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Neuperdt L, Beyer AK, Junker S, Mauz E, Hölling H, Schlack R. [Parental strain, inattention/hyperactivity symptoms and parent-reported ADHD in children and adolescents: results of the KiGGS study]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2024; 67:429-438. [PMID: 38536438 PMCID: PMC10995013 DOI: 10.1007/s00103-024-03859-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 02/27/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND A child's attention deficit hyperactivity disorder (ADHD) is associated with strain for the parents. In turn, psychosocial parental strain is associated with higher probabilities for the occurrence of inattention/hyperactivity symptoms (IHS) in their children. The aim of this paper is to assess the association between parental strain, IHS, and a parent-reported ADHD diagnosis of the children. METHODOLOGY Based on data from n = 4596 participants of the KiGGS cohort (wave 2: 2014-2017), the type and extent of parental strain was set in relation to IHS and an ADHD diagnosis of the child in cross-sectional analysis. Frequencies, means, beta coefficients, and odds ratios adjusted for sex, age, socioeconomic status, and migration background are reported. RESULTS In individual consideration, a greater number of parental strains were associated with IHS than with an ADHD diagnosis. In a multivariate analysis, financial worries and parenting problems/conflicts with the children were significant predictors of IHS and an ADHD diagnosis, respectively. In addition, four or more types of parental strain were associated with a higher likelihood of both IHS and an ADHD diagnosis. DISCUSSION Financial and child-rearing strain are relevant to parents of children with IHS and an ADHD diagnosis. Interrelationships between parental stress and a child's IHS or an ADHD diagnosis can be assumed. To relieve their burden, prevention can either aim at improving the situation of ADHD-affected families or at improving the family's handling of the child's ADHD.
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Affiliation(s)
- Laura Neuperdt
- Abteilung Epidemiologie und Gesundheitsmonitoring, Fachgebiet Psychische Gesundheit, Robert Koch-Institut, General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Ann-Kristin Beyer
- Abteilung Epidemiologie und Gesundheitsmonitoring, Fachgebiet Psychische Gesundheit, Robert Koch-Institut, General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Stephan Junker
- Abteilung Epidemiologie und Gesundheitsmonitoring, Fachgebiet Psychische Gesundheit, Robert Koch-Institut, General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Elvira Mauz
- Abteilung Epidemiologie und Gesundheitsmonitoring, Fachgebiet Psychische Gesundheit, Robert Koch-Institut, General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Heike Hölling
- Abteilung Epidemiologie und Gesundheitsmonitoring, Fachgebiet Psychische Gesundheit, Robert Koch-Institut, General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Robert Schlack
- Abteilung Epidemiologie und Gesundheitsmonitoring, Fachgebiet Psychische Gesundheit, Robert Koch-Institut, General-Pape-Str. 62-66, 12101, Berlin, Deutschland.
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2
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Schlack R, Neuperdt L, Junker S, Eicher S, Hölling H, Thom J, Ravens-Sieberer U, Beyer AK. Changes in mental health in the German child and adolescent population during the COVID-19 pandemic - Results of a rapid review. J Health Monit 2023; 8:2-72. [PMID: 36818693 PMCID: PMC9936565 DOI: 10.25646/10761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 08/15/2022] [Indexed: 02/24/2023]
Abstract
Background This rapid review examines changes in the mental health of the German child and adolescent population during the COVID-19 pandemic. Methods The basis are 39 publications, which were identified by means of systematic literature search (until 19.11.2021) and manual search. The databases of the included publications were systematized with regard to their representativeness for the general population, and the indicators used were categorized with regard to the depicted constructs and their reliability. Results The large majority of the studies took place at the beginning of the pandemic until the summer plateau 2020. Representative studies mainly reported high levels of pandemic-related stress, increases in mental health problems, and negative impacts on the quality of life. Non-representative studies showed mixed results. Vulnerable groups could only be identified to a limited extent. Both routine and care-related data showed declines in the outpatient and inpatient service utilisation during the various waves of the pandemic followed by catch-up effects. Children and adolescents turned out to be more vulnerable during the pandemic compared to adults, but their stress levels varied with the waves of the pandemic and the related containment measures. Conclusions A future forward-looking crisis and pandemic management requires a close-knit and continuous surveillance of the mental health of children as well as an improved identification of risk groups.
