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Peschel SKV, Fürtjes S, Sigrist C, Voss C, Berwanger J, Ollmann TM, Kische H, Rückert F, Koenig J, Pieper L, Beesdo-Baum K. Tension and disordered eating behaviors in the daily lives of adolescents and young adults from the general population: Associations and moderating role of trait emotion regulation. Scand J Psychol 2024; 65:252-263. [PMID: 37850537 DOI: 10.1111/sjop.12971] [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: 03/02/2023] [Revised: 08/10/2023] [Accepted: 09/15/2023] [Indexed: 10/19/2023]
Abstract
Experiences of tension and difficulties in emotion regulation have been linked to eating pathology in clinical samples and are targeted in respective treatment approaches. The present study aimed to investigate the impact of tension on engagement in disordered eating behaviors (DEBs) and potential moderating effects of trait emotion regulation in young people from the general population. A subsample of 971 adolescents and young adults from an epidemiological cohort study reported on levels of tension and four different DEBs (skipping eating, restrained eating, eating large amounts of food, loss-of-control-eating) via ecological momentary assessment (EMA), as well as on trait emotion regulation via questionnaire. In multilevel models, momentary tension did not predict levels of subsequent DEBs. However, higher average levels of tension across the EMA period predicted higher levels of all DEBs. No interactions with emotion regulation emerged. Individuals experiencing overall higher levels of tension appear to be more prone to engaging in DEBs.
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Affiliation(s)
- Stephanie K V Peschel
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Sophia Fürtjes
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Christine Sigrist
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Catharina Voss
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Johanna Berwanger
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Theresa M Ollmann
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Hanna Kische
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Frank Rückert
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Julian Koenig
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Lars Pieper
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Katja Beesdo-Baum
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
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Hense H, Ernst S, Zscheppang A, Schmitt J, Roessner V, Weniger M, Beesdo-Baum K, Knappe S. [Implementation of a novel form of care for the early detection and prevention of emotional and behavioral problems in children in the pediatric setting: Qualitative interviews with pediatricians, practice staff and parents]. Z Evid Fortbild Qual Gesundhwes 2024; 185:92-107. [PMID: 38503633 DOI: 10.1016/j.zefq.2023.12.004] [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] [Received: 02/06/2023] [Revised: 12/07/2023] [Accepted: 12/10/2023] [Indexed: 03/21/2024]
Abstract
AIM OF THE STUDY Evaluation of the implementation of a standardized screening using the Strengths and Difficulties Questionnaire (SDQ) as part of the routine pediatric health check-ups in the Dresden area (Germany) in order to detect emotional and behavioral problems (EBPs) in children early and allocate them to indicated preventive programs and/or to further counselling and treatment services. METHODS 1.) Semi-structured interviews were performed with participating pediatricians (n=4), practice staff (n=4) and custodians of screened children (n=17) and subjected to content analysis regarding feasibility, advantages and disadvantages of the screening and the targeted allocation, as well as barriers and facilitators of using the screening and the preventive programs and further services. 2.) A self-developed questionnaire survey (descriptive analysis: means and frequencies) was conducted among pediatricians (n=34/99) to inquire about the implementation of the SDQ screening regarding feasibility, advantages, disadvantages and necessary conditions for a potential adoption of the screening to standard health services. RESULTS In the interviews, the pediatricians and practice staff reported that the SDQ screening embedded in routine pediatric health check-ups was simple and could be carried out in a few minutes. The screening helped to identify and address possible EBPs in children and to recommend a targeted service. Apart from the expenditure of time, no disadvantages were mentioned. As expected, parent-related (e.g. fears, attitudes and trust in the pediatrician), child-related (does not want to reveal any information about him- or herself , attitude and motivation), service provider-related (presentation of services), organizational (necessary signatures, financing, waiting time) and service-related (duration, costs, venue, designation) factors influenced the families' use of the screening and further services. Interviewed custodians whose child participated in an indicated preventive program within the project (n=11) would recommend the SDQ screening and preventive program to other families. In the questionnaire survey 28/31 pediatricians "completely" or "rather" agreed on a 5-point Likert scale that the SDQ screening and targeted allocation should be included in standard pediatric care. DISCUSSION The use of the SDQ, which is one of the most widely used and, despite its brevity, most valid screening instruments for the early detection of EBPs, in routine pediatric health check-ups and the targeted allocation of further health services represent a feasible approach to the early identification and clarification of EBPs in children as well as their allocation to indicated preventive services. CONCLUSION An adoption of the novel form of care (SDQ screening and targeted allocation to indicated preventive programs and further services) to standard pediatric care unfolds its benefits if preventive and care services for EBPs in children are made available nationwide.
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Affiliation(s)
- Helene Hense
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Deutschland.
| | - Sophia Ernst
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Deutschland
| | - Anja Zscheppang
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Deutschland
| | - Jochen Schmitt
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Deutschland
| | - Veit Roessner
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Technische Universität Dresden, Dresden, Deutschland
| | - Max Weniger
- Behaviorale Epidemiologie, Institut für Klinische Psychologie und Psychotherapie, Technische Universität Dresden, Deutschland
| | - Katja Beesdo-Baum
- Behaviorale Epidemiologie, Institut für Klinische Psychologie und Psychotherapie, Technische Universität Dresden, Deutschland
| | - Susanne Knappe
- Behaviorale Epidemiologie, Institut für Klinische Psychologie und Psychotherapie, Technische Universität Dresden, Deutschland
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Kische H, Voss C, Haring R, Ollmann TM, Pieper L, Kirschbaum C, Beesdo-Baum K. Correction to: Hair androgen concentrations and depressive disorders in adolescents from the general population. Eur Child Adolesc Psychiatry 2024; 33:953-954. [PMID: 35587288 PMCID: PMC10894163 DOI: 10.1007/s00787-022-02009-3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Hanna Kische
- Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany.
