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Höhne E, Böge K, Karnouk C, Tschorn M, Banaschewski T, Hoell A, Sukale T, Plener P, Schneider F, Padberg F, Hasan A, Rapp MA, Bajbouj M, Kamp-Becker I. Culturally sensitive stepped care for adolescent refugees: efficacy and cost-utility of a multicentric randomized controlled trial. Eur Child Adolesc Psychiatry 2024; 33:581-593. [PMID: 36922435 PMCID: PMC10869413 DOI: 10.1007/s00787-023-02179-8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 02/27/2023] [Indexed: 03/18/2023]
Abstract
Adolescent refugees and asylum seekers (ARAS) are highly vulnerable to mental health problems. Stepped care models (SCM) and culturally sensitive therapies offer promising treatment approaches to effectively provide necessary medical and psychological support. To our knowledge, we were the first to investigate whether a culturally sensitive SCM will reduce symptoms of depression and PTSD in ARAS more effectively and efficiently than treatment as usual (TAU). We conducted a multicentric, randomized, controlled and rater-blinded trial across Germany with ARAS between the ages of 14 to 21 years. Participants (N = 158) were stratified by their level of depressive symptom severity and then equally randomized to either SCM or TAU. Depending on their severity level, SCM participants were allocated to tailored interventions. Symptom changes were assessed for depression (PHQ) and PTSD (CATS) at four time points, with the primary end point at post-intervention after 12 weeks. Based on an intention-to-treat sample, we used a linear mixed model approach for the main statistical analyses. Further evaluations included cost-utility analyses, sensitivity analyses, follow-up-analyses, response and remission rates and subgroup analysis. We found a significant reduction of PHQ (d = 0.52) and CATS (d = 0.27) scores in both groups. However, there was no significant difference between SCM and TAU. Cost-utility analyses indicated that SCM generated greater cost-utility when measured as quality-adjusted life years compared to TAU. Subgroup analysis revealed different effects for the SCM interventions depending on the outcome measure. Although culturally sensitive, SCMs did not prove to be more effective in symptom change and represent a more cost-effective treatment alternative for mentally burdened ARAS. Our research contributes to the optimization of clinical productivity and the improvement of therapeutic care for ARAS. Disorder-specific interventions should be further investigated.
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Affiliation(s)
- Edgar Höhne
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Clinic, Philipps-University Marburg, Marburg, Germany.
| | - Kerem Böge
- Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Carine Karnouk
- Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Mira Tschorn
- Department of Social and Preventive Medicine, University of Potsdam, Potsdam, Germany
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Mannheim, Germany
| | - Andreas Hoell
- Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Mannheim, Germany
| | - Thorsten Sukale
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Ulm, Germany
| | - Paul Plener
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Ulm, Germany
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Frank Schneider
- University Hospital Düsseldorf, Medical School University of Duesseldorf, Düsseldorf, Germany
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany
| | - Alkomiet Hasan
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Augsburg, BKH Augsburg, Augsburg, Germany
| | - Michael A Rapp
- Department of Social and Preventive Medicine, University of Potsdam, Potsdam, Germany
| | - Malek Bajbouj
- Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Inge Kamp-Becker
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Clinic, Philipps-University Marburg, Marburg, Germany
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Hoffmann S, Tschorn M, Spallek J. Social inequalities in early childhood language development during the COVID-19 pandemic: a descriptive study with data from three consecutive school entry surveys in Germany. Int J Equity Health 2024; 23:2. [PMID: 38178111 PMCID: PMC10768533 DOI: 10.1186/s12939-023-02079-y] [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: 07/18/2023] [Accepted: 12/06/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND Social health inequalities are still of great public health importance in modern societies. The COVID-19 pandemic may have affected social inequalities in people's health due to containment measures. As these measures particularly affected children, they might have been particularly vulnerable to increased social inequalities. The aim of the study was to describe health inequalities during the pandemic based on language delay (LD) in children in order to inform public health interventions for a population at risk of long-term health and education inequalities. METHODS Data of 5-7 year old children from three consecutive school entry surveys in the German federal state of Brandenburg were used, including data compulsorily collected before the pandemic (2018/2019: n = 19,299), at the beginning of the pandemic (2019/2020: n = 19,916) and during the pandemic (2020/2021: n = 19,698). Bivariate and multivariate binary regression analyses [OR, 95% CI] cross-sectionally examined the relationship between the prevalence of LD [yes/no] and social inequalities, operationalized by family socioeconomic position [SEP low/middle/high], migration background [native-German language/non-native German language] and length of kindergarten attendance [< 4 years/ ≥ 4 years]. Factors contributing to inequality in LD were examined by socioeconomic stratification. RESULTS Cross-sectionally, LD prevalence has decreased overall (2018/2019: 21.1%, 2019/2020: 19.2%, 2020/2021: 18.8%), and among children from both high SEP and native German-speaking families. As LD prevalence increased among children from families with low SEP and remained stable among non-native German speakers, social inequalities in LD prevalence increased slightly during the pandemic i) by low SEP (2018/2019: OR = 4.41, 3.93-4.94; 2020/2021: OR = 5.12, 4.54-5.77) and ii) by non-German native language (2018/2019: OR = 2.22, 1.86-2.66; 2020/2021: OR = 2.54, 2.19-2.95). During the pandemic, both migration background and kindergarten attendance determined LD prevalence in the high and middle SEP strata. However, the measured factors did not contribute to LD prevalence in children from families with low SEP. CONCLUSION Social inequalities in LD increased due to opposing trends in prevalence comparing low and high SEP families. To promote health equity across the life course, early childhood should be of interest for tailored public health actions (e.g. through targeted interventions for kindergarten groups). Further analytical studies should investigate determinants (e.g., parental investment).
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Affiliation(s)
- Stephanie Hoffmann
- Department of Public Health, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany.
- Lausitz Center for Digital Public Health, Institute of Health, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany.
| | - Mira Tschorn
- Social and Preventive Medicine, Department of Sports and Health Sciences, Intra-Faculty Unit Cognitive Sciences, Faculty of Human Science, University of Potsdam, Potsdam, Germany
| | - Jacob Spallek
- Department of Public Health, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany
- Lausitz Center for Digital Public Health, Institute of Health, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany
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Heinzel S, Tschorn M, Schulte-Hutner M, Schäfer F, Reese G, Pohle C, Peter F, Neuber M, Liu S, Keller J, Eichinger M, Bechtoldt M. Anxiety in response to the climate and environmental crises: validation of the Hogg Eco-Anxiety Scale in Germany. Front Psychol 2023; 14:1239425. [PMID: 37809319 PMCID: PMC10552256 DOI: 10.3389/fpsyg.2023.1239425] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 09/04/2023] [Indexed: 10/10/2023] Open
Abstract
Background As the climate and environmental crises unfold, eco-anxiety, defined as anxiety about the crises' devastating consequences for life on earth, affects mental health worldwide. Despite its importance, research on eco-anxiety is currently limited by a lack of validated assessment instruments available in different languages. Recently, Hogg and colleagues proposed a multidimensional approach to assess eco-anxiety. Here, we aim to translate the original English Hogg Eco-Anxiety Scale (HEAS) into German and to assess its reliability and validity in a German sample. Methods Following the TRAPD (translation, review, adjudication, pre-test, documentation) approach, we translated the original English scale into German. In total, 486 participants completed the German HEAS. We used Bayesian confirmatory factor analysis (CFA) to assess whether the four-factorial model of the original English version could be replicated in the German sample. Furthermore, associations with a variety of emotional reactions towards the climate crisis, general depression, anxiety, and stress were investigated. Results The German HEAS was internally consistent (Cronbach's alphas 0.71-0.86) and the Bayesian CFA showed that model fit was best for the four-factorial model, comparable to the factorial structure of the original English scale (affective symptoms, rumination, behavioral symptoms, anxiety about personal impact). Weak to moderate associations were found with negative emotional reactions towards the climate crisis and with general depression, anxiety, and stress. Discussion Our results support the original four-factorial model of the scale and indicate that the German HEAS is a reliable and valid scale to assess eco-anxiety in German speaking populations.