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Affiliation(s)
- Robert Schlack
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring,Corresponding author Dr Robert Schlack, Robert Koch Institute, Department of Epidemiology and Health Monitoring, General-Pape-Str. 62–66, 12101 Berlin, Germany, E-mail:
| | - Laura Neuperdt
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Stephan Junker
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Sophie Eicher
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Heike Hölling
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Julia Thom
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Ulrike Ravens-Sieberer
- University Medical Center Hamburg-Eppendorf, Clinic for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, research devision ‘Child Public Health’
| | - Ann-Kristin Beyer
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
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3
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Damerow S, Rommel A, Beyer AK, Hapke U, Schienkiewitz A, Starker A, Richter A, Baumert J, Fuchs J, Gaertner B, Müters S, Lemcke J, Allen J. Health situation in Germany during the COVID-19 pandemic. Developments over time for selected indicators of GEDA 2019/2020 - An update. J Health Monit 2022; 7:2-19. [PMID: 35892088 PMCID: PMC9298161 DOI: 10.25646/9883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 03/28/2022] [Indexed: 11/23/2022]
Abstract
The spread of the coronavirus SARS-CoV-2 in 2020 and the containment measures associated therewith have changed many aspects of daily life. An impact on health even beyond infections itself is assumed as well. The health situation of the population in the first phase of the pandemic was thus analysed using data from the German Health Update (GEDA 2019/2020-EHIS). By continuing the survey, the analyses for 2020 are completed (n=26,507 participants), whereby the focus is now on the third phase of the pandemic (second wave of infection, gradual reintroduction of containment measures). The health indicators are presented on a monthly basis. As in the first phase of the pandemic, no pandemic-related changes were observed for tobacco smoking/ second-hand smoke exposure and for received/lack of/provided support. In contrast to the first phase of the pandemic, declines in utilisation of medical services and depressive symptoms are not observed in the third phase. The increase in body weight/body mass index after the first phase of the pandemic did not continue. The survey period allows for a comparison of the periods before and as of the pandemic situation. A decrease in the medical services utilisation and depressive symptoms as well as an increase in the body weight/body mass index is observed in the period from March 2020 to January 2021 compared to the pre-pandemic period from April 2019 to March 2020.
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Affiliation(s)
- Stefan Damerow
- Corresponding author Stefan Damerow, Robert Koch Institute, Department of Epidemiology and Health Monitoring, General-Pape-Str. 62–66, 12101 Berlin, Germany, E-mail:
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4
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Schlack R, Peerenboom N, Neuperdt L, Junker S, Beyer AK. The effects of mental health problems in childhood and adolescence in young adults: Results of the KiGGS cohort. J Health Monit 2021; 6:3-19. [PMID: 35146318 PMCID: PMC8734087 DOI: 10.25646/8863] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 09/06/2021] [Indexed: 11/18/2022]
Abstract
Mental health problems in childhood and adolescence may have effects into adulthood. With the KiGGS cohort, data are available for the first time that can be used to track the effects of internalising and externalising problems in childhood or adolescence into young adulthood on a national database. From the KiGGS baseline survey (2003-2006) to KiGGS Wave 2 (2014-2017), a total of 3,546 children and adolescents aged 11 to 17 years were tracked over a period of eleven years into young adulthood. Mental health problems in childhood or adolescence were variously associated with impaired mental health, lower life satisfaction and poorer quality of life and indicators of sexual and reproductive health in young adulthood. When psychosocial protective factors at the time of the KiGGS baseline survey were considered, the longitudinal correlations of internalising and externalising problems with indicators of mental health, life satisfaction and physical and psychological quality of life decreased, as did, to a lesser extent, the correlations with indicators of sexual and reproductive health and, for externalising disorders, also with low educational status (reference: medium). Implications for prevention and intervention are discussed.
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Affiliation(s)
- Robert Schlack
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Nele Peerenboom
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
- University of Cambridge, Department of Psychiatry
| | - Laura Neuperdt
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Stephan Junker
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Ann-Kristin Beyer
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
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5
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Heidemann C, Scheidt-Nave C, Beyer AK, Baumert J, Thamm R, Maier B, Neuhauser H, Fuchs J, Kuhnert R, Hapke U. Health situation of adults in Germany - Results for selected indicators from GEDA 2019/2020-EHIS. J Health Monit 2021; 6:3-25. [PMID: 35146314 PMCID: PMC8734117 DOI: 10.25646/8459] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 08/09/2021] [Indexed: 01/20/2023]
Abstract
In this article, we examine selected health indicators for the adult population aged 18 years and older in Germany (n=22,708) from the German Health Update (GEDA 2019/2020-EHIS) conducted between April 2019 and September 2020. These indicators include those of self-assessed health and depressive symptoms as well as chronic physical diseases and conditions. In young adulthood (18 to 44 years), over 80% of participants report good or very good subjective health. During this phase of life, most chronic diseases and conditions are rare, although allergies are frequent, and bronchial asthma and depressive symptoms are not uncommon. From mid adulthood (45 years and older), there is a gradual increase in the prevalence of chronic diseases such as cardiovascular disease, diabetes, chronic obstructive pulmonary disease and osteoarthritis. Over 60% of older adults (65 years and older) report a chronic disease or long-term health problem, while only half continue to report good or very good subjective health. During this stage of life, allergies and depressive symptoms become less prevalent. For some diseases, there are also differences according to gender and level of education. This article demonstrates the high public health relevance of age-associated chronic physical diseases and health related limitations in everyday life in an ageing society as well as the need to provide care for certain health conditions already in young adulthood.
