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Georg AK, Holl J, Taubner S, Volkert J. Mentalisation-based online intervention for psychologically distressed parents: protocol of a non-randomised feasibility trial of the Lighthouse Parenting Programme-Online (LPP-Online). BMJ Open 2024; 14:e078548. [PMID: 38969386 PMCID: PMC11227772 DOI: 10.1136/bmjopen-2023-078548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 06/12/2024] [Indexed: 07/07/2024] Open
Abstract
INTRODUCTION Online-based interventions provide a low-threshold way to reach and support families. The mentalisation-based Lighthouse Parenting Programme is an established intervention aimed at preventing psychopathological development in children. The objective of this study is to examine the feasibility of an online adaptation of the Lighthouse Parenting Programme (LPP-Online), evaluating (a) recruitment capability, compliance, acceptability and satisfaction with the intervention; (b) the psychometric properties of and the acceptability regarding the adjunct psychological evaluation; and (c) the employed materials and resources. The study will also obtain a preliminary evaluation of participants' responses to the intervention. METHOD AND ANALYSIS In this monocentric, one-arm, non-randomised feasibility trial, n=30 psychologically distressed parents with children aged 0 to 14 years will participate in the LPP-Online for a duration of 8 weeks. The intervention consists of online group sessions and individual sessions, 38 smartphone-based ecological momentary interventions (EMI), and psychoeducational materials (website, booklet). At baseline (T0) and the end of the intervention (T1), parents complete self-report questionnaires as well as 7-day ecological momentary assessments (EMA) via smartphone. During the intervention, additional EMA are completed before and after the daily EMI. An interview regarding parents' subjective experience with the intervention will be conducted at T1. The feasibility of the intervention, the psychological evaluation and the resources will be examined using descriptive and qualitative analyses. The preliminary evaluation of the parents' response to the intervention will be conducted by analysing pre-post changes in questionnaire measures and the 7-day EMA as well as data of additional EMA completed before and after the daily EMI. ETHICS AND DISSEMINATION Ethical approval of the study has been obtained from the local ethics board (Faculty of Behavioural and Cultural Studies, University of Heidelberg). Consent to participate will be obtained before starting the assessments. Results will be disseminated as publications in peer-reviewed scientific journals and at international conferences. REGISTRATION DETAILS German Clinical Trials Register (DRKS00027423), OSF (https://doi.org/10.17605/OSF.IO/942YW).
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Affiliation(s)
- Anna Katharina Georg
- Institute for Psychosocial Prevention, University Hospital Heidelberg, Heidelberg, Germany
| | - Julia Holl
- Institute for Psychosocial Prevention, University Hospital Heidelberg, Heidelberg, Germany
- Psychological Institute, Department of Clinical Psychology and Psychotherapy, Heidelberg University, Heidelberg, Germany
| | - Svenja Taubner
- Institute for Psychosocial Prevention, University Hospital Heidelberg, Heidelberg, Germany
| | - Jana Volkert
- Clinic for Psychosomatic Medicine and Psychotherapy, University of Ulm, Ulm, Germany
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Cassuriaga J, Feter N, da Silva LS, Feter J, Delpino FM, Rocha JQS, Vieira YP, Caputo EL, Reichert FF, da Silva MC, Rombaldi AJ. Exercise as medicine! Physical activity mitigated the impact of the COVID-19 pandemic on depressive symptoms in adults with depression. J Psychiatr Res 2024; 175:153-159. [PMID: 38735260 DOI: 10.1016/j.jpsychires.2024.05.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 02/09/2024] [Accepted: 05/08/2024] [Indexed: 05/14/2024]
Abstract
We investigated the longitudinal association between physical activity (PA) and symptoms of depression and anxiety in people with depression during the COVID-19 pandemic. We used data from baseline (June 2020) to wave 3 (June 2021) of the PAMPA Cohort, an ambispective cohort with adults in south Brazil. The Hospital Anxiety and Depression Scale assessed depressive and anxiety symptoms in all waves. Participants reported frequency (minutes), type (aerobic, strength, combined), and place (out of home, at home) of physical activity at baseline. Generalized linear models were used to investigate the interaction between time and PA, adjusting for possible confounding variables. Subjective memory decline was assessed using multivariate Cox proportional hazard regression models to obtain