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Affiliation(s)
- Stephan Heinzel
- Institute of Psychology, Department of Educational Sciences and Psychology, TU Dortmund University, Dortmund, Germany
- Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
| | - Mira Tschorn
- Social and Preventive Medicine, Department of Sports and Health Sciences, University of Potsdam, Potsdam, Germany
| | | | - Fabian Schäfer
- Sustainable Development, Darmstadt University of Applied Sciences, Darmstadt, Germany
- Klimabildung e.V., Bochum, Germany
| | - Gerhard Reese
- Department of Psychology, RPTU Kaiserslautern Landau, Campus Landau, Landau, Germany
| | | | - Felix Peter
- Department of School Psychology, State School Administration of Saxony-Anhalt, Halle (Saale), Germany
| | - Michael Neuber
- Center for Technology and Society, Technical University of Berlin, Berlin, Germany
| | - Shuyan Liu
- Department of Psychiatry and Psychotherapy (CCM), Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Jan Keller
- Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
| | - Michael Eichinger
- Center for Preventive Medicine and Digital Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Myriam Bechtoldt
- Department of Management, EBS Universität für Wirtschaft und Recht, Oestrich-Winkel, Germany
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Förstner BR, Böttger SJ, Moldavski A, Bajbouj M, Pfennig A, Manook A, Ising M, Pittig A, Heinig I, Heinz A, Mathiak K, Schulze TG, Schneider F, Kamp-Becker I, Meyer-Lindenberg A, Padberg F, Banaschewski T, Bauer M, Rupprecht R, Wittchen HU, Rapp MA, Tschorn M. The associations of Positive and Negative Valence Systems, Cognitive Systems and Social Processes on disease severity in anxiety and depressive disorders. Front Psychiatry 2023; 14:1161097. [PMID: 37398596 PMCID: PMC10313476 DOI: 10.3389/fpsyt.2023.1161097] [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] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 05/19/2023] [Indexed: 07/04/2023] Open
Abstract
Background Anxiety and depressive disorders share common features of mood dysfunctions. This has stimulated interest in transdiagnostic dimensional research as proposed by the Research Domain Criteria (RDoC) approach by the National Institute of Mental Health (NIMH) aiming to improve the understanding of underlying disease mechanisms. The purpose of this study was to investigate the processing of RDoC domains in relation to disease severity in order to identify latent disorder-specific as well as transdiagnostic indicators of disease severity in patients with anxiety and depressive disorders. Methods Within the German research network for mental disorders, 895 participants (n = 476 female, n = 602 anxiety disorder, n = 257 depressive disorder) were recruited for the Phenotypic, Diagnostic and Clinical Domain Assessment Network Germany (PD-CAN) and included in this cross-sectional study. We performed incremental regression models to investigate the association of four RDoC domains on disease severity in patients with affective disorders: Positive (PVS) and Negative Valance System (NVS), Cognitive Systems (CS) and Social Processes (SP). Results The results confirmed a transdiagnostic relationship for all four domains, as we found significant main effects on disease severity within domain-specific models (PVS: β = -0.35; NVS: β = 0.39; CS: β = -0.12; SP: β = -0.32). We also found three significant interaction effects with main diagnosis showing a disease-specific association. Limitations The cross-sectional study design prevents causal conclusions. Further limitations include possible outliers and heteroskedasticity in all regression models which we appropriately controlled for. Conclusion Our key results show that symptom burden in anxiety and depressive disorders is associated with latent RDoC indicators in transdiagnostic and disease-specific ways.
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Affiliation(s)
- Bernd R. Förstner
- Social and Preventive Medicine, Department of Sports and Health Sciences, University of Potsdam, Potsdam, Germany
| | - Sarah Jane Böttger
- Social and Preventive Medicine, Department of Sports and Health Sciences, University of Potsdam, Potsdam, Germany
| | - Alexander Moldavski
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Mannheim, Germany
| | - Malek Bajbouj
- Charité–Universitätsmedizin Berlin, Department of Psychiatry, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Andrea Pfennig
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - André Manook
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Marcus Ising
- Max Planck Institute of Psychiatry, Munich, Germany
| | - Andre Pittig
- Institute of Clinical Psychology and Psychotherapy, Technical University Dresden, Dresden, Germany
- Translational Psychotherapy, Institute of Psychology, University of Goettingen, Goettingen, Germany
| | - Ingmar Heinig
- Institute of Clinical Psychology and Psychotherapy, Technical University Dresden, Dresden, Germany
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy CCM, Charité–Universitätsmedizin Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Klaus Mathiak
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
- JARA-Brain, Research Center Jülich, Jülich, Germany
| | - Thomas G. Schulze
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and Behavioral Sciences, Norton College of Medicine, SUNY Upstate Medical University, Syracuse, NY, United States
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University, Baltimore, MD, United States
| | - Frank Schneider
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
- University Hospital Düsseldorf, Medical School, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Inge Kamp-Becker
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Philipps University Marburg, Marburg, Germany
| | - Andreas Meyer-Lindenberg
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Mannheim, Germany
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Mannheim, Germany
| | - Michael Bauer
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Rainer Rupprecht
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Hans-Ulrich Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technical University Dresden, Dresden, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Michael A. Rapp
- Social and Preventive Medicine, Department of Sports and Health Sciences, University of Potsdam, Potsdam, Germany
| | - Mira Tschorn
- Social and Preventive Medicine, Department of Sports and Health Sciences, University of Potsdam, Potsdam, Germany
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Böttger SJ, Förstner BR, Szalek L, Koller-Schlaud K, Rapp MA, Tschorn M. Mood and anxiety disorders within the Research Domain Criteria framework of Positive and Negative Valence Systems: a scoping review. Front Hum Neurosci 2023; 17:1184978. [PMID: 37333832 PMCID: PMC10272468 DOI: 10.3389/fnhum.2023.1184978] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 05/02/2023] [Indexed: 06/20/2023] Open
Abstract
Introduction While a growing body of research is adopting Research Domain Criteria (RDoC)-related methods and constructs, there is still a lack of comprehensive reviews on the state of published research on Positive Valence Systems (PVS) and Negative Valence Systems (NVS) in mood and anxiety disorders consistent with the RDoC framework. Methods Five electronic databases were searched to identify peer-reviewed publications covering research on "positive valence" and "negative valence" as well as "valence," "affect," and "emotion" for individuals with symptoms of mood and anxiety disorders. Data was extracted with a focus on disorder, domain, (sub-) constructs, units of analysis, key results, and study design. Findings are presented along four sections, distinguishing between primary articles and reviews each for PVS, NVS, and cross-domain PVS and NVS. Results A total of 231 abstracts were identified, and 43 met the inclusion criteria for this scoping review. Seventeen publications addressed research on PVS, seventeen on NVS, and nine covered cross-domain research on PVS and NVS. Psychological constructs were typically examined across different units of analysis, with the majority of publications incorporating two or more measures. Molecular, genetic, and physiological aspects were mainly investigated via review articles, primary articles focused on self-report, behavioral, and, to a lesser extent, physiological measures. Conclusions This present scoping review shows that mood and anxiety disorders were actively studied using a range of genetic, molecular, neuronal, physiological, behavioral, and self-report measures within the RDoC PVS and NVS. Results highlight the essential role of specific cortical frontal brain structures and of subcortical limbic structures in impaired emotional processing in mood and anxiety disorders. Findings also indicate overall limited research on NVS in bipolar disorders and PVS in anxiety disorders, a majority of self-report studies, and predominantly observational studies. Future research is needed to develop more RDoC-consistent advancements and intervention studies targeting neuroscience-driven PVS and NVS constructs.
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Affiliation(s)
- Sarah Jane Böttger
- Social and Preventive Medicine, Department of Sports and Health Sciences, University of Potsdam, Potsdam, Germany
- DZPG (German Center of Mental Health), partner site Berlin/Potsdam, Potsdam, Germany
| | - Bernd R. Förstner
- Social and Preventive Medicine, Department of Sports and Health Sciences, University of Potsdam, Potsdam, Germany
- DZPG (German Center of Mental Health), partner site Berlin/Potsdam, Potsdam, Germany
| | - Laura Szalek
- Social and Preventive Medicine, Department of Sports and Health Sciences, University of Potsdam, Potsdam, Germany
| | - Kristin Koller-Schlaud
- Department of Psychiatry, Psychotherapy and Psychosomatics, Brandenburg Medical School, University Hospital Ruppin-Brandenburg, Neuruppin, Germany
| | - Michael A. Rapp
- Social and Preventive Medicine, Department of Sports and Health Sciences, University of Potsdam, Potsdam, Germany
- DZPG (German Center of Mental Health), partner site Berlin/Potsdam, Potsdam, Germany
| | - Mira Tschorn
- Social and Preventive Medicine, Department of Sports and Health Sciences, University of Potsdam, Potsdam, Germany
- DZPG (German Center of Mental Health), partner site Berlin/Potsdam, Potsdam, Germany
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Loss J, Blume M, Neuperdt L, Flerlage N, Weihrauch T, Manz K, Thamm R, Poethko-Müller C, Mauz E, Rattay P, Allen J, Tschorn M. What is the health status of girls and boys in the COVID-19 pandemic? Selected results of the KIDA study. J Health Monit 2023; 8:39-56. [PMID: 37408715 PMCID: PMC10318563 DOI: 10.25646/11436] [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: 01/19/2023] [Accepted: 03/16/2023] [Indexed: 07/07/2023]
Abstract
Background It is well known that there are gender differences in the health behaviour and physical and mental health of children. The COVID-19 pandemic influenced the health and lifestyles of children and adolescents by changing their living conditions. The present work investigates whether gender differences in selected health indicators are evident more than two years after the onset of the pandemic. Methods In the study Kindergesundheit in Deutschland aktuell (KIDA) (German Children's Health Update), cross-sectional telephone surveys were conducted with parents of 3- to 15-year-olds (n=3,478). Parental information on the general and mental health of the child, on increased need for health care and mental health services, as well as on physical activity and utilisation of sports activities were queried in standardised manner. Gender differences were assessed using Chi2 tests. Results A total of 91% of the girls and 92% of the boys had their general health assessed as being (very) good by their parents (difference not significant, n.s.). An increased need for care and support was indicated for 10.6% of the 3- to 15-year-olds (girls: 9%, boys: 12%, n.s.). Boys met the physical activity recommendations of the WHO significantly more often (60%) than girls (54%). Good to excellent mental health was reported for 93% of both boys and girls. When changes during the pandemic were reported, no differences were found in the responses for girls compared to boys. Conclusions Gender differences were found for individual parameters and age groups. These differences must be assessed in the context of other social determinants of health, and need to be considered when planning preventive measures.
