagulants (n = 15) have been excluded resulting in 392 subjects for further analysis. Lag time, endogenous thrombin potential (ETP) and peak height…

Association of Birth Weight With Foveolar Thickness in Adulthood: Results From a Population-Based Study

Purpose Low birth weight (BW) is associated with alterations of foveal shape development in childhood—leading to an increased retinal thickness of the fovea. The aim of the present study was to assess whether BW has a long-term effect on foveal retinal thickness (RT) and is still present in adulthood. Methods In the German population-based Gutenberg Health Study (GHS), participants were examined with spectral-domain optical coherence tomography. The association between self-reported BW and RT in the foveolar and perifoveal locations was assessed. Multivariable linear regression analyses with adjustment for potential confounders and grading of foveal hypoplasia were performed. Results Overal…

Depression in Atrial Fibrillation in the General Population

BACKGROUND: Initial evidence suggests that depressive symptoms are more frequent in patients with atrial fibrillation. Data from the general population are limited. METHODS AND RESULTS: In 10,000 individuals (mean age 56±11 years, 49.4% women) of the population-based Gutenberg Health Study we assessed depression by the Patient Health Questionnaire (PHQ-9) and a history of depression in relation to manifest atrial fibrillation (n = 309 cases). The median (25th/75th percentile) PHQ-9 score of depressive symptoms was 4 (2/6) in atrial fibrillation individuals versus 3 (2/6) individuals without atrial fibrillation, P(X2-Test) = 0.32. Multivariable regression analyses of the severity of depressi…

Similarities and Differences of Mental Health in Women and Men: A Systematic Review of Findings in Three Large German Cohorts

In Germany, large, population-based cohort studies have been implemented in order to identify risk and protective factors for maintaining health across the life span. The purpose of this systematic review is to analyse findings from three large ongoing cohorts and to identify sex-specific prevalence rates, risk and protective factors for mental health. Published studies from the Cooperative Health Research in the Region Augsburg (KORA), the Study of Health in Pomerania (SHIP) and the Gutenberg Health Study (GHS)), representing the southern, north-eastern and middle parts of Germany, were identified through searches of the databases PubMed and Web of Science. A total of 52 articles was ident…

Distribution, genetic and cardiovascular determinants of FVIII:c - Data from the population-based Gutenberg Health Study

Background: Elevated levels of FVIII:c are associated with risk for both venous and arterial thromboembolism. However, no population-based study on the sex-specific distribution and reference ranges of plasma FVIII: c and its cardiovascular determinants is available. Methods: FVIII:c was analyzed in a randomly selected sample of 2533 males and 2440 females from the Gutenberg Health Study in Germany. Multivariable regression analyses for FVIII:c were performed under adjustment for genetic determinants, cardiovascular risk factors and cardiovascular disease. Results and conclusions: Females (126.6% (95% CI: 125.2/128)) showed higher FVIII:c levels than males (121.2% (119.8/122.7)). FVIII:c le…

Socio-demographic, health-related, and individual correlates of diagnostic self-testing by lay people: Results from a representative survey in Germany

Introduction A broad range of self-tests (testing for e.g. HIV, cancer, hepatitis B/C) have become available and can be conducted by lay consumers without the help of a health professional. The aims of this study were to (a) investigate the prevalence of self-testing, (b) identify the most frequently used self-tests, and (c) explore the associations between socio-demographic, health-related and individual factors with self-testing. Methods A face-to-face plus paper-pencil cross-sectional survey was conducted. The sample consisted of 2.527 respondents who were representative of the German population in terms of the age, sex, and residence. Basic descriptive statistics and univariate logistic…

Codierung der Tätigkeitsangaben im Basiskollektiv der Gutenberg-Gesundheitsstudie unter Anwendung der Klassifikation der Berufe KldB 2010 — Darstellung des Vorgehens und der Datenqualität

In der Basiserhebung der Gutenberg- Gesundheitsstudie Mainz wurden die Berufsbiografien von 15.010 Probanden erfasst. Um die Textangaben aus 67.389 einzelnen Tatigkeitsphasen fur epidemiologische Auswertungen nutzen zu konnen, wurde eine Codierung nach der deutschen Klassifikation der Berufe KldB 2010 durchgefuhrt. Ziel des Artikels ist, das methodische Vorgehen und die Qualitat der angewandten Berufscodierung darzustellen.

Distinctiveness and overlap of depersonalization with anxiety and depression in a community sample: results from the Gutenberg Heart Study.

Depersonalization disorder is considered to be a common clinical phenomenon and disorder with an enormous gap between prevalence and detection partly due to the common interpretation of depersonalization (DP) being a negligible variant of anxiety and depression. Therefore, we sought to analyze (1) the prevalence rate of DP in a large community sample (n=5000) according to a recently developed ultra brief two-item depersonalization screener; (2) the associations with depression, anxiety, physical and mental health status; and 93) whether DP contributes independently to the health status beyond anxiety and depression. The prevalence of clinically significant DP was 0.8% (n=41), and 8.5% (n=42…

Does a cognitive-training programme improve the performance of middle-aged employees undergoing in-patient psychosomatic treatment?