| | - Catharina Voss
- Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
| | - Robin Haring
- Faculty of Applied Public Health, European University of Applied Sciences, Rostock, Germany
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Theresa Magdalena Ollmann
- Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
| | - Lars Pieper
- Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
- Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Clemens Kirschbaum
- Department of Biopsychology, Technische Universität Dresden, Dresden, Germany
| | - Katja Beesdo-Baum
- Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
- Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
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Reich H, Niermann HCM, Voss C, Venz J, Pieper L, Beesdo-Baum K. Sociodemographic, psychological, and clinical characteristics associated with health service (non-)use for mental disorders in adolescents and young adults from the general population. Eur Child Adolesc Psychiatry 2024; 33:391-400. [PMID: 36807526 PMCID: PMC10869368 DOI: 10.1007/s00787-023-02146-3] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 01/19/2023] [Indexed: 02/21/2023]
Abstract
Most adolescents and young adults who experience psychological distress do not seek professional help. This study aims to enhance the understanding of sociodemographic, psychological, and clinical characteristics associated with the underuse of health services by adolescents and young adults with mental disorders. Data from a cross-sectional, epidemiological study with a population-based sample (N = 1180 participants, 14-21 years old) were used. Participants completed a fully standardized, computer-assisted diagnostic interview (DIA-X-5/D-CIDI) administered by trained clinical interviewers to assess lifetime mental disorders according to DSM-5 as well as lifetime health service use for mental health problems, and completed self-report questionnaires to assess various psychological variables (e.g., stigma). Predictors of health service use were examined using univariate and multiple logistic regression analyses, data were weighted for age and sex to improve representativeness Of n = 597 participants with any lifetime mental disorder, 32.4% [95% CI 28.4; 36.7] had ever used any health services because of a mental health, psychosomatic, or substance use problem. Even less had received psychotherapeutic or pharmacological treatment (Cognitive Behavioral Therapy: 12.1% [9.5; 15.2]; other psychotherapy: 10.7% [8.4; 13.7]; medication: 5.4% [3.7; 7.8]). High education was associated with less health service use (low/ middle/ other vs. high education: 53.8% vs. 26.9%; OR = 0.26, p < .001). In the multiple regression model, stigma toward mental disorders was the single psychological variable associated with a reduced likelihood of using health services (OR = 0.69 [0.52; 0.90], p < .01). These findings draw attention to the treatment gap for mental disorders during adolescence and highlight related factors to be addressed in public health contexts.
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Affiliation(s)
- H Reich
- Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
- Depression Research Centre of the German Depression Foundation, Department for Psychiatry, Psychosomatics and Psychotherapy, Goethe University, Heinrich-Hoffmann-Str. 10, Frankfurt am Main, 60528, Frankfurt, Germany
| | - H C M Niermann
- Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
| | - C Voss
- Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
| | - J Venz
- Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
| | - L Pieper
- Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
| | - K Beesdo-Baum
- Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany.
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Ernst J, Rückert F, Ollmann TM, Voss C, Kische H, Knappe S, Beesdo-Baum K. Social Interactions in Everyday Life of Socially Anxious Adolescents: Effects on Mental State, Anxiety, and Depression. Res Child Adolesc Psychopathol 2024; 52:207-222. [PMID: 37768440 PMCID: PMC10834615 DOI: 10.1007/s10802-023-01121-5] [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] [Accepted: 08/28/2023] [Indexed: 09/29/2023]
Abstract
Unfavorable interpersonal behavior in social anxiety disorder (SAD) contributes to the maintenance of the disorder and may also be related to the development of secondary depression. Since there is limited research on daily life behavior in SAD, this study aimed to describe social interaction behavior and analyze the effect of positive interactions on depression, anxiety, and mental state. Data were obtained from the Behavior and Mind Health study (11/2015-12/2016), an epidemiological cohort study of adolescents and young adults (n = 1,180, aged 14-21 years) from Dresden, Germany. Interpersonal behavior, current mental state, anxiety, and depression were assessed eight times per day over four days using smartphone-based ecological momentary assessments. The analyzed subsample consisted of n = 723 participants, comparing 12-month SAD (n = 60) and healthy controls (HC; n = 663). The interaction behavior of participants with SAD did not differ substantially from that of HC in terms of frequency of social interactions, type of interaction partner, and time spent communicating, although they reported fewer real-life interaction partners (SAD: M = 2.49, SD = 4.78; HC: M = 3.18, SD = 6.43; F(17,044) = 23.92, p < 0.001). When comparing mental state, anxiety, and depression after interactions with familiar people to no interaction, no differences were found between SAD and HC. However, interactions with unfamiliar people negatively affected depressive symptoms in individuals with SAD (b = 0.53; SE = 0.25; 95%CI: 0.04-1.03; p = 0.036). In adolescents with SAD, social situations with unfamiliar people seem to be processed in a dysfunctional way, contributing to increased depressive mood in everyday life. This is particularly interesting given the high rate of secondary depression in SAD.
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Affiliation(s)
- Julia Ernst
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, TUD Dresden University of Technology, Chemnitzer Straße 46, 01187, Dresden, Germany.