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Affiliation(s)
- Julika Loss
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Miriam Blume
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Laura Neuperdt
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Nadine Flerlage
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Tim Weihrauch
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Kristin Manz
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Roma Thamm
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | | | - Elvira Mauz
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Petra Rattay
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Jennifer Allen
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Mira Tschorn
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
- University of Potsdam, Social and Preventive Medicine, Department of Sports and Health Sciences
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Hoffmann S, Tschorn M, Michalski N, Hoebel J, Förstner BR, Rapp MA, Spallek J. Do regional characteristics predict developmental delay? Analyses of German school entry examination. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.342] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Children's health and development are strongly linked to their living situation, including their family's socioeconomic position (SEP) and living region. However, research on the impact of the living region on children's development beyond family SEP is scarce. This study evaluated whether rurality and regional socioeconomic deprivation (DEP) are associated with children's development independently of family SEP.
Methods
The study used population-based data of 5-6.5 years old children (n = 22,801) from mandatory school entry examinations (SEE) in the German federal state of Brandenburg, which were examined in 2018/2019. The SEE data have been linked with data on i. rurality that was defined by an inverted population density and ii. regional DEP that were provided by the German Index of Socioeconomic Deprivation. By binary multilevel models, the predictive values of rurality and regional DEP for global developmental delay (GDD) were evaluated, while adjusting for family SEP.
Results
Children with high family SEP showed reduced odds for GDD compared to medium family SEP (female: OR = 4.26, CI95=3.14-5.79, male: OR = 3.46, CI95=2.83-4.22) and low family SEP (female: OR = 16.58, CI95=11.90-23.09, male: OR = 12.79, CI95=10.13-16.16). Regional DEP additionally predicted GDD, with higher odds for children from more deprived regions (female: OR = 1.35, CI95=1.13-1.62, male: OR = 1.20, CI95=1.05-1.39). Rurality did not predict GDD beyond family SEP and regional DEP.
Conclusions
In addition to family SEP, the regional DEP has an effect on children's developmental delay. Hence, Public Health should take into account regional socioeconomic conditions as determinant of health over the life course in addition to family SEP.
Key messages
• Regional socioeconomic deprivation contributes to inequalities in children's development and health.
• Besides family SEP, regional socioeconomic circumstances are of particular interest to promote health over the life course.
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Affiliation(s)
- S Hoffmann
- Department of Public Health, Brandenburg University of Technology CB-SFB , Senftenberg, Germany
| | - M Tschorn
- Faculty of Health Sciences Brandenburg, Research Area Services Research and e-Health , Potsdam, Germany
- Department of Sports and Health Sciences, Faculty of Human Science, University Potsdam , Potsdam, Germany
| | - N Michalski
- Division of Social Determinants of Health, Robert Koch Institute , Berlin, Germany
| | - J Hoebel
- Division of Social Determinants of Health, Robert Koch Institute , Berlin, Germany
| | - BR Förstner
- Department of Sports and Health Sciences, Faculty of Human Science, University Potsdam , Potsdam, Germany
| | - MA Rapp
- Faculty of Health Sciences Brandenburg, Research Area Services Research and e-Health , Potsdam, Germany
- Department of Sports and Health Sciences, Faculty of Human Science, University Potsdam , Potsdam, Germany
| | - J Spallek
- Department of Public Health, Brandenburg University of Technology CB-SFB , Senftenberg, Germany
- Faculty of Health Sciences Brandenburg, Research Area Services Research and e-Health , Potsdam, Germany
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Tschorn M, Neuperdt L, Blume M, Flerlage N, Allen J, Loss J. Von welchen Eindämmungsmaßnahmen in der
SARS-CoV-2-Pandemie sind Kinder und Jugendlichen betroffen? – Ergebnisse
der KIDA-Studie des Robert Koch-Instituts. Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Tschorn M, Loss J, Allen J, Blume M, Scheidt-Nave C, Thamm R, Poethko-Müller C, Neuperdt L, Hölling H, Mauz E, Waldhauer J, Mueters S, Hövener C, Flerlage N, Krug S. Wie steht es um die Gesundheit von Kindern und Jugendlichen in der
SARS-CoV-2-Pandemie im Jahr 2022? – Ergebnisse der KIDA-Studie des
Robert Koch-Instituts. Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Tschorn M, Poethko-Müller C, Thamm R, Scheidt-Nave C. Subjektive Gesundheit, körperliche Symptombelastung und
spezieller Versorgungsbedarf von Kindern und Jugendlichen nach zwei Jahren
SARS-CoV-2-Pandemie: erste Ergebnisse der KIDA-Studie 2022. Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Böge K, Karnouk C, Hoell A, Tschorn M, Kamp-Becker I, Padberg F, Übleis A, Hasan A, Falkai P, Salize HJ, Meyer-Lindenberg A, Banaschewski T, Schneider F, Habel U, Plener P, Hahn E, Wiechers M, Strupf M, Jobst A, Millenet S, Hoehne E, Sukale T, Dinauer R, Schuster M, Mehran N, Kaiser F, Bröcheler S, Lieb K, Heinz A, Rapp M, Bajbouj M. Effectiveness and cost-effectiveness for the treatment of depressive symptoms in refugees and asylum seekers: A multi-centred randomized controlled trial. Lancet Reg Health Eur 2022; 19:100413. [PMID: 35694653 PMCID: PMC9184853 DOI: 10.1016/j.lanepe.2022.100413] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background Current evidence points towards a high prevalence of psychological distress in refugee populations, contrasting with a scarcity of resources and amplified by linguistic, institutional, financial, and cultural barriers. The objective of the study is to investigate the overall effectiveness and cost-effectiveness of a Stepped Care and Collaborative Model (SCCM) at reducing depressive symptoms in refugees, compared with the overall routine care practices within Germany's mental healthcare system (treatment-as-usual, TAU). Methods A multicentre, clinician-blinded, randomised, controlled trial was conducted across seven university sites in Germany. Asylum seekers and refugees with relevant depressive symptoms with a Patient Health Questionnaires score of ≥ 5 and a Refugee Health Screener score of ≥ 12. Participants were randomly allocated to one of two treatment arms (SCCM or TAU) for an intervention period of three months between April 2018 and March 2020. In the SCCM, participants were allocated to interventions tailored to their symptom severity, including watchful waiting, peer-to-peer- or smartphone intervention, psychological group therapies or mental health expert treatment. The primary endpoint was defined as the change in depressive symptoms (Patient Health Questionnaire-9, PHQ-9) after 12 weeks. The secondary outcome was the change in Montgomery Åsberg Depression Rating Scale (MADRS) from baseline to post-intervention. Findings The intention-to-treat sample included 584 participants who were randomized to the SCCM (n= 294) or TAU (n=290). Using a mixed-effects general linear model with time, and the interaction of time by randomisation group as fixed effects and study site as random effect, we found significant effects for time (p < .001) and time by group interaction (p < .05) for intention-to-treat and per-protocol analysis. Estimated marginal means of the PHQ-9 scores after 12 weeks were significantly lower in SCCM than in TAU (for intention-to-treat: PHQ-9 mean difference at T1 1.30, 95% CI 1.12 to 1.48, p < .001; Cohen's d=.23; baseline-adjusted PHQ-9 mean difference at T1 0.57, 95% CI 0.40 to 0.74, p < .001). Cost-effectiveness and net monetary benefit analyses provided evidence of cost-effectiveness for the primary outcome and quality-adjusted life years. Robustness of results were confirmed by sensitivity analyses. Interpretation The SSCM resulted in a more effective and cost-effective reduction of depressive symptoms compared with TAU. Findings suggest a suitable model to provide mental health services in circumstances where resources are limited, particularly in the context of forced migration and pandemics. Funding This project is funded by the Innovationsfond and German Ministry of Health [grant number 01VSF16061]. The present trial is registered under Clinical-Trials.gov under the registration number: NCT03109028. https://clinicaltrials.gov/ct2/show/NCT03109028
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Förstner BR, Tschorn M, Reinoso-Schiller N, Maričić LM, Röcher E, Kalman JL, Stroth S, Mayer AV, Schwarz K, Kaiser A, Pfennig A, Manook A, Ising M, Heinig I, Pittig A, Heinz A, Mathiak K, Schulze TG, Schneider F, Kamp-Becker I, Meyer-Lindenberg A, Padberg F, Banaschewski T, Bauer M, Rupprecht R, Wittchen HU, Rapp MA. Mapping Research Domain Criteria using a transdiagnostic mini-RDoC assessment in mental disorders: a confirmatory factor analysis. Eur Arch Psychiatry Clin Neurosci 2022; 273:527-539. [PMID: 35778521 PMCID: PMC10085934 DOI: 10.1007/s00406-022-01440-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 05/23/2022] [Indexed: 11/28/2022]
Abstract
This study aimed to build on the relationship of well-established self-report and behavioral assessments to the latent constructs positive (PVS) and negative valence systems (NVS), cognitive systems (CS), and social processes (SP) of the Research Domain Criteria (RDoC) framework in a large transnosological population which cuts across DSM/ICD-10 disorder criteria categories. One thousand four hundred and thirty one participants (42.1% suffering from anxiety/fear-related, 18.2% from depressive, 7.9% from schizophrenia spectrum, 7.5% from bipolar, 3.4% from autism spectrum, 2.2% from other disorders, 18.4% healthy controls, and 0.2% with no diagnosis specified) recruited in studies within the German research network for mental disorders for the Phenotypic, Diagnostic and Clinical Domain Assessment Network Germany (PD-CAN) were examined with a Mini-RDoC-Assessment including behavioral and self-report measures. The respective data was analyzed with confirmatory factor analysis (CFA) to delineate the underlying latent RDoC-structure. A revised four-factor model reflecting the core domains positive and negative valence systems as well as cognitive systems and social processes showed a good fit across this sample and showed significantly better fit compared to a one factor solution. The connections between the domains PVS, NVS and SP could be substantiated, indicating a universal latent structure spanning across known nosological entities. This study is the first to give an impression on the latent structure and intercorrelations between four core Research Domain Criteria in a transnosological sample. We emphasize the possibility of using already existing and well validated self-report and behavioral measurements to capture aspects of the latent structure informed by the RDoC matrix.