adjusted hazard ratio (HR) and respective 95% confidence interval (CI). Participants (n = 424) with self-reported clinically diagnosed depression were included. We observed a non-linear increase trajectory of depression during the first year of the COVID-19 pandemic. PA was associated with a slower trajectory of depressive (slope: -1.89; 95%CI: -3.34, -0.43 points) but not anxiety (slope: -1.33; 95%CI: -2.93, 0.25 points) symptoms during the COVID-19 pandemic. Participants who continued physically active from pre-pandemic in wave 1 showed a lower risk of subjective memory decline during follow-up than those who persisted inactive in the same period (HR: 0.52; 95%CI: 0.30, 0.89). PA attenuated the impact of the COVID-19 pandemic on depressive symptoms in adults living with depression in south Brazil. Regularity of physical activity was associated with fewer depression and anxiety symptoms and a lower risk of subjective memory decline.
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Affiliation(s)
- Julia Cassuriaga
- Postgraduate Program Multicenter in Physiological Sciences, Universidade Federal de Pelotas, Brazil; Postgraduate Program in Physical Education, School of Physical Education, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Natan Feter
- Postgraduate Program in Epidemiology, School of Medicine, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil.
| | - Luísa Silveira da Silva
- Postgraduate Program in Epidemiology, School of Medicine, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Jayne Feter
- Postgraduate Program in Health Sciences, School of Medicine, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil
| | | | - Juliana Quadros Santos Rocha
- Postgraduate Programme in Health Sciences, Federal University of Rio Grande, Rio Grande, Rio Grande do Sul, Brazil
| | - Yohana Pereira Vieira
- Postgraduate Programme in Health Sciences, Federal University of Rio Grande, Rio Grande, Rio Grande do Sul, Brazil
| | - Eduardo Lucia Caputo
- Postgraduate Programme in Health Sciences, Federal University of Rio Grande, Rio Grande, Rio Grande do Sul, Brazil
| | - Felipe Fossati Reichert
- Postgraduate Program in Physical Education, School of Physical Education, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Marcelo Cozzensa da Silva
- Postgraduate Program in Physical Education, School of Physical Education, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Airton José Rombaldi
- Postgraduate Program in Physical Education, School of Physical Education, Universidade Federal de Pelotas, Pelotas, Brazil
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Gelkopf M, Berger R, Dicker-Oren SD, Lapid Pickman L, Greene T. Trauma history predicts depression and posttraumatic stress symptoms better than a psychiatric diagnosis: Comparing wartime, routine time, and early COVID-19 in Israel. Stress Health 2024; 40:e3254. [PMID: 37165573 DOI: 10.1002/smi.3254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 03/14/2023] [Accepted: 04/17/2023] [Indexed: 05/12/2023]
Abstract
Individuals with a psychiatric diagnosis and those with a history of trauma are at high risk for depression and posttraumatic stress symptoms (PTSS) following exposure to new traumatic events. Nevertheless, research is scarce on how having both a psychiatric diagnosis and a trauma history affect reactions to new traumatic events, and how different trauma types may affect individuals with a psychiatric diagnosis. We thus examined whether different stressful contexts (War and COVID-19) affected individuals with and without a psychiatric diagnosis differentially and whether results might be explained by prior trauma exposure. In the same cohort, we assessed depression and PTSS during wartime (2014), routine time (2016), and during the COVID-19 pandemic (2020) in a sample with (n = 89) and without (n = 104) a self-reported psychiatric diagnosis. This cohort was recruited during the 2014 Israel-Gaza War using social media, snowballing and outreach to mental health rehabilitation centres. We used a linear mixed modelling approach on data from the entire sample, as well as on the two study groups separately. We found that trauma history predicted PTSS and depression whereas a history of psychiatric diagnosis did not. Regarding trauma types, we found that individuals in the psychiatric diagnosis group relative to themselves had more symptoms during COVID-19 compared to war and routine time, while those without diagnosis had more PTSS and depression symptoms during wartime compared to routine time and COVID-19. In conclusion, a traumatic past may have an important influence on reactions to different types of traumatic events. Distinct traumatic events may affect individuals with or without a psychiatric diagnosis differentially.