| | - Frank Rückert
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, TUD Dresden University of Technology, Chemnitzer Straße 46, 01187, Dresden, Germany
| | - Theresa Magdalena Ollmann
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, TUD Dresden University of Technology, Chemnitzer Straße 46, 01187, Dresden, Germany
| | - Catharina Voss
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, TUD Dresden University of Technology, Chemnitzer Straße 46, 01187, Dresden, Germany
| | - Hanna Kische
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, TUD Dresden University of Technology, Chemnitzer Straße 46, 01187, Dresden, Germany
| | - Susanne Knappe
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, TUD Dresden University of Technology, Chemnitzer Straße 46, 01187, Dresden, Germany
- Evangelische Hochschule Dresden (ehs), University of Applied Sciences for Social Work, Education and Nursing, Dresden, Germany
| | - Katja Beesdo-Baum
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, TUD Dresden University of Technology, Chemnitzer Straße 46, 01187, Dresden, Germany
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Weniger M, Beesdo-Baum K, Ernst J, Siegmund CB, Porst PT, McDonald M, Roessner V, Knappe S. [Indicative prevention programs for mental health promotion in preschool and primary school age: Willingness of pediatricians and families to participate in an innovative care chain]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2024; 67:23-35. [PMID: 37921872 PMCID: PMC10776478 DOI: 10.1007/s00103-023-03787-0] [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: 02/26/2023] [Accepted: 09/22/2023] [Indexed: 11/05/2023]
Abstract
BACKGROUND Mental health problems usually have their onset in childhood. Undiagnosed, they may progress into mental disorders. Despite their effectiveness, existing preventive programs have been rarely used. We aimed to examine to what extent the establishment of a care chain can identify children at high risk at an early stage and assign them to preventive interventions. In addition, prevention program participation was assessed. METHODS In a prospective implementation study, the Strengths and Difficulties Questionnaire was administered as a screening instrument to families during regular pediatric health examinations (U9-U11, child age 5-10 years). Families received feedback directly from the pediatrician, and in the case of borderline abnormal emotional or behavioral problems, a recommendation for an indicative prevention program. Program indication was additionally determined in an entry examination prior to program participation. RESULTS In the area of Dresden (Germany), n = 46 (38.7%) pediatricians participated in the project. In n = 28 pediatric practices, n = 3231 (86.4%) families participated in the screening and n = 864 (26.7%) children received a prevention recommendation. Of the families, n = 118/864 (13.7%) self-registered for the prevention programs, n = 215/624 (35.5%) showed interest after being contacted by the study teamn. Through other pathways, n = 139 families requested participation. Clinical evaluation interviews to assess prevention indication were conducted in n = 337 children (n = 461; via all entry pathways). Finally, n = 237 (n = 337) children participated in an indicated prevention program. CONCLUSION Expanding screening to mental health problems during regular health checkups is feasible, useful, and widely accepted. In order to implement a care chain, a supply structure should be established to enable referral to and uptake of preventive interventions.
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Affiliation(s)
- Max Weniger
- Institut für Klinische Psychologie und Psychotherapie, Professur für Behaviorale Epidemiologie, Technische Universität Dresden, Chemnitzer Straße 46, 01187, Dresden, Sachsen, Deutschland
| | - Katja Beesdo-Baum
- Institut für Klinische Psychologie und Psychotherapie, Professur für Behaviorale Epidemiologie, Technische Universität Dresden, Chemnitzer Straße 46, 01187, Dresden, Sachsen, Deutschland
| | - Julia Ernst
- Institut für Klinische Psychologie und Psychotherapie, Professur für Behaviorale Epidemiologie, Technische Universität Dresden, Chemnitzer Straße 46, 01187, Dresden, Sachsen, Deutschland
| | - Cornelia Beate Siegmund
- Institut für Klinische Psychologie und Psychotherapie, Professur für Behaviorale Epidemiologie, Technische Universität Dresden, Chemnitzer Straße 46, 01187, Dresden, Sachsen, Deutschland
| | - Patricia Theresa Porst
- Institut für Klinische Psychologie und Psychotherapie, Professur für Behaviorale Epidemiologie, Technische Universität Dresden, Chemnitzer Straße 46, 01187, Dresden, Sachsen, Deutschland
| | - Maria McDonald
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Sachsen, Deutschland
| | - Veit Roessner
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Sachsen, Deutschland
| | - Susanne Knappe
- Institut für Klinische Psychologie und Psychotherapie, Professur für Behaviorale Epidemiologie, Technische Universität Dresden, Chemnitzer Straße 46, 01187, Dresden, Sachsen, Deutschland
- Evangelische Hochschule Dresden, Dresden, Sachsen, Deutschland
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Wendler-Bödicker C, Kische H, Voss C, Beesdo-Baum K. The Association Between Childhood Maltreatment and Body (dis)satisfaction in Adolescents and Young Adults from the General Population. J Trauma Dissociation 2024; 25:113-128. [PMID: 37403492 DOI: 10.1080/15299732.2023.2231927] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 06/04/2023] [Indexed: 07/06/2023]
Abstract
Adolescents with a history of childhood maltreatment are vulnerable to body dissatisfaction and associated psychopathology such as eating disorders. The aim of this study was to expand the understanding of the association between childhood maltreatment and body dissatisfaction in adolescents and young adults. In an epidemiological cohort study, N = 1,001 participants aged 14-21 years from Dresden, Germany, completed self-report measures on childhood maltreatment, body image, and self-esteem. Lifetime mental disorders were assessed in standardized clinical interviews. Data analyses included multiple regression and mediation analyses. More than one-third of the participants reported experiences of childhood maltreatment (37.4%), in which emotional neglect and abuse were the most frequent subtypes. Individuals with a history of childhood maltreatment showed significantly less satisfaction with their physical appearance than participants without such adverse experiences. In a single mediator model, self-esteem emerged as potential mediator in the association between child maltreatment and body (dis)satisfaction. Experiences of childhood maltreatment may be considered as risk factor for the development of body dissatisfaction in adolescents, and the role of potential mediator variables such as self-esteem warrants further prospective research.