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Affiliation(s)
- Bernd R Förstner
- Social and Preventive Medicine, Department of Sports and Health Sciences, University of Potsdam, Am Neuen Palais 10, 14469, Potsdam, Germany
| | - Mira Tschorn
- Social and Preventive Medicine, Department of Sports and Health Sciences, University of Potsdam, Am Neuen Palais 10, 14469, Potsdam, Germany
| | - Nicolas Reinoso-Schiller
- Social and Preventive Medicine, Department of Sports and Health Sciences, University of Potsdam, Am Neuen Palais 10, 14469, Potsdam, Germany
| | - Lea Mascarell Maričić
- Department of Psychiatry and Psychotherapy CCM, Charité, Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Erik Röcher
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - Janos L Kalman
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Sanna Stroth
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Philipps University Marburg, Marburg, Germany
| | - Annalina V Mayer
- Social Neuroscience Lab, Department of Psychiatry and Psychotherapy, Center of Brain, Behavior, and Metabolism (CBBM), University of Lübeck, Lübeck, Germany
| | - Kristina Schwarz
- Department of Psychiatry and Psychotherapy, Mannheim, Central Institute of Mental Health, Medical Faculty Mannheim, Mannheim, Germany
| | - Anna Kaiser
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Mannheim, Germany
| | - Andrea Pfennig
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Medical Faculty, Technische Universität Dresden, Dresden, Germany
| | - André Manook
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Marcus Ising
- Max Planck Institute of Psychiatry, Munich, Germany
| | - Ingmar Heinig
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Andre Pittig
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
- Translational Psychotherapy, Department of Psychology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy CCM, Charité, Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Klaus Mathiak
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
- JARA-Brain, Research Center Jülich, Jülich, Germany
| | - Thomas G Schulze
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
| | - Frank Schneider
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
- University Hospital Düsseldorf, Medical School, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Inge Kamp-Becker
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Philipps University Marburg, Marburg, Germany
| | - Andreas Meyer-Lindenberg
- Department of Psychiatry and Psychotherapy, Mannheim, Central Institute of Mental Health, Medical Faculty Mannheim, Mannheim, Germany
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Mannheim, Germany
| | - Michael Bauer
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Medical Faculty, Technische Universität Dresden, Dresden, Germany
| | - Rainer Rupprecht
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Hans-Ulrich Wittchen
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Michael A Rapp
- Social and Preventive Medicine, Department of Sports and Health Sciences, University of Potsdam, Am Neuen Palais 10, 14469, Potsdam, Germany.
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Tschorn M, Schulze S, Förstner BR, Holmberg C, Spallek J, Heinz A, Rapp MA. Predictors and prevalence of hazardous alcohol use in middle-late to late adulthood in Europe. Aging Ment Health 2022; 27:1001-1010. [PMID: 35639449 DOI: 10.1080/13607863.2022.2076208] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Objectives: Even low to moderate levels of alcohol consumption can have detrimental health consequences, especially in older adults (OA). Although many studies report an increase in the proportion of drinkers among OA, there are regional variations. Therefore, we examined alcohol consumption and the prevalence of hazardous alcohol use (HAU) among men and women aged 50+ years in four European regions and investigated predictors of HAU.Methods: We analyzed data of N = 35,042 participants of the European SHARE study. We investigated differences in alcohol consumption (units last week) according to gender, age and EU-region using ANOVAs. Furthermore, logistic regression models were used to examine the effect of income, education, marital status, history of a low-quality parent-child relationship and smoking on HAU, also stratified for gender and EU-region. HAU was operationalized as binge drinking or risky drinking (<12.5 units of 10 ml alcohol/week).Results: Overall, past week alcohol consumption was 5.0 units (±7.8), prevalence of HAU was 25.4% within our sample of European adults aged 50+ years. Male gender, younger age and living in Western Europe were linked to both higher alcohol consumption and higher risks of HAU. Income, education, smoking, a low-quality parent-child relationship, living in Northern and especially Eastern Europe were positively associated with HAU. Stratified analyses revealed differences by region and gender.Conclusions: HAU was highly prevalent within this European sample of OA. Alcohol consumption and determinants of HAU differed between EU-regions, hinting to a necessity of risk-stratified population-level strategies to prevent HAU and subsequent alcohol use disorders.
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Affiliation(s)
- Mira Tschorn
- Social and Preventive Medicine, Department of Sports and Health Sciences, Intra-faculty unit "Cognitive Sciences," Faculty of Human Science, University of Potsdam, Potsdam, Germany.,Faculty of Health Sciences Brandenburg, Research Area Services Research and e-Health, University of Potsdam, Potsdam, Germany
| | - Susanne Schulze
- Social and Preventive Medicine, Department of Sports and Health Sciences, Intra-faculty unit "Cognitive Sciences," Faculty of Human Science, University of Potsdam, Potsdam, Germany.,Faculty of Health Sciences Brandenburg, Research Area Services Research and e-Health, University of Potsdam, Potsdam, Germany
| | - Bernd R Förstner
- Social and Preventive Medicine, Department of Sports and Health Sciences, Intra-faculty unit "Cognitive Sciences," Faculty of Human Science, University of Potsdam, Potsdam, Germany
| | - Christine Holmberg
- Faculty of Health Sciences Brandenburg, Research Area Services Research and e-Health, University of Potsdam, Potsdam, Germany.,Social Medicine and Epidemiology, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Germany
| | - Jacob Spallek
- Faculty of Health Sciences Brandenburg, Research Area Services Research and e-Health, University of Potsdam, Potsdam, Germany.,Department of Public Health, Brandenburg University of Technology Cottbus-Senftenberg (BTU-CS), Germany
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy CCM, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Michael A Rapp
- Social and Preventive Medicine, Department of Sports and Health Sciences, Intra-faculty unit "Cognitive Sciences," Faculty of Human Science, University of Potsdam, Potsdam, Germany.,Faculty of Health Sciences Brandenburg, Research Area Services Research and e-Health, University of Potsdam, Potsdam, Germany
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Rane RP, de Man EF, Kim J, Görgen K, Tschorn M, Rapp MA, Banaschewski T, Bokde ALW, Desrivieres S, Flor H, Grigis A, Garavan H, Gowland PA, Brühl R, Martinot JL, Martinot MLP, Artiges E, Nees F, Papadopoulos Orfanos D, Lemaitre H, Paus T, Poustka L, Fröhner J, Robinson L, Smolka MN, Winterer J, Whelan R, Schumann G, Walter H, Heinz A, Ritter K. Structural differences in adolescent brains can predict alcohol misuse. eLife 2022; 11:e77545. [PMID: 35616520 PMCID: PMC9255959 DOI: 10.7554/elife.77545] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 05/25/2022] [Indexed: 12/02/2022] Open
Abstract
Alcohol misuse during adolescence (AAM) has been associated with disruptive development of adolescent brains. In this longitudinal machine learning (ML) study, we could predict AAM significantly from brain structure (T1-weighted imaging and DTI) with accuracies of 73 -78% in the IMAGEN dataset (n∼1182). Our results not only show that structural differences in brain can predict AAM, but also suggests that such differences might precede AAM behavior in the data. We predicted 10 phenotypes of AAM at age 22 using brain MRI features at ages 14, 19, and 22. Binge drinking was found to be the most predictable phenotype. The most informative brain features were located in the ventricular CSF, and in white matter tracts of the corpus callosum, internal capsule, and brain stem. In the cortex, they were spread across the occipital, frontal, and temporal lobes and in the cingulate cortex. We also experimented with four different ML models and several confound control techniques. Support Vector Machine (SVM) with rbf kernel and Gradient Boosting consistently performed better than the linear models, linear SVM and Logistic Regression. Our study also demonstrates how the choice of the predicted phenotype, ML model, and confound correction technique are all crucial decisions in an explorative ML study analyzing psychiatric disorders with small effect sizes such as AAM.