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Affiliation(s)
- Christin Heidemann
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
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6
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Heidemann C, Scheidt-Nave C, Beyer AK, Baumert J, Thamm R, Maier B, Neuhauser H, Fuchs J, Kuhnert R, Hapke U. Health situation of adults in Germany - Results for selected indicators from GEDA 2019/2020-EHIS. J Health Monit 2021. [PMID: 35146314 DOI: 10.25646/8456:3-27] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
In this article, we examine selected health indicators for the adult population aged 18 years and older in Germany (n=22,708) from the German Health Update (GEDA 2019/2020-EHIS) conducted between April 2019 and September 2020. These indicators include those of self-assessed health and depressive symptoms as well as chronic physical diseases and conditions. In young adulthood (18 to 44 years), over 80% of participants report good or very good subjective health. During this phase of life, most chronic diseases and conditions are rare, although allergies are frequent, and bronchial asthma and depressive symptoms are not uncommon. From mid adulthood (45 years and older), there is a gradual increase in the prevalence of chronic diseases such as cardiovascular disease, diabetes, chronic obstructive pulmonary disease and osteoarthritis. Over 60% of older adults (65 years and older) report a chronic disease or long-term health problem, while only half continue to report good or very good subjective health. During this stage of life, allergies and depressive symptoms become less prevalent. For some diseases, there are also differences according to gender and level of education. This article demonstrates the high public health relevance of age-associated chronic physical diseases and health related limitations in everyday life in an ageing society as well as the need to provide care for certain health conditions already in young adulthood.
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Affiliation(s)
- Christin Heidemann
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | | | - Ann-Kristin Beyer
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Jens Baumert
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Roma Thamm
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Birga Maier
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Hannelore Neuhauser
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Judith Fuchs
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Ronny Kuhnert
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Ulfert Hapke
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
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7
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Damerow S, Rommel A, Prütz F, Beyer AK, Hapke U, Schienkiewitz A, Starker A, Richter A, Baumert J, Fuchs J, Gaertner B, Müters S, Lemcke J, Allen J. Corrigendum: Developments in the health situation in Germany during the initial stage of the COVID-19 pandemic for selected indicators of GEDA 2019/2020-EHIS. J Health Monit 2021; 5:20. [PMID: 35146277 PMCID: PMC8734093 DOI: 10.25646/8384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
[This corrects the article on p. 3-20 in vol. 5.].
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8
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Scheidt-Nave C, Barnes B, Beyer AK, Busch MA, Hapke U, Heidemann C, Imhoff M, Mumm R, Paprott R, Steppuhn H, von Berenberg-Gossler P, Kraywinkel K. Care for the chronically ill in Germany - The challenges during the COVID-19 pandemic. J Health Monit 2021; 5:2-27. [PMID: 35146280 PMCID: PMC8734154 DOI: 10.25646/7168] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 11/02/2020] [Indexed: 12/16/2022]
Abstract
The COVID-19 pandemic is posing major challenges to the health care sector. This scoping review compiles evidence concerning changes to health care service availability and utilisation as well as possible impacts on health for selected groups of chronically ill people in Germany. The focus is on cancer, cardiovascular diseases, diabetes mellitus and mental disorders. Most empirical data available concerned inpatient care and showed a clear decline in the utilisation of inpatient treatments in March and April 2020 in the areas of oncology and cardiology as well as in mental health. For cardiovascular emergencies such as heart attack and stroke, a decline was observed especially regarding less serious cases. Although there were indications of treatment delays, there was no evidence thus far that emergency care had been generally compromised due to adjustments to inpatient care capacities. In the outpatient setting, extensive adjustments to health care services availability were observed for all disease groups considered. Overall, very limited empirical data were available. In particular, hardly any data were available on how changes in care impacted population health. There is an urgent need for continuous surveillance and evaluation based on health care and epidemiological data.