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Affiliation(s)
- Christine Wendler-Bödicker
- Institute of Clinical Psychology and Psychotherapy Behavioral Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Hanna Kische
- Institute of Clinical Psychology and Psychotherapy Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany
| | - Catharina Voss
- Institute of Clinical Psychology and Psychotherapy Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany
| | - Katja Beesdo-Baum
- Institute of Clinical Psychology and Psychotherapy Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany
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Kische H, Voss C, Haring R, Ollmann TM, Pieper L, Kirschbaum C, Beesdo-Baum K. Hair androgen concentrations and depressive disorders in adolescents from the general population. Eur Child Adolesc Psychiatry 2023; 32:1375-1389. [PMID: 35112167 PMCID: PMC10326161 DOI: 10.1007/s00787-021-01929-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 07/30/2021] [Accepted: 12/12/2021] [Indexed: 11/26/2022]
Abstract
Although the link between androgens and depression is well established in adults, the effects of cofactors on this association are less clearly understood, particularly in youth. Epidemiological cohort study of adolescents in Dresden, Germany. Analyses comprised data of 985 individuals assessed at baseline and of 512 individuals at 1-year follow-up. We investigated multivariable regression models for cross-sectional and longitudinal associations of hair testosterone, dehydroepiandrosterone (DHEA), and their cortisol ratios with 12-month diagnoses of major depressive disorder (MDD) and MDD without any anxiety disorder assessed with standardized diagnostic interview (DIA-X-5), and with dimensional depression scores (PHQ-9, PROMIS), separately for males and females. The potential moderating effect of social support was determined. Cross-sectional analyses yielded inverse associations of testosterone and DHEA with MDD and MDD without any anxiety disorders in males. In cross-sectional and longitudinal analyses, baseline ratio cortisol/DHEA was significantly, inversely associated to PROMIS-depression in males. Only cross-sectional associations for ratio cortisol/DHEA and PROMIS-depression remained significant after Bonferroni-Holm correction. No robust associations were observed in female participants. Social support exerted no consistent moderating effect on the investigated association. The present observational cohort study showed no consistent association of hair androgen concentrations with depressive disorders in adolescents. However, findings provide some support for the association between the cortisol/DHEA ratio and depression in males. Longitudinal research designs in large samples are needed to understand the interplay between androgens, depression, and developmental and social factors in youth.
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Affiliation(s)
- Hanna Kische
- Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany.
| | - Catharina Voss
- Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
| | - Robin Haring
- Faculty of Applied Public Health, European University of Applied Sciences, Rostock, Germany
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Theresa Magdalena Ollmann
- Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
| | - Lars Pieper
- Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
- Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Clemens Kirschbaum
- Department of Biopsychology, Technische Universität Dresden, Dresden, Germany
| | - Katja Beesdo-Baum
- Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
- Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
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9
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Peschel SKV, Fürtjes S, Voss C, Sigrist C, Berwanger J, Ollmann TM, Kische H, Rückert F, Koenig J, Beesdo-Baum K. Temporal associations between experiential avoidance and disordered eating behaviors in adolescents and young adults: findings from an epidemiological cohort study with ecological momentary assessment. Eat Weight Disord 2023; 28:58. [PMID: 37405497 DOI: 10.1007/s40519-023-01584-x] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 06/27/2023] [Indexed: 07/06/2023] Open
Abstract
PURPOSE Previous studies linking experiential avoidance (EA) and eating pathology have largely relied on single measurements based on traditional retrospective questionnaires. Taking advantage of available repeated assessments of EA and disordered eating behaviors (DEBs) in the everyday lives of young people from an epidemiological cohort, we aimed to investigate ecologically valid temporal associations between these constructs. METHODS A random population sample of N = 1180 14-21-year-olds from Dresden, Germany, participated at baseline (2015/2016). As part of smartphone-based ecological momentary assessment (EMA), participants reported on engagement in EA and four DEBs (skipping eating, eating large amounts of food, loss-of-control eating, and restrained eating) up to eight times per day for four days. Multilevel modeling of concurrent and time-lagged associations between EA and DEBs, was conducted among those with at least 50% EMA-compliance (n = 1069). RESULTS EA was associated with higher concurrent levels of all four types of concurrent DEBs. In addition, EA significantly predicted subsequent levels of restrained eating. Only loss-of-control eating significantly predicted subsequent EA, and this effect depended on the timespan between consecutive assessments. When this timespan was short, higher Loss-of-control eating predicted lower subsequent EA, while it predicted higher subsequent EA when the timespan was longer. CONCLUSION The present findings suggest that EA is temporally closely linked to greater engagement in DEBs, supporting theoretical assumptions that DEBs may serve an attempted avoidance function in the context of unpleasant inner experiences. Future studies may benefit from examining samples with more pronounced eating pathology. LEVEL OF EVIDENCE Level IV: Evidence obtained from multiple time series with or without the intervention, such as case studies.
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Affiliation(s)
- Stephanie K V Peschel
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
| | - Sophia Fürtjes
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Catharina Voss
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Christine Sigrist
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Johanna Berwanger
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Theresa M Ollmann
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Hanna Kische
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Frank Rückert
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Julian Koenig
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Katja Beesdo-Baum
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
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10
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Asselmann E, Zenker M, Rückert F, Kische H, Pieper L, Beesdo-Baum K. Ecological momentary assessment and applied relaxation: Results of a randomized indicated preventive trial in individuals at increased risk for mental disorders. PLoS One 2023; 18:e0286750. [PMID: 37289760 PMCID: PMC10249886 DOI: 10.1371/journal.pone.0286750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 05/19/2023] [Indexed: 06/10/2023] Open
Abstract
Applied Relaxation (AR) is an established behavioral mental health intervention, but its efficacy in real life contexts remains unclear. Using randomized controlled trial data, we examined whether AR can effectively reduce mental health problems in daily life. A sample of 277 adults with increased psychopathological symptoms but without 12-month DSM-5 mental disorders at study entry was randomly assigned to an intervention group receiving AR training (n = 139) and an assessment-only control group (n = 138). Ecological momentary assessments were used to assess psychological outcomes in daily life over a period of seven days at baseline, post, and 12-month follow-up, respectively. Multilevel analyses indicated that all psychopathological symptoms decreased more in the intervention group than in the control group from baseline to post (range β = -0.31 for DASS-depression to β = -0.06 for PROMIS-anger). However, from post to follow-up, psychopathological symptoms decreased more in the control group than in the intervention group, so that only the intervention effects for PROMIS-depression (β = -0.10) and PROMIS-anger (β = -0.09) remained until follow-up. Moreover, positive affect (β = 0.19), internal control beliefs (β = 0.15), favorable coping (β = 0.60), and unfavorable coping (β = -0.41) improved more in the intervention group than in the control group, and these effects were mostly maintained in the long term. Some effects were stronger among women, older individuals, and individuals with higher initial symptoms. These findings suggest that AR can effectively reduce mental health problems in daily life. Trial registration. The trial has been registered at ClinicalTrials.gov (NCT03311529).