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Affiliation(s)
- Roshan Prakash Rane
- Charité – Universitätsmedizin Berlin (corporate member of Freie Universiät at Berlin, Humboldt-Universiät at zu Berlin, and Berlin Institute of Health), Department of Psychiatry and Psychotherapy, Bernstein Center for Computational NeuroscienceBerlinGermany
| | - Evert Ferdinand de Man
- Faculty IV – Electrical Engineering and Computer Science, Technische Universität BerlinBerlinGermany
| | - JiHoon Kim
- Department of Education and Psychology, Freie Universität BerlinBerlinGermany
| | - Kai Görgen
- Charité – Universitätsmedizin Berlin (corporate member of Freie Universiät at Berlin, Humboldt-Universiät at zu Berlin, and Berlin Institute of Health), Department of Psychiatry and Psychotherapy, Bernstein Center for Computational NeuroscienceBerlinGermany
- Science of Intelligence, Research Cluster of ExcellenceBerlinGermany
| | - Mira Tschorn
- Social and Preventive Medicine, Department of Sports and Health Sciences, Intra-faculty unit “Cognitive Sciences”, Faculty of Human Science, and Faculty of Health Sciences Brandenburg, Research Area Services Research and e-Health, University of PotsdamPotsdamGermany
| | - Michael A Rapp
- Social and Preventive Medicine, Department of Sports and Health Sciences, Intra-faculty unit “Cognitive Sciences”, Faculty of Human Science, and Faculty of Health Sciences Brandenburg, Research Area Services Research and e-Health, University of PotsdamPotsdamGermany
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg UniversityMannheimGermany
| | - Arun LW Bokde
- Discipline of Psychiatry, School of Medicine and Trinity College Institute of Neuroscience, Trinity College DublinDublinIreland
| | - Sylvane Desrivieres
- Centre for Population Neuroscience and Precision Medicine (PONS), Institute of Psychiatry, Psychology Neuroscience SGDP Centre, King’s College LondonLondonUnited Kingdom
| | - Herta Flor
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg UniversityHeidelbergGermany
- Department of Psychology, School of Social Sciences, University of MannheimMannheimGermany
| | | | - Hugh Garavan
- Departments of Psychiatry and Psychology, University of VermontBurlingtonUnited States
| | - Penny A Gowland
- Sir Peter Mansfield Imaging Centre School of Physics and Astronomy, University of NottinghamNottinghamUnited Kingdom
| | | | - Jean-Luc Martinot
- Institut National de la Santé et de la Recherche Médicale, INSERM U A10 ”Trajectoires développementales en psychiatrie” Universite Paris-Saclay, Ecole Normale Supérieure Paris-Saclay, CNRS, Centre BorelliGif-sur-YvetteFrance
| | - Marie-Laure Paillere Martinot
- Institut National de la Santé et de la Recherche Médicale, INSERM U A10 ”Trajectoires développementales en psychiatrie” Universite Paris-Saclay, Ecole Normale Supérieure Paris-Saclay, CNRS, Centre BorelliGif-sur-YvetteFrance
- AP-HP Sorbonne Université, Department of Child and Adolescent Psychiatry, Pitié-Salpêtrière HospitalParisFrance
| | - Eric Artiges
- Institut National de la Santé et de la Recherche Médicale, INSERM U A10 ”Trajectoires développementales en psychiatrie” Universite Paris-Saclay, Ecole Normale Supérieure Paris-Saclay, CNRS, Centre BorelliGif-sur-YvetteFrance
- Psychiatry Department, EPS Barthélémy DurandEtampesFrance
| | - Frauke Nees
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg UniversityMannheimGermany
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg UniversityHeidelbergGermany
- PONS Research Group, Dept of Psychiatry and Psychotherapy, Campus Charite Mitte, Humboldt UniversityBerlinGermany
| | | | - Herve Lemaitre
- NeuroSpin, CEA, Université Paris-SaclayParisFrance
- Institut des Maladies Neurodégénératives, UMR 5293, CNRS, CEA, University of BordeauxBordeauxFrance
| | - Tomas Paus
- Department of Psychiatry, Faculty of Medicine and Centre Hospitalier Universitaire Sainte-Justine, University of MontrealMontrealCanada
- Departments of Psychiatry and Psychology, University of TorontoTorontoCanada
| | - Luise Poustka
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Centre GöttingenGöttingenGermany
| | - Juliane Fröhner
- Department of Psychiatry and Neuroimaging Center, Technische Universität DresdenDresdenGermany
| | - Lauren Robinson
- Department of Psychological Medicine, Section for Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King’s College LondonLondonUnited Kingdom
| | - Michael N Smolka
- Department of Psychiatry and Neuroimaging Center, Technische Universität DresdenDresdenGermany
| | - Jeanne Winterer
- Charité – Universitätsmedizin Berlin (corporate member of Freie Universiät at Berlin, Humboldt-Universiät at zu Berlin, and Berlin Institute of Health), Department of Psychiatry and Psychotherapy, Bernstein Center for Computational NeuroscienceBerlinGermany
- Department of Education and Psychology, Freie Universität BerlinBerlinGermany
| | - Robert Whelan
- School of Psychology and Global Brain Health Institute, Trinity College DublinDublinIreland
| | - Gunter Schumann
- PONS Research Group, Dept of Psychiatry and Psychotherapy, Campus Charite Mitte, Humboldt UniversityBerlinGermany
| | - Henrik Walter
- Charité – Universitätsmedizin Berlin (corporate member of Freie Universiät at Berlin, Humboldt-Universiät at zu Berlin, and Berlin Institute of Health), Department of Psychiatry and Psychotherapy, Bernstein Center for Computational NeuroscienceBerlinGermany
| | - Andreas Heinz
- Charité – Universitätsmedizin Berlin (corporate member of Freie Universiät at Berlin, Humboldt-Universiät at zu Berlin, and Berlin Institute of Health), Department of Psychiatry and Psychotherapy, Bernstein Center for Computational NeuroscienceBerlinGermany
| | - Kerstin Ritter
- Charité – Universitätsmedizin Berlin (corporate member of Freie Universiät at Berlin, Humboldt-Universiät at zu Berlin, and Berlin Institute of Health), Department of Psychiatry and Psychotherapy, Bernstein Center for Computational NeuroscienceBerlinGermany
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Hoffmann S, Tschorn M, Michalski N, Hoebel J, Förstner BR, Rapp MA, Spallek J. Association of regional socioeconomic deprivation and rurality with global developmental delay in early childhood: Data from mandatory school entry examinations in Germany. Health Place 2022; 75:102794. [PMID: 35364469 DOI: 10.1016/j.healthplace.2022.102794] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 03/01/2022] [Accepted: 03/15/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND From birth to young adulthood, health and development of young people are strongly linked to their living situation, including their family's socioeconomic position (SEP) and living environment. The impact of regional characteristics on development in early childhood beyond family SEP has been rarely investigated. This study aimed to identify regional predictors of global developmental delay at school entry taking family SEP into consideration. METHOD We used representative, population-based data from mandatory school entry examinations of the German federal state of Brandenburg in 2018/2019 with n=22,801 preschool children. By applying binary multilevel models, we hierarchically analyzed the effect of regional deprivation defined by the German Index of Socioeconomic Deprivation (GISD) and rurality operationalized as inverted population density of the children's school district on global developmental delay (GDD) while adjusting for family SEP (low, medium and high). RESULTS Family SEP was significantly and strongly linked to GDD. Children with the highest family SEP showed a lower odds for GDD compared to a medium SEP (female: OR=4.26, male: OR=3.46) and low SEP (female: OR=16.58, male: OR=12.79). Furthermore, we discovered a smaller, but additional and independent effect of regional socioeconomic deprivation on GDD, with a higher odds for children from a more deprived school district (female: OR=1.35, male: OR=1.20). However, rurality did not show a significant link to GDD in preschool children beyond family SEP and regional deprivation. CONCLUSION Family SEP and regional deprivation are risk factors for child development and of particular interest to promote health of children in early childhood and over the life course.
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Affiliation(s)
- Stephanie Hoffmann
- Department of Public Health, Brandenburg University of Technology Cottbus-Senftenberg, Germany
| | - Mira Tschorn
- Faculty of Health Sciences Brandenburg, Research Area Services Research and e-Health, University of Potsdam, Potsdam, Germany; Social and Preventive Medicine, Department of Sports and Health Sciences, Intra-faculty Unit "Cognitive Sciences", Faculty of Human Science, University of Potsdam, Potsdam, Germany
| | - Niels Michalski
- Division of Social Determinants of Health, Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Jens Hoebel
- Division of Social Determinants of Health, Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Bernd R Förstner
- Social and Preventive Medicine, Department of Sports and Health Sciences, Intra-faculty Unit "Cognitive Sciences", Faculty of Human Science, University of Potsdam, Potsdam, Germany
| | - Michael A Rapp
- Faculty of Health Sciences Brandenburg, Research Area Services Research and e-Health, University of Potsdam, Potsdam, Germany; Social and Preventive Medicine, Department of Sports and Health Sciences, Intra-faculty Unit "Cognitive Sciences", Faculty of Human Science, University of Potsdam, Potsdam, Germany
| | - Jacob Spallek
- Department of Public Health, Brandenburg University of Technology Cottbus-Senftenberg, Germany; Faculty of Health Sciences Brandenburg, Research Area Services Research and e-Health, University of Potsdam, Potsdam, Germany.