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9
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Schlack R, Neuperdt L, Hölling H, De Bock F, Ravens-Sieberer U, Mauz E, Wachtler B, Beyer AK. Impact of the COVID-19 pandemic and the related containment measures on the mental health of children and adolescents. J Health Monit 2020; 5:21-31. [PMID: 35146278 PMCID: PMC8822999 DOI: 10.25646/7174] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 10/19/2020] [Indexed: 01/23/2023]
Abstract
Children and adolescents are particularly affected by the COVID-19 pandemic and the official containment measures. However, the effects on their mental health have been little studied. The aim of this narrative review is to summarize existing evidence on the mental health of children and adolescents in the first weeks of the COVID-19 pandemic and during the measures taken to contain it in Germany. First international and national studies draw a differential picture. Children and adolescents showed symptoms of anxiety and depression as well as a reduced quality of life. The closure of childcare and educational facilities and the associated loss of the familiar daytime structure as well as loss of contact and independent learning at home posed considerable challenges for affected children and their families. Spatial confinement at home and the lack of alternative options of stay during the containment measures could also have lead to increased family stress, heightened family aggression, and domestic violence. However, the findings of several studies also show that many families coped with the time during the containment measures mostly well. In the event of possible future pandemics or further waves of the COVID-19 pandemic, the needs of adolescents and their families during the containment measures should be given greater consideration.
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Affiliation(s)
- Robert Schlack
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Laura Neuperdt
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Heike Hölling
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Freia De Bock
- Federal Centre for Health Education, Cologne Department Effectiveness and Efficiency of Health Education
| | - Ulrike Ravens-Sieberer
- University Medical Center Hamburg-Eppendorf Center for Psychosocial Medicine, Clinic for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Child Public Health
| | - Elvira Mauz
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Benjamin Wachtler
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Ann-Kristin Beyer
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
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10
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Damerow S, Rommel A, Prütz F, Beyer AK, Hapke U, Schienkiewitz A, Starker A, Richter A, Baumert J, Fuchs J, Gaertner B, Müters S, Lemcke J, Allen J. Developments in the health situation in Germany during the initial stage of the COVID-19 pandemic for selected indicators of GEDA 2019/2020-EHIS. J Health Monit 2020; 5:3-20. [PMID: 35146276 PMCID: PMC8823006 DOI: 10.25646/7172.2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 11/16/2020] [Indexed: 12/19/2022]
Abstract
SARS-CoV-2, the novel coronavirus, has posed major challenges in Germany in 2020. It is unclear whether the pandemic and containment measures will have an impact on the health of the population beyond the point of infection. The German Health Update (GEDA 2019/2020-EHIS) is a nationwide survey of the population aged 15 years and older (n=23,001) that was conducted between April 2019 and September 2020. The focus of the analysis was on indicators for which pandemic-related changes could be expected. Based on regression models, adjusted proportions and mean values were estimated as trends over time. Any differences in the values found for the time period of containment measures in spring 2020 and the reference period 2019 were statistically tested. Since the implementation of containment measures, both body weight and body mass index (BMI) have increased. The utilisation of general and specialist medical services decreased temporarily. The number of tobacco smokers during the observation period also decreased, yet without revealing a clear link to the pandemic situation. No differences were found in the general population for depressive symptoms and household assistance received and provided. During the period of containment measures, changes to the health situation beyond the occurrence of infections can be observed. However, a more differentiated explanation of these findings will require further analyses.
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Affiliation(s)
- Stefan Damerow
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Alexander Rommel
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Franziska Prütz
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Ann-Kristin Beyer
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Ulfert Hapke
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Anja Schienkiewitz
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Anne Starker
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Almut Richter
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Jens Baumert
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Judith Fuchs
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Beate Gaertner
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Stephan Müters
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Johannes Lemcke
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Jennifer Allen
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
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Tegeler C, Beyer AK, Hoppmann F, Ludwig V, Kessler EM. Current state of research on psychotherapy for home-living vulnerable older adults with depression. Z Gerontol Geriatr 2020; 53:721-727. [PMID: 33185718 PMCID: PMC7661801 DOI: 10.1007/s00391-020-01805-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 10/10/2020] [Indexed: 01/24/2023]
Abstract
Older home-living vulnerable adults often suffer from chronic conditions accompanied by restrictions in mobility, social participation and reduced independence. Among this rapidly growing population depression is a common and serious health problem; however, there are shortcomings in the diagnosis of depression and provision of psychotherapy. Despite growing evidence in treating depression among the group of nursing home residents or the "young-old", there is a research gap regarding needs-oriented healthcare strategies for very old, frail or care-dependent older adults living at home. The present article provides an overview of different outpatient psychotherapeutic treatment approaches for vulnerable older adults with depression, in particular adaptations tailored to those who are homebound or in need of care. Based on the current state of research, this article derives recommendations for psychotherapy in this special setting to consider the physical and psychosocial resources of this patient group. Furthermore, healthcare strategies for embedding psychotherapy in collaborative, telehealth or home-delivered healthcare services are described and their applicability as psychosocial support for older adults during the coronavirus disease 2019 (COVID-19) pandemic is discussed. Psychotherapy is an efficacious treatment for depression in home-living vulnerable older adults. Further implementing telehealth or home delivered settings, individually tailored psychotherapeutic approaches as well as collaborative and stepped care approaches can increase utilization and medical supply of this patient group. More research and innovative programs are needed to improve access to and provision of psychotherapeutic care as well as their social inclusion.