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Affiliation(s)
- Eva Asselmann
- Department of Psychology, Institute for Mental Health and Behavioral Medicine, HMU Health and Medical University, Potsdam, Germany
- Faculty of Psychology, Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany
| | - Monique Zenker
- Faculty of Psychology, Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany
| | - Frank Rückert
- Faculty of Psychology, Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany
| | - Hanna Kische
- Faculty of Psychology, Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany
| | - Lars Pieper
- Faculty of Psychology, Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany
| | - Katja Beesdo-Baum
- Faculty of Psychology, Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany
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11
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Groenewold NA, Bas-Hoogendam JM, Amod AR, Laansma MA, Van Velzen LS, Aghajani M, Hilbert K, Oh H, Salas R, Jackowski AP, Pan PM, Salum GA, Blair JR, Blair KS, Hirsch J, Pantazatos SP, Schneier FR, Talati A, Roelofs K, Volman I, Blanco-Hinojo L, Cardoner N, Pujol J, Beesdo-Baum K, Ching CRK, Thomopoulos SI, Jansen A, Kircher T, Krug A, Nenadić I, Stein F, Dannlowski U, Grotegerd D, Lemke H, Meinert S, Winter A, Erb M, Kreifelts B, Gong Q, Lui S, Zhu F, Mwangi B, Soares JC, Wu MJ, Bayram A, Canli M, Tükel R, Westenberg PM, Heeren A, Cremers HR, Hofmann D, Straube T, Doruyter AGG, Lochner C, Peterburs J, Van Tol MJ, Gur RE, Kaczkurkin AN, Larsen B, Satterthwaite TD, Filippi CA, Gold AL, Harrewijn A, Zugman A, Bülow R, Grabe HJ, Völzke H, Wittfeld K, Böhnlein J, Dohm K, Kugel H, Schrammen E, Zwanzger P, Leehr EJ, Sindermann L, Ball TM, Fonzo GA, Paulus MP, Simmons A, Stein MB, Klumpp H, Phan KL, Furmark T, Månsson KNT, Manzouri A, Avery SN, Blackford JU, Clauss JA, Feola B, Harper JC, Sylvester CM, Lueken U, Veltman DJ, Winkler AM, Jahanshad N, Pine DS, Thompson PM, Stein DJ, Van der Wee NJA. Volume of subcortical brain regions in social anxiety disorder: mega-analytic results from 37 samples in the ENIGMA-Anxiety Working Group. Mol Psychiatry 2023; 28:1079-1089. [PMID: 36653677 PMCID: PMC10804423 DOI: 10.1038/s41380-022-01933-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 10/31/2022] [Accepted: 12/15/2022] [Indexed: 01/20/2023]
Abstract
There is limited convergence in neuroimaging investigations into volumes of subcortical brain regions in social anxiety disorder (SAD). The inconsistent findings may arise from variations in methodological approaches across studies, including sample selection based on age and clinical characteristics. The ENIGMA-Anxiety Working Group initiated a global mega-analysis to determine whether differences in subcortical volumes can be detected in adults and adolescents with SAD relative to healthy controls. Volumetric data from 37 international samples with 1115 SAD patients and 2775 controls were obtained from ENIGMA-standardized protocols for image segmentation and quality assurance. Linear mixed-effects analyses were adjusted for comparisons across seven subcortical regions in each hemisphere using family-wise error (FWE)-correction. Mixed-effects d effect sizes were calculated. In the full sample, SAD patients showed smaller bilateral putamen volume than controls (left: d = -0.077, pFWE = 0.037; right: d = -0.104, pFWE = 0.001), and a significant interaction between SAD and age was found for the left putamen (r = -0.034, pFWE = 0.045). Smaller bilateral putamen volumes (left: d = -0.141, pFWE < 0.001; right: d = -0.158, pFWE < 0.001) and larger bilateral pallidum volumes (left: d = 0.129, pFWE = 0.006; right: d = 0.099, pFWE = 0.046) were detected in adult SAD patients relative to controls, but no volumetric differences were apparent in adolescent SAD patients relative to controls. Comorbid anxiety disorders and age of SAD onset were additional determinants of SAD-related volumetric differences in subcortical regions. To conclude, subtle volumetric alterations in subcortical regions in SAD were detected. Heterogeneity in age and clinical characteristics may partly explain inconsistencies in previous findings. The association between alterations in subcortical volumes and SAD illness progression deserves further investigation, especially from adolescence into adulthood.
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Affiliation(s)
- Nynke A Groenewold
- Neuroscience Institute, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
- South African Medical Research Council (SA-MRC) Unit on Child and Adolescent Health, Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.