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16
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Förstner B, Tschorn M, Heinz A, Mathiak K, Schulze T, Schneider F, Kamp-Becker I, Meyer-Lindenberg A, Padberg F, Banaschewski T, Bauer M, Rupprecht R, Hans-Ulrich W, Rapp M. Research Domain Criteria (RDoC) und ihr Zusammenhang zur Krankheitsschwere. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732278] [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: 10/20/2022]
Affiliation(s)
- B Förstner
- Prof. Sozial- und Praeventivmedizin, Universität Potsdam
| | - M Tschorn
- Prof. Sozial- und Praeventivmedizin, Universität Potsdam
| | - A Heinz
- Klinik für Psychiatrie und Psychotherapie CCM, Charité – Universitätsmedizin Berlin
| | - K Mathiak
- Experimental Behavioral Psychobiology, Universitätsklinikum Aachen, AöR
| | - T Schulze
- Institut für Psychiatrische Phänomik und Genomik, LMU Klinikum
| | - F Schneider
- Universitätsklinikum Düsseldorf (UKD) - MNR-Klinik
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Uniklinik RWTH Aachen
| | - I Kamp-Becker
- Universitätsklinikum Marburg - Klinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie
| | - A Meyer-Lindenberg
- Zentralinstitut für Seelische Gesundheit, Klinik für Psychiatrie und Psychotherapie
| | - F Padberg
- Munich Center for Brain Stimulation, LMU Klinikum der Universität München – AöR
| | - T Banaschewski
- Zentralinstitut für Seelische Gesundheit, Klinik für Psychiatrie und Psychotherapie des Kindes- und Jugendalters
| | - M Bauer
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Carl Gustav Carus
| | - R Rupprecht
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Regensburg
| | - W Hans-Ulrich
- Institut für Klinische Psychologie und Psychotherapie, Technische Universität Dresden
| | - M Rapp
- Prof. Sozial- und Praeventivmedizin, Universität Potsdam
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17
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Tschorn M, Lorenz RC, O’Reilly PF, Reichenberg A, Banaschewski T, Bokde ALW, Quinlan EB, Desrivières S, Flor H, Grigis A, Garavan H, Gowland P, Ittermann B, Martinot JL, Artiges E, Nees F, Papadopoulos Orfanos D, Poustka L, Millenet S, Fröhner JH, Smolka MN, Walter H, Whelan R, Schumann G, Heinz A, Rapp MA. Differential predictors for alcohol use in adolescents as a function of familial risk. Transl Psychiatry 2021; 11:157. [PMID: 33664233 PMCID: PMC7933140 DOI: 10.1038/s41398-021-01260-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 12/21/2020] [Accepted: 01/28/2021] [Indexed: 12/19/2022] Open
Abstract
Traditional models of future alcohol use in adolescents have used variable-centered approaches, predicting alcohol use from a set of variables across entire samples or populations. Following the proposition that predictive factors may vary in adolescents as a function of family history, we used a two-pronged approach by first defining clusters of familial risk, followed by prediction analyses within each cluster. Thus, for the first time in adolescents, we tested whether adolescents with a family history of drug abuse exhibit a set of predictors different from adolescents without a family history. We apply this approach to a genetic risk score and individual differences in personality, cognition, behavior (risk-taking and discounting) substance use behavior at age 14, life events, and functional brain imaging, to predict scores on the alcohol use disorders identification test (AUDIT) at age 14 and 16 in a sample of adolescents (N = 1659 at baseline, N = 1327 at follow-up) from the IMAGEN cohort, a longitudinal community-based cohort of adolescents. In the absence of familial risk (n = 616), individual differences in baseline drinking, personality measures (extraversion, negative thinking), discounting behaviors, life events, and ventral striatal activation during reward anticipation were significantly associated with future AUDIT scores, while the overall model explained 22% of the variance in future AUDIT. In the presence of familial risk (n = 711), drinking behavior at age 14, personality measures (extraversion, impulsivity), behavioral risk-taking, and life events were significantly associated with future AUDIT scores, explaining 20.1% of the overall variance. Results suggest that individual differences in personality, cognition, life events, brain function, and drinking behavior contribute differentially to the prediction of future alcohol misuse. This approach may inform more individualized preventive interventions.
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Affiliation(s)
- Mira Tschorn
- grid.11348.3f0000 0001 0942 1117Social and Preventive Medicine, Department of Sports and Health Sciences, Intra-faculty unit “Cognitive Sciences”, Faculty of Human Science, and Faculty of Health Sciences Brandenburg, Research Area Services Research and e-Health, University of Potsdam, Potsdam, Germany
| | - Robert C. Lorenz
- grid.11348.3f0000 0001 0942 1117Social and Preventive Medicine, Department of Sports and Health Sciences, Intra-faculty unit “Cognitive Sciences”, Faculty of Human Science, and Faculty of Health Sciences Brandenburg, Research Area Services Research and e-Health, University of Potsdam, Potsdam, Germany
| | - Paul F. O’Reilly
- grid.13097.3c0000 0001 2322 6764Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK ,grid.59734.3c0000 0001 0670 2351Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Abraham Reichenberg
- grid.59734.3c0000 0001 0670 2351Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Tobias Banaschewski
- grid.413757.30000 0004 0477 2235Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, 68159 Mannheim, Germany
| | - Arun L. W. Bokde
- grid.8217.c0000 0004 1936 9705Discipline of Psychiatry, School of Medicine and Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Erin B. Quinlan
- grid.13097.3c0000 0001 2322 6764Centre for Population Neuroscience and Precision Medicine (PONS), Institute of Psychiatry, Psychology & Neuroscience, SGDP Centre, King’s College London, London, UK
| | - Sylvane Desrivières
- grid.13097.3c0000 0001 2322 6764Centre for Population Neuroscience and Precision Medicine (PONS), Institute of Psychiatry, Psychology & Neuroscience, SGDP Centre, King’s College London, London, UK
| | - Herta Flor
- grid.413757.30000 0004 0477 2235Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, Mannheim, Germany ,grid.5601.20000 0001 0943 599XDepartment of Psychology, School of Social Sciences, University of Mannheim, 68131 Mannheim, Germany
| | - Antoine Grigis
- grid.457334.2NeuroSpin, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - Hugh Garavan
- grid.59062.380000 0004 1936 7689Departments of Psychiatry and Psychology, University of Vermont, 05405 Burlington, VT USA
| | - Penny Gowland
- grid.4563.40000 0004 1936 8868Sir Peter Mansfield Imaging Centre School of Physics and Astronomy, University of Nottingham, University Park, Nottingham, UK
| | - Bernd Ittermann
- grid.4764.10000 0001 2186 1887Physikalisch-Technische Bundesanstalt (PTB), Braunschweig and Berlin, Berlin, Germany
| | - Jean-Luc Martinot
- grid.460789.40000 0004 4910 6535Institut National de la Santé et de la Recherche Médicale, INSERM U1299 “Trajectoires développementales & psychiatrie”, University Paris Saclay, Ecole Normale supérieure Paris-Saclay, CNRS, Centre Borelli, Gif-sur-Yvette, France
| | - Eric Artiges
- grid.4444.00000 0001 2112 9282Institut National de la Santé et de la Recherche Médicale, INSERM U1299 “Trajectoires développementales & psychiatrie”, University Paris Saclay, Ecole Normale supérieure Paris-Saclay, CNRS, Centre Borelli; and Psychiatry Department, EPS Barthélémy Durand, Etampes, France
| | - Frauke Nees
- grid.413757.30000 0004 0477 2235Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, 68159 Mannheim, Germany ,grid.413757.30000 0004 0477 2235Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, Mannheim, Germany ,Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig Holstein, Kiel University, Kiel, Germany
| | | | - Luise Poustka
- grid.411984.10000 0001 0482 5331Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Centre Göttingen, von-Siebold-Str. 5, 37075 Göttingen, Germany
| | - Sabina Millenet
- grid.413757.30000 0004 0477 2235Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, 68159 Mannheim, Germany
| | - Juliane H. Fröhner
- grid.4488.00000 0001 2111 7257Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
| | - Michael N. Smolka
- grid.4488.00000 0001 2111 7257Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
| | - Henrik Walter
- Department of Psychiatry and Psychotherapy CCM, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Robert Whelan
- grid.8217.c0000 0004 1936 9705School of Psychology and Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Gunter Schumann
- grid.13097.3c0000 0001 2322 6764Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK ,grid.13097.3c0000 0001 2322 6764Centre for Population Neuroscience and Precision Medicine (PONS), Institute of Psychiatry, Psychology & Neuroscience, SGDP Centre, King’s College London, London, UK ,grid.8547.e0000 0001 0125 2443PONS Research Group, Dept of Psychiatry and Psychotherapy, Campus Charite Mitte, Humboldt University, Berlin and Leibniz Institute for Neurobiology, Magdeburg, Germany, and Institute for Science and Technology of Brain-inspired Intelligence (ISTBI), Fudan University, Shanghai, PR China
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy CCM, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Michael A. Rapp
- grid.11348.3f0000 0001 0942 1117Social and Preventive Medicine, Department of Sports and Health Sciences, Intra-faculty unit “Cognitive Sciences”, Faculty of Human Science, and Faculty of Health Sciences Brandenburg, Research Area Services Research and e-Health, University of Potsdam, Potsdam, Germany
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18
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Beer K, Kuhlmann SL, Tschorn M, Arolt V, Grosse L, Haverkamp W, Waltenberger J, Strehle J, Martus P, Müller-Nordhorn J, Rieckmann N, Ströhle A. Anxiety disorders and post-traumatic stress disorder in patients with coronary heart disease. Journal of Affective Disorders Reports 2020. [DOI: 10.1016/j.jadr.2020.100009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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19
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Warnke K, Brandt J, Jörgens S, Arolt V, Beer K, Domschke K, Haverkamp W, Kuhlmann SL, Müller-Nordhorn J, Rieckmann N, Schwarte K, Ströhle A, Tschorn M, Waltenberger J, Grosse L. Association of 5-HTTLPR/rs25531 with depressive symptoms in patients with coronary heart disease: A prospective study. J Affect Disord 2020; 277:531-539. [PMID: 32889377 DOI: 10.1016/j.jad.2020.08.046] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 06/06/2020] [Accepted: 08/20/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND 5-HTTLPR/rs25531 is suspected to be involved in the pathogenesis of both coronary heart disease (CHD)1 and depression. We aimed to investigate the role of 5-HTTLPR/rs25531 in the development of depressive symptoms among CHD patients in a longitudinal design. METHODS N = 265 participants with CHD diagnosis were included while hospitalized in a department of cardiology and genotyped for the 5-HTTLPR/rs25531. Depressive symptoms were measured using the Patient Health Questionnaire (PHQ-9)7 at baseline and after 6 and 12 months. Binary logistic regression models were used to analyze the association of 5-HTTLPR/rs25531 with the prevalence of depressive symptoms at each time point as well as with the incidence and persistence of depressive symptoms at follow-up. RESULTS "LALA" genotype was associated with a higher prevalence of depressive symptoms 12 months after study inclusion. "LALA" genotype was associated with a higher incidence of depressive symptoms 6 and 12 months after study inclusion. There was no association of 5-HTTLPR/rs25531 with the persistence of depressive symptoms. LIMITATIONS Inclusion criteria did not demand a particular cardiac event at baseline, which aggravated the interpretation of the time-specific results. The majority of the participants was of male gender which could cause bias. The present study only vaguely differentiated between ethnical groups which might cause bias regarding nationality-dependent allele distributions. CONCLUSION The present study suggests a time-dependent association of the "LALA" genotype with depressive symptoms in CHD patients. 5-HTTLPR/rs25531 might be an important marker to detect risk groups for later onset depressive symptoms among CHD patients.