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Affiliation(s)
- Christina Tegeler
- Department of Psychology, MSB Medical School Berlin, Rüdesheimer Str. 50, 14197, Berlin, Germany.
| | - Ann-Kristin Beyer
- Institute for Medical Sociology and Rehabilitation Science, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Fee Hoppmann
- Department of Psychology, MSB Medical School Berlin, Rüdesheimer Str. 50, 14197, Berlin, Germany
| | - Valentina Ludwig
- Department of Psychology, MSB Medical School Berlin, Rüdesheimer Str. 50, 14197, Berlin, Germany
| | - Eva-Marie Kessler
- Department of Psychology, MSB Medical School Berlin, Rüdesheimer Str. 50, 14197, Berlin, Germany.
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Abstract
This is a review of existing self-report measures for assessing views on ageing. It provides an overview of instruments, for which basic psychometric properties are available and describes them according to the purposes for which they are suitable. Literature search resulted in the inclusion of 89 instruments which were categorised along eight dimensions. The majority of measures focus on explicit cognitions about people's own age and ageing or other (older) people. A substantial amount of tools account for the multidimensionality and multidirectionality of views on ageing, i.e. the idea that ageing is accompanied by both gains and losses in several different domains. To some extent, measures reflect that ageing is a long-term process and that views on ageing are malleable, rather than just stable traits. Cluster analysis revealed heterogeneity in instruments regarding the dimensions of Ecosystem, Balance, Stability, Dynamics, and Complexity. It becomes apparent, however, that approaches to measure views on ageing should be extended to more specifically target the implicit level as well as affective, physiological, and behavioural manifestations. Additionally, means for capturing views on ageing on the societal level and tools with a distinct time reference are needed. This is particularly important when one wants to account for the lifelong dynamics of views on ageing.
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Affiliation(s)
- Verena Klusmann
- Department of Psychology, Psychological Assessment & Health Psychology, University of Konstanz, Box 47, 78457 Constance, Germany
- Department of Psychology and Human Movement Science, University of Hamburg, Hamburg, Germany
| | - Nanna Notthoff
- Faculty of Sport Science, Leipzig University, Leipzig, Germany
| | | | - Anne Blawert
- Department of Social Medicine and Prevention, Institute of Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Martina Gabrian
- DFG Scientific Network Images of Aging, Constance/Frankfurt, Germany
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13
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Schlack R, Neuperdt L, Hölling H, De Bock F, Ravens-Sieberer U, Mauz E, Wachtler B, Beyer AK. Impact of the COVID-19 pandemic and the related containment measures on the mental health of children and adolescents. J Health Monit 2020. [PMID: 35146278 DOI: 10.25646/7173:23--34] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
Children and adolescents are particularly affected by the COVID-19 pandemic and the official containment measures. However, the effects on their mental health have been little studied. The aim of this narrative review is to summarize existing evidence on the mental health of children and adolescents in the first weeks of the COVID-19 pandemic and during the measures taken to contain it in Germany. First international and national studies draw a differential picture. Children and adolescents showed symptoms of anxiety and depression as well as a reduced quality of life. The closure of childcare and educational facilities and the associated loss of the familiar daytime structure as well as loss of contact and independent learning at home posed considerable challenges for affected children and their families. Spatial confinement at home and the lack of alternative options of stay during the containment measures could also have lead to increased family stress, heightened family aggression, and domestic violence. However, the findings of several studies also show that many families coped with the time during the containment measures mostly well. In the event of possible future pandemics or further waves of the COVID-19 pandemic, the needs of adolescents and their families during the containment measures should be given greater consideration.