| | - Janna Marie Bas-Hoogendam
- Department of Psychiatry, Leiden University Medical Center, Leiden, Netherlands
- Department of Developmental and Educational Psychology, Institute of Psychology, Leiden University, Leiden, Netherlands
- Leiden Institute for Brain and Cognition, Leiden, Netherlands
| | - Alyssa R Amod
- Neuroscience Institute, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Max A Laansma
- Department of Anatomy & Neurosciences, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Laura S Van Velzen
- Orygen & Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Moji Aghajani
- Leiden University, Institute of Education & Child Studies, Section Forensic Family & Youth Care, Leiden, Netherlands
| | - Kevin Hilbert
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Hyuntaek Oh
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Ramiro Salas
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
- Michael E DeBakey VA Medical Center, Center for Translational Research on Inflammatory Diseases, Houston, TX, USA
| | - Andrea P Jackowski
- LiNC, Department of Psychiatry, Federal University of São Paulo, São Paulo, SP, Brazil
| | - Pedro M Pan
- LiNC, Department of Psychiatry, Federal University of São Paulo, São Paulo, SP, Brazil
| | - Giovanni A Salum
- Section on Negative Affect and Social Processes, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - James R Blair
- Child and Adolescent Mental Health Centre, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
| | - Karina S Blair
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Joy Hirsch
- Departments of Psychiatry & Neurobiology, Yale School of Medicine, New Haven, CT, USA
| | - Spiro P Pantazatos
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Franklin R Schneier
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Ardesheer Talati
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Karin Roelofs
- Donders Institute for Brain, Cognition and Behavior, Radboud University Behavioral Science Institute, Radboud University, Nijmegen, Netherlands
| | - Inge Volman
- Wellcome Centre for Integrative Neuroimaging Neuroimaging (WIN), Centre for Functional MRI of the Brain (FMRIB), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK
| | - Laura Blanco-Hinojo
- MRI Research Unit, Department of Radiology, Hospital del Mar, Barcelona, Spain
- Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM G21, Barcelona, Spain
| | - Narcís Cardoner
- Department of Mental Health, University Hospital Parc Taulí-I3PT, Barcelona, Spain, Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Carlos III Health Institute, Madrid, Spain
| | - Jesus Pujol
- MRI Research Unit, Department of Radiology, Hospital del Mar, Barcelona, Spain
- Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM G21, Barcelona, Spain
| | - Katja Beesdo-Baum
- Behavioral Epidemiology, Institute of Clinical Psycholog and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Christopher R K Ching
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Sophia I Thomopoulos
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Andreas Jansen
- Core-Facility Brainimaging, Faculty of Medicine, University of Marburg, Marburg, Germany
| | - Tilo Kircher
- Department of Psychiatry, University of Marburg, Marburg, Germany
| | - Axel Krug
- Department of Psychiatry, University of Marburg, Marburg, Germany
- Department of Psychiatry, University Hospital of Bonn, Bonn, Germany
| | - Igor Nenadić
- Department of Psychiatry, University of Marburg, Marburg, Germany
| | - Frederike Stein
- Department of Psychiatry, University of Marburg, Marburg, Germany
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Dominik Grotegerd
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Hannah Lemke
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Susanne Meinert
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
- Institute for Translational Neuroscience, University of Münster, Münster, Germany
| | - Alexandra Winter
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Michael Erb
- Department of Biomedical Magnetic Resonance, University of Tübingen, Tübingen, Germany
| | - Benjamin Kreifelts
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University of Tübingen, Tübingen, Germany
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Su Lui
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Fei Zhu
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Benson Mwangi
- Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Jair C Soares
- Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Mon-Ju Wu
- Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Ali Bayram
- Department of Neuroscience, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Istanbul, Turkey
| | - Mesut Canli
- Department of Physiology, Istanbul University, Istanbul, Turkey
| | - Raşit Tükel
- Department of Psychiatry, Istanbul University, Istanbul, Turkey
| | - P Michiel Westenberg
- Department of Developmental and Educational Psychology, Institute of Psychology, Leiden University, Leiden, Netherlands
- Leiden Institute for Brain and Cognition, Leiden, Netherlands
| | - Alexandre Heeren
- Psychological Science Research Institute, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Henk R Cremers
- Department of Clinical Psychology, University of Amsterdam, Amsterdam, Netherlands
| | - David Hofmann
- Institute of Medical Psychology and Systems Neuroscience, University of Münster, Münster, Germany
| | - Thomas Straube
- Institute of Medical Psychology and Systems Neuroscience, University of Münster, Münster, Germany
| | | | - Christine Lochner
- SA-MRC Unit on Risk and Resilience in Mental Disorders, Stellenbosch University, Stellenbosch, South Africa
| | - Jutta Peterburs
- Institute of Systems Medicine and Faculty of Human Medicine, MSH Medical School Hamburg, Hamburg, Germany
| | - Marie-José Van Tol
- Cognitive Neuroscience Center, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Raquel E Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Bart Larsen
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Courtney A Filippi
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Andrea L Gold
- Department of Psychiatry and Human Behavior, Brown University Warren Alpert Medical School, Providence, RI, USA
| | - Anita Harrewijn
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - André Zugman
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Robin Bülow
- Institute for Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Hans J Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Greifswald, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Katharina Wittfeld
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Greifswald, Germany
| | - Joscha Böhnlein
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Katharina Dohm
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Harald Kugel
- University Clinic for Radiology, University of Münster, Münster, Germany
| | - Elisabeth Schrammen
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Peter Zwanzger
- KBO-Inn-Salzach-Klinikum, Munich, Germany
- Department of Psychiatry and Psychotherapy, Ludwig Maximilians University of Munich, Munich, Germany
| | - Elisabeth J Leehr
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Lisa Sindermann
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Tali M Ball
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Gregory A Fonzo
- Department of Psychiatry and Behavioral Sciences, The University of Texas at Austin Dell Medical School, Austin, TX, USA
| | | | - Alan Simmons
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Murray B Stein
- Departments of Psychiatry & School of Public Health, University of California, San Diego, La Jolla, CA, USA
| | - Heide Klumpp
- Departments of Psychology & Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - K Luan Phan
- Department of Psychiatry & Behavioral Health, the Ohio State University, Columbus, OH, USA
| | - Tomas Furmark
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | | | | | - Suzanne N Avery
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | | | - Brandee Feola
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Chad M Sylvester
- Department of Psychiatry, Washington University, St. Louis, MO, USA
| | - Ulrike Lueken
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Dick J Veltman
- Department of Psychiatry, Amsterdam UMC location VUMC, Amsterdam, Netherlands
| | - Anderson M Winkler
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Neda Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Daniel S Pine
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Dan J Stein
- Neuroscience Institute, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- SA-MRC Unit on Risk & Resilience in Mental Disorders, University of Cape Town, Cape Town, South Africa
| | - Nic J A Van der Wee
- Department of Psychiatry, Leiden University Medical Center, Leiden, Netherlands
- Leiden Institute for Brain and Cognition, Leiden, Netherlands
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Seidl E, Venz J, Ollmann TM, Voss C, Hoyer J, Pieper L, Beesdo-Baum K. Dynamics of affect, cognition and behavior in a general population sample of adolescents and young adults with current and remitted anxiety disorders: An Ecological Momentary Assessment study. J Anxiety Disord 2023; 93:102646. [PMID: 36427380 DOI: 10.1016/j.janxdis.2022.102646] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 01/04/2022] [Revised: 10/24/2022] [Accepted: 11/07/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND Measures of dynamic changes in affect/emotions (variability, instability, inertia) have been linked to anxiety disorders (AD). We examine dynamics in affect, cognition and behavior in youth with current and remitted AD. METHODS Mental disorders were assessed in a general population sample (N = 1180, age 14-21; Dresden, Germany) using standardized interview. Ecological Momentary Assessment of real-life affect, cognition and behavior took place eight times/day for four days. RESULTS Individuals with current AD (n = 65) compared to healthy controls (HC, n = 531) revealed heightened variability of anxious and manic symptomatology, experiential avoidance, optimism and positive thoughts. Remitted AD (n = 52) showed lower variability of anxious and manic symptomatology and positive thoughts compared to current AD, while no differences were found compared to HC. Current AD and HC differed significantly in instability. Remitted AD showed lower instability of all constructs except for anger than current AD, and higher instability on all constructs except for positive and negative thoughts compared to HC. Current AD showed higher inertia of anger and negative thoughts than HC, and less inertia of positive thoughts than remitted AD. DISCUSSION AD in youths is particularly linked to higher variability and instability of intertwined emotion-related experiences that partly persist after remission, informing emotion regulation models and interventions.