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Affiliation(s)
- Katharina Warnke
- Department of Psychiatry and Psychotherapy, University Hospital Münster, Germany.
| | - Julia Brandt
- Department of Psychiatry and Psychotherapy, University Hospital Münster, Germany
| | - Silke Jörgens
- Department of Psychiatry and Psychotherapy, University Hospital Münster, Germany
| | - Volker Arolt
- Department of Psychiatry and Psychotherapy, University Hospital Münster, Germany
| | - Katja Beer
- Charité - Universitätsmedizin Berlin, corporate member of the Freie Universität Berlin, Humboldt-Universität zu Berlin, and the Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Berlin, Germany
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Wilhelm Haverkamp
- Charité - Universitätsmedizin Berlin, corporate member of the Freie Universität Berlin, Humboldt-Universität zu Berlin, and the Berlin Institute of Health, Department of Internal Medicine and Cardiology, Berlin, Germany
| | - Stella L Kuhlmann
- Charité - Universitätsmedizin Berlin, corporate member of the Freie Universität Berlin, Humboldt-Universität zu Berlin, and the Berlin Institute of Health, Division of Emergency and Acute Medicine (CVK, CCM), Berlin, Germany; Charité - Universitätsmedizin Berlin, corporate member of the Freie Universität Berlin, Humboldt-Universität zu Berlin, and the Berlin Institute of Health, Institute of Public Health, Berlin, Germany
| | - Jacqueline Müller-Nordhorn
- Charité - Universitätsmedizin Berlin, corporate member of the Freie Universität Berlin, Humboldt-Universität zu Berlin, and the Berlin Institute of Health, Institute of Public Health, Berlin, Germany; Bavarian Food and Health Safety Authority, Oberschleißheim, Germany
| | - Nina Rieckmann
- Charité - Universitätsmedizin Berlin, corporate member of the Freie Universität Berlin, Humboldt-Universität zu Berlin, and the Berlin Institute of Health, Institute of Public Health, Berlin, Germany
| | - Kathrin Schwarte
- Department of Psychiatry and Psychotherapy, University Hospital Münster, Germany
| | - Andreas Ströhle
- Charité - Universitätsmedizin Berlin, corporate member of the Freie Universität Berlin, Humboldt-Universität zu Berlin, and the Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Berlin, Germany
| | - Mira Tschorn
- Charité - Universitätsmedizin Berlin, corporate member of the Freie Universität Berlin, Humboldt-Universität zu Berlin, and the Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Berlin, Germany; Social and Preventive Medicine, University of Potsdam, Potsdam, Germany
| | | | - Laura Grosse
- Department of Psychiatry and Psychotherapy, University Hospital Münster, Germany; Intercultural Business Psychology, Hamm-Lippstadt University of Applied Sciences, Hamm, Germany
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20
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Rapp MA, Tschorn M, Supprian T, Thomas C, Kreisel S, Benninghoff J, Schumann G, Heinz A. [Potentials and limits of aging cohort studies for geriatric psychiatry]. Nervenarzt 2020; 92:219-227. [PMID: 33242121 DOI: 10.1007/s00115-020-01035-3] [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] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/30/2020] [Indexed: 11/29/2022]
Abstract
The sizeable number of population-based cohort studies of aging in Germany have provided highly valuable contributions for the specification of risk factors and predictors for frequent mental disorders in old age, especially dementia and depression. The results from these cohort studies enable the specification of mechanisms for the development of and preventative interventions for common mental disorders in old age. On the other hand, there is a significant paucity of clinical cohort studies investigating disease trajectories and possible markers for specific individualized interventions of frequent mental disorders in old age. In this article, we report selected key findings from cohort studies of aging and discuss novel approaches for the integration and harmonization of population-based and clinical cohort studies.
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Affiliation(s)
- M A Rapp
- Sozial- und Präventivmedizin, Department Sport- und Gesundheitswissenschaften, Strukturbereich Kognitionswissenschaften, Universität Potsdam, Am Neuen Palais 10, 14469, Potsdam, Deutschland.
| | - M Tschorn
- Sozial- und Präventivmedizin, Department Sport- und Gesundheitswissenschaften, Strukturbereich Kognitionswissenschaften, Universität Potsdam, Am Neuen Palais 10, 14469, Potsdam, Deutschland
| | - T Supprian
- Abteilung Gerontopsychiatrie, LVR-Klinikum Düsseldorf, Kliniken der Heinrich-Heine-Universität, Düsseldorf, Deutschland
| | - C Thomas
- Klinik für Psychiatrie und Psychotherapie für Ältere, Klinikum Stuttgart, Stuttgart, Deutschland
| | - S Kreisel
- Abteilung Gerontopsychiatrie, Campus Bielefeld-Bethel, Universitätsklinikum Ostwestfalen-Lippe, Bielefeld, Deutschland
| | - J Benninghoff
- Zentrum für Altersmedizin und Entwicklungsstörungen, kbo-Isar-Amper-Klinikum München-Ost, Haar, Deutschland
| | - G Schumann
- Klinik für Psychiatrie und Psychotherapie, PONS Zentrum, Charité Universitätsmedizin Berlin, Berlin, Deutschland
| | - A Heinz
- Klinik für Psychiatrie und Psychotherapie, PONS Zentrum, Charité Universitätsmedizin Berlin, Berlin, Deutschland
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21
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Brandt J, Warnke K, Jörgens S, Arolt V, Beer K, Domschke K, Haverkamp W, Kuhlmann SL, Müller-Nordhorn J, Rieckmann N, Schwarte K, Ströhle A, Tschorn M, Waltenberger J, Grosse L. Association of FKBP5 genotype with depressive symptoms in patients with coronary heart disease: a prospective study. J Neural Transm (Vienna) 2020; 127:1651-1662. [PMID: 32860562 PMCID: PMC7665971 DOI: 10.1007/s00702-020-02243-6] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 08/10/2020] [Indexed: 12/14/2022]
Abstract
Depression and coronary heart disease (CHD) are prevalent and often co-occurring disorders. Both have been associated with a dysregulated stress system. As a central element of the stress system, the FKBP5 gene has been shown to be associated with depression. In a prospective design, this study aims to investigate the association of FKBP5 with depressive symptoms in CHD patients. N = 268 hospitalized CHD patients were included. Depressive symptoms were measured using the Hospital Anxiety and Depression Scale (HADS-D) at four time points (baseline, and after 1 month, 6 months, and 12 months). The functional FKBP5 single-nucleotide polymorphism (SNP) rs1360780 was selected for genotyping. Linear regression models showed that a higher number of FKBP5 C alleles was associated with more depressive symptoms in CHD patients both at baseline (p = 0.015) and at 12-months follow-up (p = 0.025) after adjustment for confounders. Further analyses revealed that this effect was driven by an interaction of FKBP5 genotype with patients’ prior CHD course. Specifically, only in patients with a prior myocardial infarction or coronary revascularization, more depressive symptoms were associated with a higher number of C alleles (baseline: p = 0.046; 1-month: p = 0.026; 6-months: p = 0.028). Moreover, a higher number of C alleles was significantly related to a greater risk for dyslipidemia (p = .016). Our results point to a relevance of FKBP5 in the association of the two stress-related diseases depression and CHD.