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Affiliation(s)
- Marc Gelkopf
- Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Rony Berger
- Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv-Yafo, Israel
- Center for Compassionate and Mindful Education, Tel Aviv University, Tel Aviv-Yafo, Israel
| | - Sheila Daniela Dicker-Oren
- Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Liron Lapid Pickman
- Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Talya Greene
- Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
- Clinical, Educational and Health Psychology, University College London, London, UK
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Ackermann A, Weihrauch D, Wiesmüller GA, Hurraß J. [From the practice of monitoring SARS-CoV-2 test sites in the city of Cologne]. DAS GESUNDHEITSWESEN 2024; 86:28-36. [PMID: 37852277 PMCID: PMC11248172 DOI: 10.1055/a-2144-5703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2023]
Abstract
In spring 2021, a law for the nationwide opening of test centers in Germany was passed. The local health department fulfilled the task of monitoring the test centers that subsequently opened throughout Cologne regarding the infectious and hygienic risks. Inspections were carried out using structured checklists. A retrospect evaluation of the identified deficiencies was run for the period between March 15 and July 31, 2021. In 84% of the cases, hygienic deficiencies were found when the test sites were inspected for the first time. 35% of the test sites were closed immediately, most of them temporarily. These first results provide information on frequent and important hygienic problems of the rapid set up of test sites and important advice for avoiding those and thus protecting employees and test persons.
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Affiliation(s)
| | | | - Gerhard A Wiesmüller
- Institut für Arbeits-, Sozial- und Umweltmedizin, Uniklinik RWTH Aachen, Aachen, Germany
- Zentrum für Umwelt, Hygiene und Mykologie Köln GmbH, ZfMK Köln, Köln, Germany
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Aichholzer M, Schiweck C, Uckermark C, Hamzehloiya T, Reif-Leonhard C, Golbach R, Reif A, Edwin Thanarajah S. Impact of COVID-19 on the treatment of depressive patients in Germany-a gap in care for the mentally ill? Front Psychiatry 2023; 14:1198632. [PMID: 37840810 PMCID: PMC10569605 DOI: 10.3389/fpsyt.2023.1198632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 08/21/2023] [Indexed: 10/17/2023] Open
Abstract
Background The COVID-19 pandemic led to a higher incidence of depression and a worsening of psychiatric conditions, while pre-existing constraints of the healthcare system and safety regulations limited psychiatric care. Aims We investigated the impact of the pandemic on the clinical care of patients with a single episode (SE-MDD) or major depressive disorder (MDD) in Germany. Methods Nationwide inpatient data were extracted from the German Institute for Hospital Remuneration System for 2020 and 2021 (depression data) and the Robert Koch Institute (COVID-19 incidence). Changes in inpatients were tested with linear regression models. Local cases of depression in our department compared to 2019 were explored with one-way ANOVA and Dunnett's test. Results Across Germany, the inpatient numbers with both SE-MDD and MDD declined by more than 50% during three out of four COVID-19 waves. Higher COVID-19 incidence correlated with decreased inpatient numbers. In our department, fewer MDD inpatients were treated in 2020 (adj. p < 0.001) and 2021 (adj. p < 0.001) compared to 2019, while the number of SE-MDD inpatients remained stable. During this period fewer elective and more emergency inpatients were admitted. In parallel, MDD outpatient admissions increased in 2021 compared to 2019 (adj. p = 0.002) and 2020 (adj. p = 0.003). Conclusion During high COVID-19 infection rates, MDD patients received less inpatient care, which might cause poor outcomes in the near future. These data highlight the necessity for improved infrastructure in the in- and outpatient domains to facilitate accessibility to adequate care.