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Affiliation(s)
- Esther Seidl
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Research Group Security and Privacy, Faculty of Computer Science, University of Vienna, Austria
| | - John Venz
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Theresa Magdalena Ollmann
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Catharina Voss
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Jana Hoyer
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Lars Pieper
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Katja Beesdo-Baum
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
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13
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Kische H, Voss C, Pieper L, Beesdo-Baum K. ODP029 Associations between Objective and Subjective Indicators of Stress and Sleep Disturbance in Adolescents and Young Adults from the General Population. J Endocr Soc 2022. [DOI: 10.1210/jendso/bvac150.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Abstract
Background
Sleep is a complex and dynamic vital state, occupying one third of human's lifetime. Disturbed sleep can be a symptom of and a risk factor for a wide range of mental disorders and somatic diseases. One pathway through which sleep problems may lead to health problems is by dysregulation of the body's physiological stress response system as indicated by aberrant cortisol. Previous findings showed that poor sleep quality and sleep disruption were associated with elevated cortisol levels in adults. Regarding adolescents, there is evidence that sleep problems are linked to hyper-reactivity to stress with effects being stronger in girls than boys. In addition, adolescence itself was associated with decreased sleep quality and an increase in perceived stress dependent on age. However, little evidence is available for the association between objective and subjective stress markers and sleep in the daily life of adolescents from the general population. The aim of this study was to examine the association between 1) cortisol and 2) subjective stress with sleep in adolescents and young adults.
Methods
We used baseline data (11/2015–12/2016) of the Behavior and Mind Health(BeMIND) study, an epidemiological study based on a random community sample of individuals aged 14 to 21 years (Dresden, Germany, N = 1,180). We assessed sleep disturbance with the short form of the PROMIS Sleep-Disturbance questionnaire (8 items) via Ecological Momentary Assessment, conducted on four days directly after awakening, calculated mean. Cortisol was measured in hair (pg/mg) and saliva (nmol/l). Cortisol awakening response and total cortisol were calculated. Subjective stress was assessed via 1) the Perceived Stress Scale (PSS), 2) the Trier Inventory of the Assessment of Chronic Stress-Screening (TICS), and 3) two items for time urgency (subjective stress in school/at work/university and leisure, self-developed). Weighted linear regressions with robust standard errors were performed after exclusions (n = 1132, 48.4% female). Models were adjusted for sex, age, pubertal development and rerun in sex-specific analyses.
Results
Mean age was 17.83 (SD 0. 07). Neither hair, nor saliva cortisol was associated with PROMIS Sleep (hair cortisol: unstandardized β-coefficient: -0. 002, 95% confidence interval (CI): -0. 012; 0. 007). All analyzed subjective stress variables were associated with PROMIS Sleep. We found positive associations between PSS (β-coefficient: 0.151, 95% CI: 0.117; 0.183), TICS (β-coefficient: 0. 056, 95% CI: 0. 045; 0. 066), and time urgency (β-coefficient: 0.114, 95% CI: 0. 061; 0.166) with sleep. There was no evidence for sex-specific effects.
Conclusion
Results confirmed the association between perceived stress and sleep in a population-based study with adolescents and young adults, that was previously shown mainly in adults. No evidence for a link between cortisol and sleep was found. Further analyses would benefit from a longitudinal perspective and consideration of mediating/moderation variables to elucidate the complex interplay between stress and sleep.
Presentation: No date and time listed
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Beesdo-Baum K, Zenker M, Rückert F, Kische H, Pieper L, Asselmann E. Efficacy of Applied Relaxation as indicated preventive intervention in individuals at increased risk for mental disorders: A randomized controlled trial. Behav Res Ther 2022; 157:104162. [DOI: 10.1016/j.brat.2022.104162] [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] [Received: 03/26/2021] [Revised: 06/07/2022] [Accepted: 07/08/2022] [Indexed: 11/02/2022]
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Kische H, Ollmann TM, Voss C, Hoyer J, Rückert F, Pieper L, Kirschbaum C, Beesdo-Baum K. Corrigendum to "Associations of saliva cortisol and hair cortisol with generalized anxiety, social anxiety, and major depressive disorder: An epidemiological cohort study in adolescents and young adults" [Psychoneuroendocrinology 126 (2021)]. Psychoneuroendocrinology 2022; 141:105797. [PMID: 35595616 DOI: 10.1016/j.psyneuen.2022.105797] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Hanna Kische
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universit¨at Dresden, Dresden, Germany.