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Affiliation(s)
- Julia Brandt
- Department of Psychiatry and Psychotherapy, University Hospital Münster, Albert-Schweitzer-Campus 1, Geb. A9, 48149, Münster, Germany.
| | - Katharina Warnke
- Department of Psychiatry and Psychotherapy, University Hospital Münster, Albert-Schweitzer-Campus 1, Geb. A9, 48149, Münster, Germany
| | - Silke Jörgens
- Department of Psychiatry and Psychotherapy, University Hospital Münster, Albert-Schweitzer-Campus 1, Geb. A9, 48149, Münster, Germany
| | - Volker Arolt
- Department of Psychiatry and Psychotherapy, University Hospital Münster, Albert-Schweitzer-Campus 1, Geb. A9, 48149, Münster, Germany
| | - Katja Beer
- Charité-Universitätsmedizin Berlin, Corporate member of the Freie Universität Berlin, Humboldt-Universität zu Berlin, and the Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Berlin, Germany
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Wilhelm Haverkamp
- Charité-Universitätsmedizin Berlin, Corporate member of the Freie Universität Berlin, Humboldt-Universität zu Berlin, and the Berlin Institute of Health, Department of Internal Medicine and Cardiology, Berlin, Germany
| | - Stella L Kuhlmann
- Charité-Universitätsmedizin Berlin, Corporate member of the Freie Universität Berlin, Humboldt-Universität zu Berlin, and the Berlin Institute of Health, Division of Emergency and Acute Medicine (CVK, CCM), Berlin, Germany
- Charité-Universitätsmedizin Berlin, Corporate member of the Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Institute of Public Health, Berlin, Germany
| | - Jacqueline Müller-Nordhorn
- Charité-Universitätsmedizin Berlin, Corporate member of the Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Institute of Public Health, Berlin, Germany
- Bavarian Food and Health Safety Authority, Oberschleißheim, Germany
| | - Nina Rieckmann
- Charité-Universitätsmedizin Berlin, Corporate member of the Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Institute of Public Health, Berlin, Germany
| | - Kathrin Schwarte
- Department of Psychiatry and Psychotherapy, University Hospital Münster, Albert-Schweitzer-Campus 1, Geb. A9, 48149, Münster, Germany
| | - Andreas Ströhle
- Charité-Universitätsmedizin Berlin, Corporate member of the Freie Universität Berlin, Humboldt-Universität zu Berlin, and the Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Berlin, Germany
| | - Mira Tschorn
- Charité-Universitätsmedizin Berlin, Corporate member of the Freie Universität Berlin, Humboldt-Universität zu Berlin, and the Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Berlin, Germany
- Social and Preventive Medicine, University of Potsdam, Potsdam, Germany
| | | | - Laura Grosse
- Department of Psychiatry and Psychotherapy, University Hospital Münster, Albert-Schweitzer-Campus 1, Geb. A9, 48149, Münster, Germany
- Intercultural Business Psychology, Hamm-Lippstadt University of Applied Sciences, Hamm, Germany
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22
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Kuhlmann SL, Tschorn M, Arolt V, Beer K, Brandt J, Grosse L, Haverkamp W, Müller-Nordhorn J, Rieckmann N, Waltenberger J, Warnke K, Hellweg R, Ströhle A. Serum brain-derived neurotrophic factor and depressive symptoms in coronary heart disease patients: Role of cognitive functions. Psychoneuroendocrinology 2017; 79:175-176. [PMID: 28292627 DOI: 10.1016/j.psyneuen.2017.02.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 02/10/2017] [Indexed: 11/16/2022]
Affiliation(s)
- Stella L Kuhlmann
- Institute of Public Health, Charité-Universitätsmedizin Berlin, Berlin, Germany; Institute of Medical Psychology, Charité-Universitätsmedizin Berlin, Berlin, Germany.
| | - Mira Tschorn
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Berlin, Germany; Social and Preventive Medicine, University of Potsdam, Potsdam, Germany
| | - Volker Arolt
- Department of Psychiatry, University of Münster, Germany
| | - Katja Beer
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Julia Brandt
- Department of Psychiatry, University of Münster, Germany
| | - Laura Grosse
- Department of Psychiatry, University of Münster, Germany
| | - Wilhelm Haverkamp
- Department of Internal Medicine and Cardiology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | | | - Nina Rieckmann
- Institute of Public Health, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | | | | | - Rainer Hellweg
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Andreas Ströhle
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Berlin, Germany
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23
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Tschorn M, Rieckmann N, Arolt V, Beer K, Haverkamp W, Martus P, Waltenberger J, Müller-Nordhorn J, Ströhle A. Erkennungsgüte dreier deutschsprachiger Screeninginstrumente für Depression bei hospitalisierten Patienten mit koronarer Herzerkrankung. Psychiat Prax 2017; 46:41-48. [DOI: 10.1055/s-0042-123434] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Zusammenfassung
Ziel Vergleich der Erkennungsgüte von drei Depressions-Screeninginstrumenten bei Patienten mit koronarer Herzerkrankung (KHK).
Methodik 1019 KHK-Patienten erhielten den Patient Health Questionnaire (PHQ-9 und PHQ-2) und die Hospital Anxiety and Depression Scale (HADS-D) sowie ein klinisches Interview (Composite International Diagnostic Interview) als Referenzstandard.
Ergebnisse Bezüglich der Erkennungsgüte waren PHQ-9 und HADS-D dem PHQ-2 überlegen. Optimale Cut-off-Werte waren 7 (PHQ-9 und HADS-D) und 2 (PHQ-2).
Schlussfolgerung PHQ-9 und HADS-D haben eine vergleichbare Diskriminationsfähigkeit für depressive Störungen bei KHK-Patienten.
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Affiliation(s)
- Mira Tschorn
- Klinik für Psychiatrie und Psychotherapie, Charité – Universitätsmedizin Berlin
- Sozial- und Präventivmedizin, Strukturbereich Kognitionswissenschaften, Department Sport- und Gesundheitswissenschaften, Universität Potsdam
| | - Nina Rieckmann
- Institut für Public Health, Charité – Universitätsmedizin Berlin
| | - Volker Arolt
- Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Münster
| | - Katja Beer
- Klinik für Psychiatrie und Psychotherapie, Charité – Universitätsmedizin Berlin
| | - Wilhelm Haverkamp
- Medizinische Klinik mit Schwerpunkt Kardiologie, Charité – Universitätsmedizin Berlin
| | - Peter Martus
- Institut für Klinische Epidemiologie und angewandte Biometrie, Universitätsklinikum Tübingen
| | | | | | - Andreas Ströhle
- Klinik für Psychiatrie und Psychotherapie, Charité – Universitätsmedizin Berlin
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Kuhlmann SL, Tschorn M, Arolt V, Beer K, Brandt J, Grosse L, Haverkamp W, Müller-Nordhorn J, Rieckmann N, Waltenberger J, Warnke K, Hellweg R, Ströhle A. Serum brain-derived neurotrophic factor and stability of depressive symptoms in coronary heart disease patients: A prospective study. Psychoneuroendocrinology 2017; 77:196-202. [PMID: 28092760 DOI: 10.1016/j.psyneuen.2016.12.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 12/15/2016] [Accepted: 12/20/2016] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Brain-derived neurotrophic factor (BDNF) supports neurogenesis, angiogenesis, and promotes the survival of various cell types in the brain and the coronary system. Moreover, BDNF is associated with both coronary heart disease (CHD) and depression. The current study aims to investigate whether serum BDNF levels are associated with the course of depressive symptoms in CHD patients. METHODS At baseline, N=225 CHD patients were enrolled while hospitalized. Of these, N=190 (84%) could be followed up 6 months later. Depressive symptoms were assessed both at baseline and at the 6-months follow-up using the Patient Health Questionnaire (PHQ-9). Serum BDNF concentrations were measured using fluorometric Enzyme-linked immunosorbent assays (ELISA). RESULTS Logistic regression models showed that lower BDNF levels were associated with persistent depressive symptoms, even after adjustment for age, sex, smoking and potential medical confounders. The incidence of depressive symptoms was not related to lower BDNF levels. However, somatic comorbidity (as measured by the Charlson Comorbidity Index) was significantly associated with the incidence of depressive symptoms. CONCLUSIONS Our findings suggest a role of BDNF in the link between CHD and depressive symptoms. Particularly, low serum BDNF levels could be considered as a valuable biomarker for the persistence of depressive symptoms among depressed CHD patients.
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Affiliation(s)
- Stella L Kuhlmann
- Institute of Public Health, Charité-Universitätsmedizin Berlin, Berlin, Germany; Institute of Medical Psychology, Charité-Universitätsmedizin Berlin, Berlin, Germany.
| | - Mira Tschorn
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Berlin, Germany; Social and Preventive Medicine, University of Potsdam, Potsdam, Germany
| | - Volker Arolt
- Department of Psychiatry, University of Münster, Germany
| | - Katja Beer
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Julia Brandt
- Department of Psychiatry, University of Münster, Germany
| | - Laura Grosse
- Department of Psychiatry, University of Münster, Germany
| | - Wilhelm Haverkamp
- Department of Internal Medicine and Cardiology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | | | - Nina Rieckmann
- Institute of Public Health, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | | | | | - Rainer Hellweg
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Andreas Ströhle
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Berlin, Germany
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