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Affiliation(s)
- Mareike Aichholzer
- Department for Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Carmen Schiweck
- Department for Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Carmen Uckermark
- Department for Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Tirage Hamzehloiya
- Department for Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Christine Reif-Leonhard
- Department for Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Rejane Golbach
- Department of Medicine, Institute of Biostatistics and Mathematical Modelling, Goethe University, Frankfurt, Germany
| | - Andreas Reif
- Department for Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Sharmili Edwin Thanarajah
- Department for Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
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Elsner A, Mergl R, Allgaier AK, Hegerl U. Suicide rates during and after the first COVID-19 lockdown in Germany in 2020. PLoS One 2023; 18:e0289136. [PMID: 37656723 PMCID: PMC10473467 DOI: 10.1371/journal.pone.0289136] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 07/11/2023] [Indexed: 09/03/2023] Open
Abstract
The impact of the COVID-19 pandemic and of measures implemented to curb the spread of the virus on suicidal behavior has been investigated in different regions of the world, but does not yet allow to draw conclusions for Germany. Especially lockdowns might have effects on suicide rates via impact on mental disorders, changes in the choice of suicide method, a decrease in help seeking behavior, or a deterioration in the quality of medical care for people with mental disorders. The following research questions were addressed: i) did suicide rates in Germany in 2020 change during lockdown and non-lockdown periods when compared to a ten-year baseline? ii) was there a change in the proportion of suicide methods during the lockdown compared to baseline? An interrupted time-series analysis based on a linear regression was used. For the comparisons of predicted and observed suicide rates, excess suicide mortality rates (ESMR) were chosen among others. Changes in the choice of method were analyzed by comparing the rates of different methods to those at baseline. Although the mean suicide rate in 2020 was not significantly different from baseline, the weekly analysis of suicide rates revealed a significant difference (χ2 = 64.16; df = 39; p = 0.007), with some weeks showing higher and others lower rates than previous years. The effects for separate weeks were attenuated to non-significance after correction for multiple testing. Suicide mortality during the first lockdown in 2020 was significantly lower than expected (ESMR = 0.933; 95% CI: 0.890; 0.985) whereas, in the post-lockdown period, the registered suicide mortality was not significantly different from the expected one (ESMR = 1.024; 95% CI: 0.997; 1.051). During lockdown, there was a significant increase of the percentage of the suicide method categories jumping and 'other methods' and a decrease of poisoning and lying in front of a moving object. Being able to determine whether the choice of more or less lethal methods during lockdown versus non-lockdown periods partly explains this finding would require a representative assessment of attempted suicides.
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Affiliation(s)
- Anne Elsner
- German Depression Foundation, Leipzig, Germany
| | - Roland Mergl
- Universität der Bundeswehr München, Institute of Psychology, Neubiberg, Germany
| | | | - Ulrich Hegerl
- German Depression Foundation, Leipzig, Germany
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University Frankfurt (Distinguished Professorship funded by Dr. Senckenbergische Stiftung), Frankfurt am Main, Germany
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Camargo D, Navarro-Tapia E, Pérez-Tur J, Cardona F. Relationship between COVID-19 Pandemic Confinement and Worsening or Onset of Depressive Disorders. Brain Sci 2023; 13:899. [PMID: 37371377 DOI: 10.3390/brainsci13060899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 05/26/2023] [Accepted: 05/30/2023] [Indexed: 06/29/2023] Open
Abstract
Several studies indicate that the pandemic and associated confinement measures may have had an impact on mental health, producing the onset or persistence of symptoms such as stress, anxiety, depression, and fear. This systematic review aims to identify the factors influencing the onset or worsening of depressive symptoms during COVID-19-related confinement. Our systematic search produced 451 articles from selected databases, 398 of which were excluded based on established criteria, while 53 were selected for review. Most studies have reported an increase in the prevalence of depressive symptoms in the general population during the first weeks of confinement. The predominant risk factors associated with the appearance of depressive symptoms included female sex, low educational level, young age, economic difficulties, comorbidities, and a history of previous depressive episodes. People with a pre-existing diagnosis of depressive disorder generally experienced a worsening of their symptoms during confinement in most of the reviewed studies. Moreover, symptomatology persisted at higher levels post-confinement, without significant improvement despite relief in confinement measures. Therefore, ongoing evaluations of post-pandemic depressive symptoms are necessary to advance the knowledge of the relationship between pandemics and depression, allowing accurate conclusions and associations to be made.