Purpose. With the ever-increasing average life expectancy and rising age of retirement, cognitive and work capacities in advanced age take on great importance. Cognitive impairments, however, increase with age. The effect of cognitive-training programmes on people with mild cognitive impairment has not been verified in any systematic investigations.Method. This study presents a cognitive-training programme designed for middle-aged employees that was implemented and evaluated at the Psychosomatic Clinic Bad Neustadt/Saale in an AB study design (A: no intervention; B: intervention).Results. Memory performance of the intervention group (n = 33) improved significantly between intake and dischar…

Characterizing psychosocial distress in melanoma patients using the expert rating instrument PO-Bado SF

Background Although psychosocial distress has been evaluated well in cancer entities like breast or prostate cancer, its impact on melanoma patients still needs to be characterized. The objectives of this study were to (i) evaluate psychosocial distress in melanoma patients using an expert rating instrument [basic documentation for psycho-oncology short version (PO-Bado SF)]; (ii) determine associated demographic and clinical variables; and (iii) assess the acceptance of using PO-Bado SF as a routine procedure in a skin cancer unit. Methods A cross-sectional group of 696 melanoma patients was recruited. During the routine contact, doctors assessed the patients subjective distress using PO-B…

Peripheral corneal thickness and associated factors - results from the population-based German Gutenberg Health Study.

PURPOSE Changes in peripheral corneal thickness are described in various corneal diseases such as corneal ectasia. However, few data exist describing the increase in corneal thickness from central to peripheral and reporting the normal distribution of corneal thickness in rings around the corneal centre. The aim of this study was to report these cornea characteristics and investigate associated factors in a population-based setting. METHODS The Gutenberg Health Study is a prospective, population-based study examining participants in a 5-year follow-up (age range 40-80 years) using Scheimpflug imaging. Corneal thickness was assessed in each participant at the apex, as well as in the corneal …

Recalled parental rearing behavior in adult women and men with depressive and anxiety symptoms: Findings from a community study.

Objectives: Addressing the lack of population-based data, the purpose of this representative study was to assess sex- and age-specific associations of maternal and paternal rearing behavior with depressiveness and anxiety controlling for sociodemographic and somatic variables. Methods: 8,175 subjects participating in a population-based study completed standardized questionnaires measuring Recalled Parental Rearing Behavior and distress. Results: Women recalled their fathers as more controlling and warmer, and their mothers as more rejecting than men. Comparisons between age groups (≤ 60 vs. > 60 years) revealed that younger participants recalled more parental control and emotional warmth. I…

Prevalence of pterygium and identification of associated factors in a German population - results from the Gutenberg Health Study.

Intake of Vitamin K Antagonists and Worsening of Cardiac and Vascular Disease: Results From the Population‐Based Gutenberg Health Study

Background Preclinical data have indicated a link between use of vitamin K antagonists ( VKA ) and detrimental effects on vascular structure and function. The objective of the present study was to determine the relationship between VKA intake and different phenotypes of subclinical cardiovascular disease in the population. Methods and Results Clinical and laboratory data, as well as medical–technical examinations were assessed from 15 010 individuals aged 35 to 74 years during a highly standardized 5‐hour visit at the study center of the population‐based Gutenberg Health Study. In total, the study sample comprised 287 VKA users and 14 564 VKA nonusers. Multivariable analysis revealed an in…

Erratum, Psychisches Befinden, Beschwerden und Belastungen: Ergebnisse einer repräsentativen Studie.

Zusammenfassung. Die Erfassung von Beschwerden und der Befindlichkeit sind wesentlicher Teil eines klinisch-diagnostischen Prozesses. Da Angststorungen und Depressionen in hohem Mase mit verschiedenen psychischen und korperlichen Belastung einhergehen, wurden in dieser Studie primar die pradiktiven Eigenschaften der Beschwerden-Liste (B-LR) und der Befindlichkeits-Skala (Bf-SR) in revidierter Form mittels Regressionsanalysen (linear und hierarchisch) an einer Stichprobe von N = 2504 untersucht. Als abhangiges Kriterium galt die Auspragung von Angst- und Depressionssymptomen, ermittelt uber das Kurzscreening Patient-Health-Questionnaire-4 (PHQ-4). Da vermutet wurde, dass entsprechende Sympto…

The role of stress and self-efficacy in somatic and psychological symptoms during the climacteric period - Is there a specific association?

Abstract Objectives To investigate the influence and specificity of sociodemographic and psychological factors on the perception of symptoms associated with menopause. Study design Data are based on a nationwide cross-sectional survey study in Germany. A representative sample of 1350 females aged 14–95 years was examined. Sociodemographic factors, perceived stress, and self-efficacy were assessed. Women were divided into three age groups (young women ≤ 44 years; perimenopausal women 45–60 years; older women ≥ 61 years), and the Menopause Rating Scale (MRS) was used over the entire life span. Main outcome measures Total score on the Menopause Rating Scale (MRS) and hot flushes/sweating asses…

Internet Addiction and Internet Gaming Disorder

Several forms of excessive pathological Internet use, such as Internet addiction (IA), Internet gaming disorder (IGD), or gaming disorder (GD) are perceived as public health concerns. IGD was included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a research diagnosis and recently GD was announced for the International Classification of Disease (ICD-11). IA represents a variety of excessive and unregulated consumption of video games, social networking, chat rooms, use of online pornography, online gambling, or the aimless gathering and research of information. The outpatient treatment program Short-Term Treatment of Internet and Computer Game Addiction (STICA) aims …