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Affiliation(s)
- Robert Schlack
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Laura Neuperdt
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Heike Hölling
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Freia De Bock
- Federal Centre for Health Education, Cologne Department Effectiveness and Efficiency of Health Education
| | - Ulrike Ravens-Sieberer
- University Medical Center Hamburg-Eppendorf Center for Psychosocial Medicine, Clinic for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Child Public Health
| | - Elvira Mauz
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Benjamin Wachtler
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Ann-Kristin Beyer
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
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14
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Abstract
A number of longitudinal studies have pointed to the long-term impact of different views on aging (VoA) on health in later life, whereas the reverse relationship has rarely been examined. Serious cardiovascular events such as myocardial infarction or stroke are life-threatening events which might in turn lead to changes in VoA. The present longitudinal study examined the effect of a cardiovascular event (CVE) on VoA over a three-year period using pooled data from three waves of the German Ageing Survey (2008, 2011, 2014, age range: 40-95 years). In order to account for alternative explanations for changes in VoA, individuals without CVE (n = 200) were matched to individuals who experienced a CVE (n = 202) using a propensity score matching procedure. Compared to individuals without CVE, individuals who experienced a CVE showed adverse changes in three VoA indicators (self-perceptions of aging as associated with physical losses/with ongoing development; subjective age). These results suggest that CVE can in fact change how individuals view their own aging. According to previous studies, this can lead to future health changes and thus become a health-related downward spiral. Health promotion programs could, therefore, profit by adding specific VoA interventions for individuals who experienced a CVE.
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Affiliation(s)
- Susanne Wurm
- Institute for Community Medicine, Department of Social Medicine and Prevention, University Medicine Greifswald, Walther-Rathenau-Str. 48, 17475 Greifswald, Germany
| | - Maja Wiest
- Freie Universität Berlin, Habelschwerdter Allee 45, 14195 Berlin, Germany
| | - Julia K. Wolff
- Institute for Community Medicine, Department of Social Medicine and Prevention, University Medicine Greifswald, Walther-Rathenau-Str. 48, 17475 Greifswald, Germany
- IGES Institute Berlin, Friedrichstraße 180, 10117 Berlin, Germany
| | - Ann-Kristin Beyer
- Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Svenja M. Spuling
- German Centre of Gerontology (DZA), Manfred-von-Richthofen-Str. 2, 12101 Berlin, Germany
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Gellert P, Beyer AK, Tegeler C, Vathke C, Nordheim J, Kuhlmey A, Kessler EM. Outpatient psychotherapy for home-living vulnerable older adults with depression: study protocol of the PSY-CARE trial. BMC Geriatr 2020; 20:271. [PMID: 32758135 PMCID: PMC7409457 DOI: 10.1186/s12877-020-01661-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 07/22/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND There is a need to improve psychotherapeutic approaches to treatment for vulnerable older adults with depression in terms of both clinical practice and health care supply. Against this background, PSY-CARE is testing the feasibility and effectiveness of outpatient psychotherapy for home-living older adults in need of care with depression in Berlin, Germany, and neighboring suburban areas. METHODS In a two-arm single-center pragmatic randomized controlled trial (RCT), manual-guided outpatient psychotherapy will be compared to brief psychosocial counseling. The study population will be compromised of older adults with clinically significant depressive symptoms who have a long-term care grade, as assessed by the German compulsory state nursing care insurance. In the intervention group, individual cognitive-behavioral psychotherapy tailored to the specific needs of this population will be offered by residential psychotherapists as part of the regular healthcare service. In the active control group, participants will receive individual psychosocial telephone counselling and a self-help guide. The planned sample size is N = 130 (n = 65 participants per group). The reduction of depressive symptoms (primary outcome) as well as the maintaining of activities of daily living, quality of life, and functioning will be assessed with questionnaires provided at baseline, after the end of the intervention and after three months. Feasibility and process evaluation will be conducted qualitatively based on documentation and interviews with psychotherapists, gatekeepers and the participants. DISCUSSION PSY-CARE investigates the potentials and limitations of providing outpatient psychotherapeutic treatment meeting the demands of vulnerable home-living older adults with depression under the real conditions of the health care system. The study will provide practical implications to improve access to and quality of outpatient psychotherapy for this poorly supplied population. TRIAL REGISTRATION The trial is registered at ISRCTN55646265 ; February 15, 2019.
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Affiliation(s)
- Paul Gellert
- Institute for Medical Sociology and Rehabilitation Science, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.