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Affiliation(s)
- Daniela Camargo
- Faculty of Health Sciences, Valencian International University (VIU), 46002 Valencia, Spain
| | - Elisabet Navarro-Tapia
- Faculty of Health Sciences, Valencian International University (VIU), 46002 Valencia, Spain
| | - Jordi Pérez-Tur
- Unitat de Genètica Molecular, Instituto de Biomedicina de Valencia-CSIC, 46010 Valencia, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, Instituto de Salud Carlos III (CIBER-CIBERNED-ISCIII), 28029 Madrid, Spain
| | - Fernando Cardona
- Unitat de Genètica Molecular, Instituto de Biomedicina de Valencia-CSIC, 46010 Valencia, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, Instituto de Salud Carlos III (CIBER-CIBERNED-ISCIII), 28029 Madrid, Spain
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von der Groeben S, Czaplicki A, Hegerl U, Reich H. Telemedicine during the COVID-19 pandemic in Germany: Results from three nationally representative surveys on use, attitudes and barriers among adults affected by depression. Internet Interv 2023; 32:100622. [PMID: 37091132 PMCID: PMC10114311 DOI: 10.1016/j.invent.2023.100622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 03/14/2023] [Accepted: 04/17/2023] [Indexed: 04/25/2023] Open
Abstract
Introduction The COVID-19 pandemic has necessitated a reduction in face-to-face consultations, resulting in significant limitations in healthcare for individuals with depression. To ensure safe and adequate care, e-health services, such as telemedicine, gained a more prominent role. Governments have eased restrictions on the use of telemedicine, enabling healthcare professionals to increasingly offer video and telephone consultations. Objective This study examines, 1) possible changes over the course of the pandemic in reported use of video and telephone consultations and intended future use of video consultations with healthcare professionals among adults with diagnosed depression; 2) their attitudes towards video and telephone consultations and perceived barriers towards using e-health after prolonged time of the pandemic; and 3) differences in results between subgroups based on sociodemographic and clinical characteristics. Methods Three population-representative online surveys were conducted in Germany at different timepoints (t) during the COVID-19 pandemic. Respondents aged 18-69 years with a professionally diagnosed depression were included in the present analyses (t1: June/July 2020 with n = 1094; t2: February 2021 with n = 1038; t3: September 2021 with n = 1255). Results The overall proportion of adults with depression who used video or telephone consultations did not change significantly in the time surveyed (t1: 16.51 %, n = 179; t2: 20.23 %, n = 210; t3: 18.47 %, n = 230). However, among users, reported use of video consultations with a psychotherapist increased significantly from t1 (34.83 %, n = 62) to t3 (44.98 %, n = 102, p = .023). Intended future use of VC for healthcare varied depending on the purpose of the consultation. Significant differences over time were only found for the purpose of using VC to discuss clinical findings, laboratory results and diagnostic analyses with a doctor, with higher intentions reported at t2 during lockdown in Germany. At t3, the majority of adults with depression felt that video and telephone consultations were too impersonal and considered them more as a helpful support rather than an alternative to face-to-face psychotherapy. Key barriers to using e-health were found within the societal context and the lacking support from significant others for using e-health, while knowledge and skills represented facilitators for using e-health. Conclusion Despite ambivalent attitudes towards video and telephone consultations among adults with depression, reported use of video consultations with a psychotherapist increased during the COVID-19 pandemic.
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Affiliation(s)
- S von der Groeben
- Goethe University Frankfurt, University Hospital, Depression Research Centre of the German Depression Foundation, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Germany
| | - A Czaplicki
- Goethe University Frankfurt, University Hospital, Depression Research Centre of the German Depression Foundation, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Germany
- German Depression Foundation, Leipzig, Germany
| | - U Hegerl
- Goethe University Frankfurt, University Hospital, Depression Research Centre of the German Depression Foundation, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Germany
- German Depression Foundation, Leipzig, Germany
- Johann Christian Senckenberg Distinguished Professorship, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt am Main, Germany
| | - H Reich
- Goethe University Frankfurt, University Hospital, Depression Research Centre of the German Depression Foundation, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Germany
- German Depression Foundation, Leipzig, Germany
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Hallek M, Adorjan K, Behrends U, Ertl G, Suttorp N, Lehmann C. Post-COVID Syndrome. DEUTSCHES ARZTEBLATT INTERNATIONAL 2023; 120:48-55. [PMID: 36633452 PMCID: PMC10060997 DOI: 10.3238/arztebl.m2022.0409] [Citation(s) in RCA: 25] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 11/14/2022] [Accepted: 12/19/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND As defined by the WHO, the term post-COVID syndrome (PCS) embraces a group of symptoms that can occur following the acute phase of a SARS-CoV-2 infection and as a consequence thereof. PCS is found mainly in adults, less frequently in children and adolescents. It can develop both in patients who initially had only mild symptoms or none at all and in those who had a severe course of coronavirus disease 2019 (COVID-19). METHODS The data presented here were derived from a systematic literature review. RESULTS PCS occurs in up to 15% of unvaccinated adults infected with SARS-CoV-2. The prevalence has decreased in the most recent phase of the pandemic and is lower after vaccination. The pathogenesis of PCS has not yet been fully elucidated. Virustriggered inflammation, autoimmunity, endothelial damage (to blood vessels), and persistence of virus are thought to be causative. Owing to the broad viral tropism, different organs are involved and the symptoms vary. To date, there are hardly any evidence-based recommendations for definitive diagnosis of PCS or its treatment. CONCLUSION The gaps in our knowledge mean that better documentation of the prevalence of PCS is necessary to compile the data on which early detection, diagnosis, and treatment can be based. To ensure the best possible care of patients with PCS, regional PCS centers and networks embracing existing structures from all healthcare system sectors and providers should be set up and structured diagnosis and treatment algorithms should be established. Given the sometimes serious consequences of PCS for those affected, it seems advisable to keep the number of SARS-CoV-2 infections low by protective measures tailored to the prevailing pandemic situation.
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Affiliation(s)
- Michael Hallek
- Department I of Internal Medicine, Center of Integrated Oncology ABCD, University Hospital of Cologne and German Medical Association, Berlin
| | - Kristina Adorjan
- Department I of Internal Medicine, Center of Integrated Oncology ABCD, University Hospital of Cologne and German Medical Association, Berlin
| | - Uta Behrends
- Munich Chronic Fatigue Center for Young People, Children’s Hospital, School of Medicine, Technical University Munich
| | - Georg Ertl
- German Society of Internal Medicine e.V. and Comprehensive Heart Failure Center, Würzburg
| | - Norbert Suttorp
- Medical Department of Infectious Diseases and Respiratory Medicine CCM/CVK/CBF, Charité-Universitätsmedizin Berlin
| | - Clara Lehmann
- Department I of Internal Medicine, Center of Integrated Oncology ABCD, University Hospital of Cologne and German Medical Association, Berlin
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