| | - Ann-Kristin Beyer
- Institute for Medical Sociology and Rehabilitation Science, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Christina Tegeler
- MSB Medical School Berlin, Department of Psychology, Rüdesheimer Str. 50, 14197, Berlin, Germany
| | - Claudia Vathke
- MSB Medical School Berlin, Department of Psychology, Rüdesheimer Str. 50, 14197, Berlin, Germany
| | - Johanna Nordheim
- Institute for Medical Sociology and Rehabilitation Science, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Adelheid Kuhlmey
- Institute for Medical Sociology and Rehabilitation Science, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Eva-Marie Kessler
- MSB Medical School Berlin, Department of Psychology, Rüdesheimer Str. 50, 14197, Berlin, Germany
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Wolff JK, Spuling SM, Beyer AK, Wiest M, Wurm S. DO SERIOUS HEALTH EVENTS CHANGE HOW WE VIEW OUR OWN AGING? ON THE ROLE OF CARDIOVASCULAR EVENTS. Innov Aging 2019. [PMCID: PMC6846548 DOI: 10.1093/geroni/igz038.2897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Several studies have demonstrated beneficial effects of views on aging (VoA) on health, while the reverse relationship is seldom in focus. Serious health events (e.g., myocardial infarction) are life-threatening and remind individuals of the finitude of life possibly changing their VoA. The present study investigates the effect of cardiovascular events (CVE) on longitudinal changes in VoA using pooled data of three waves of the German Ageing Survey (2008, 2011, 2014, age-range: 40-95 years). To account for alternative explanations, individuals without CVE were matched to the individuals with CVE (n = 202) using a propensity-score-matching approach. Individuals who experienced a CVE showed more adverse changes in three VoA indicators (aging associated with physical losses, ongoing development, felt age) than individuals without CVE. Results show that CVE can change how we view our own aging which in turn affects future health changes. Following a CVE people may benefit from promoting positive VoA.
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Affiliation(s)
- Julia K Wolff
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Bayern, Germany
| | | | | | - Maja Wiest
- Freie Universität Berlin, Berlin, Berlin, Germany
| | - Susanne Wurm
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Bayern, Germany
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17
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Abstract
Individual views on aging refer to either older people in general or to a person’s own age and aging. Classical approaches seem to hardly map the multidimensional, multidirectional, and highly individual nature of experiences as well as the malleability of perceptions of aging. For this paper, we reviewed existing measures of views of aging. These were categorized based on eight dimensions which were defined by an expert panel and based on current characterizations of views on aging in the literature. Results on 96 instruments call for a strengthening of the affective and the behavioral components in contrast to the apparently cognitive focus of the measures and argue for a stronger emphasis on the developmental nature of views on aging (time references, changes). This is particularly important when aiming to study the lifelong dynamics of views on aging. The suitability of innovative extensions will be discussed.
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Affiliation(s)
| | | | - Anne Blawert
- Friedrich-Alexander University of Erlangen-Nürnberg, Nuremberg, Bayern, Germany
| | - Martina Gabrian
- Independent Researcher Scientific Network Images of Aging, Frankfurt, Hessen, Germany
| | - Verena Klusmann
- University of Konstanz, Konstanz, Baden-Wurttemberg, Germany
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18
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Beyer AK, Wolff JK, Freiberger E, Wurm S. Are self-perceptions of ageing modifiable? Examination of an exercise programme with vs. without a self-perceptions of ageing-intervention for older adults. Psychol Health 2019; 34:661-676. [DOI: 10.1080/08870446.2018.1556273] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Ann-Kristin Beyer
- Institute of Psychogerontology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Nürnberg, Germany
| | - Julia K. Wolff
- Institute of Psychogerontology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Nürnberg, Germany
- IGES Institute for Health Care Research, Berlin, Germany
| | - Ellen Freiberger
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Nürnberg, Germany
| | - Susanne Wurm
- Institute of Psychogerontology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Nürnberg, Germany
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19
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Ulbricht S, Beyer AK, Lein S, Lehnert K, Dörr M, Wurm S. Altersbilder als Ressource zur Förderung eines gesunden Lebensstils bei herzkranken Erwachsenen. Das Gesundheitswesen 2018. [DOI: 10.1055/s-0038-1667641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- S Ulbricht
- Universitätsmedizin Greifswald, Institut für Sozialmedizin und Prävention, Greifswald, Deutschland
- DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung), Standort Greifswald, Deutschland
| | - AK Beyer
- Universitätsmedizin Greifswald, Institut für Sozialmedizin und Prävention, Greifswald, Deutschland
| | - S Lein
- Universitätsmedizin Greifswald, Institut für Sozialmedizin und Prävention, Greifswald, Deutschland
- DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung), Standort Greifswald, Deutschland
| | - K Lehnert
- Universitätsmedizin Greifswald, Institut für Sozialmedizin und Prävention, Greifswald, Deutschland
- DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung), Standort Greifswald, Deutschland
| | - M Dörr
- Universitätsmedizin Greifswald, Institut für Sozialmedizin und Prävention, Greifswald, Deutschland
- DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung), Standort Greifswald, Deutschland
| | - S Wurm
- Universitätsmedizin Greifswald, Institut für Sozialmedizin und Prävention, Greifswald, Deutschland
- DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung), Standort Greifswald, Deutschland
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20
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Wolff JK, Beyer AK, Wurm S, Nowossadeck S, Wiest M. Regional Impact of Population Aging on Changes in Individual Self-perceptions of Aging: Findings From the German Ageing Survey. Gerontologist 2018; 58:47-56. [PMID: 28958001 DOI: 10.1093/geront/gnx127] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 07/17/2017] [Indexed: 11/14/2022] Open
Abstract
Background and Objectives The importance of self-perceptions of aging (SPA) for health and longevity is well documented. Comparably little is known about factors that contribute to SPA. Besides individual factors, the context a person lives in may shape SPA. Research has so far focused on country-level differences in age stereotypes, indicating that rapid population aging accompanies more negative age stereotypes. The present study expands previous research by investigating the impact of district-specific population aging within one country on different facets of SPA. Research Design and Methods Based on a large representative survey in Germany, the study investigates changes in SPA as ongoing development as well as the SPA of physical loss over a 12-year period in adults aged 40+. The study uses several indicators of population aging (e.g., population development, average age, greying index), to identify four clusters differing in their pace of population aging. Based on three-level latent change models, these clusters were compared in their impact on changes in SPA. Results Compared to districts with an average rate of population aging, the study shows that persons living in regions with a fast population aging rate (C1) hold more negative SPA in both facets (ps = .01). Districts with slow population aging (C2) have significantly higher SPA ongoing development (p = .03). Discussion and Implications The study underlines the importance for regional differences in population aging on the development of SPA. In particular, societies should be aware that fast population aging may result in more negative SPA.
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Affiliation(s)
- Julia K Wolff
- Institute of Psychogerontology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Germany.,IGES Institute, Division Quality-Evaluation-Reporting, Berlin, Germany.,German Centre of Gerontology, Berlin
| | - Ann-Kristin Beyer
- Institute of Psychogerontology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Germany.,German Centre of Gerontology, Berlin
| | - Susanne Wurm
- Institute of Psychogerontology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Germany
| | | | - Maja Wiest
- Department of Empirical Research on Further Education, Freie Universität Berlin, Germany
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Beyer AK, Wolff JK, Warner LM, Schüz B, Wurm S. The role of physical activity in the relationship between self-perceptions of ageing and self-rated health in older adults. Psychol Health 2015; 30:671-85. [DOI: 10.1080/08870446.2015.1014370] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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London B, Trudeau MC, Newton KP, Beyer AK, Copeland NG, Gilbert DJ, Jenkins NA, Satler CA, Robertson GA. Two isoforms of the mouse ether-a-go-go-related gene coassemble to form channels with properties similar to the rapidly activating component of the cardiac delayed rectifier K+ current. Circ Res 1997; 81:870-8. [PMID: 9351462 DOI: 10.1161/01.res.81.5.870] [Citation(s) in RCA: 211] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
HERG, the human ether-a-go-go-related gene, encodes a K(+)-selective channel with properties similar to the rapidly activating component of the delayed rectifier K+ current (IKr). Mutations of HERG cause the autosomal-dominant long-QT syndrome (LQTS), presumably by disrupting the normal function of IKr. The current produced by HERG is not identical to IKr, however, and the mechanism by which HERG mutations cause LQTS remains uncertain. To better define the role of Erg in the heart, we cloned Merg1 from mouse genomic and cardiac cDNA libraries. Merg1 has 16 exons and maps to mouse chromosome 5 in an area syntenic to human chromosome 7q, the map locus of HERG. We isolated three cardiac isoforms of Merg1: Merg1a is homologous to HERG and is expressed in heart, brain, and testes, Merg1a' lacks the first 59 amino acids of Merg1a and is not expressed abundantly, and Merg1b has a markedly shorter divergent N-terminal cytoplasmic domain and is expressed specifically in the heart. The Merg1 isoforms, like HERG, produce inwardly rectifying E-4031-sensitive currents when heterologously expressed in Xenopus oocytes. Merg1a and HERG produce currents with slow deactivation kinetics, whereas Merg1a' and Merg1b currents deactivate more rapidly. Merg1b coassembles with Merg1a to form channels with deactivation kinetics that are more rapid than those of Merg1a or HERG and nearly identical to IKr. In addition, a homologue of Merg1b is present in human cardiac and smooth muscle. Thus, we have identified a novel N-terminal Erg isoform that is expressed specifically in the heart, has rapid deactivation kinetics, and coassembles with the longer isoform in Xenopus oocytes. This N-terminal Erg isoform may determine the properties of IKr and contribute to the pathogenesis of LQTS.
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Affiliation(s)
- B London
- Division of Cardiology, University of Pittsburgh Medical Center, PA 15213-2582, USA.
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