| | - Theresa Magdalena Ollmann
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universit¨at Dresden, Dresden, Germany
| | - Catharina Voss
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universit¨at Dresden, Dresden, Germany
| | - Jana Hoyer
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universit¨at Dresden, Dresden, Germany; Centre for Obesity, St¨adtisches Klinikum Dresden, Dresden, Germany
| | - Frank Rückert
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universit¨at Dresden, Dresden, Germany
| | - Lars Pieper
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universit¨at Dresden, Dresden, Germany; Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Institute of Clinical Psychology and Psychotherapy, Technische Universit¨at Dresden, Dresden, Germany
| | - Clemens Kirschbaum
- Department of Biopsychology, Technische Universit¨at Dresden, Dresden, Germany
| | - Katja Beesdo-Baum
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universit¨at Dresden, Dresden, Germany; Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Institute of Clinical Psychology and Psychotherapy, Technische Universit¨at Dresden, Dresden, Germany
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Walther A, Mackens-Kiani A, Eder J, Herbig M, Herold C, Kirschbaum C, Guck J, Wittwer LD, Beesdo-Baum K, Kräter M. Depressive disorders are associated with increased peripheral blood cell deformability: a cross-sectional case-control study (Mood-Morph). Transl Psychiatry 2022; 12:150. [PMID: 35396373 PMCID: PMC8990596 DOI: 10.1038/s41398-022-01911-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 03/17/2022] [Accepted: 03/22/2022] [Indexed: 11/26/2022] Open
Abstract
Pathophysiological landmarks of depressive disorders are chronic low-grade inflammation and elevated glucocorticoid output. Both can potentially interfere with cytoskeleton organization, cell membrane bending and cell function, suggesting altered cell morpho-rheological properties like cell deformability and other cell mechanical features in depressive disorders. We performed a cross-sectional case-control study using the image-based morpho-rheological characterization of unmanipulated blood samples facilitating real-time deformability cytometry (RT-DC). Sixty-nine pre-screened individuals at high risk for depressive disorders and 70 matched healthy controls were included and clinically evaluated by Composite International Diagnostic Interview leading to lifetime and 12-month diagnoses. Facilitating deep learning on blood cell images, major blood cell types were classified and morpho-rheological parameters such as cell size and cell deformability of every individual cell was quantified. We found peripheral blood cells to be more deformable in patients with depressive disorders compared to controls, while cell size was not affected. Lifetime persistent depressive disorder was associated with increased cell deformability in monocytes and neutrophils, while in 12-month persistent depressive disorder erythrocytes deformed more. Lymphocytes were more deformable in 12-month major depressive disorder, while for lifetime major depressive disorder no differences could be identified. After correction for multiple testing, only associations for lifetime persistent depressive disorder remained significant. This is the first study analyzing morpho-rheological properties of entire blood cells and highlighting depressive disorders and in particular persistent depressive disorders to be associated with increased blood cell deformability. While all major blood cells tend to be more deformable, lymphocytes, monocytes, and neutrophils are mostly affected. This indicates that immune cell mechanical changes occur in depressive disorders, which might be predictive of persistent immune response.
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Affiliation(s)
- Andreas Walther
- Biopsychology, TU Dresden, Dresden, Germany. .,Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland.
| | - Anne Mackens-Kiani
- grid.4488.00000 0001 2111 7257Biopsychology, TU Dresden, Dresden, Germany
| | - Julian Eder
- grid.4488.00000 0001 2111 7257Biopsychology, TU Dresden, Dresden, Germany
| | - Maik Herbig
- grid.4488.00000 0001 2111 7257Center for Molecular and Cellular Bioengineering, Biotechnology Center, TU Dresden, Dresden, Germany ,grid.419562.d0000 0004 0374 4283Max Planck Institute for the Science of Light & Max-Planck-Zentrum für Physik und Medizin, Erlangen, Germany
| | - Christoph Herold
- grid.4488.00000 0001 2111 7257Center for Molecular and Cellular Bioengineering, Biotechnology Center, TU Dresden, Dresden, Germany ,Zellmechanik Dresden GmbH, Dresden, Germany
| | - Clemens Kirschbaum
- grid.4488.00000 0001 2111 7257Biopsychology, TU Dresden, Dresden, Germany
| | - Jochen Guck
- grid.4488.00000 0001 2111 7257Center for Molecular and Cellular Bioengineering, Biotechnology Center, TU Dresden, Dresden, Germany ,grid.419562.d0000 0004 0374 4283Max Planck Institute for the Science of Light & Max-Planck-Zentrum für Physik und Medizin, Erlangen, Germany
| | - Lucas Daniel Wittwer
- grid.419562.d0000 0004 0374 4283Max Planck Institute for the Science of Light & Max-Planck-Zentrum für Physik und Medizin, Erlangen, Germany ,grid.434947.90000 0004 0643 2840Faculty of Informatics/Mathematics, HTW Dresden, Dresden, Germany
| | - Katja Beesdo-Baum
- grid.4488.00000 0001 2111 7257Behavioral Epidemiology, TU Dresden, Dresden, Germany
| | - Martin Kräter
- grid.4488.00000 0001 2111 7257Center for Molecular and Cellular Bioengineering, Biotechnology Center, TU Dresden, Dresden, Germany ,grid.419562.d0000 0004 0374 4283Max Planck Institute for the Science of Light & Max-Planck-Zentrum für Physik und Medizin, Erlangen, Germany
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Ollmann TM, Seidl E, Venz J, Pieper L, Voss C, Hoyer J, Kische H, Poppenhäger SR, Schiele MA, Domschke K, Beesdo-Baum K. 5-HTT genotype and inertia of negative affect in adolescents and young adults from the general population. J Neural Transm (Vienna) 2022; 129:343-351. [PMID: 35246765 PMCID: PMC8930868 DOI: 10.1007/s00702-022-02459-8] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 01/03/2022] [Indexed: 11/28/2022]
Abstract
The study aims to replicate the previous found association of 5-HTTLPR and inertia of negative affect in daily life of adolescents and young adults. Data of 877 adolescents (aged 14–21 years) of the Behavior and Mind Health (BeMIND) study (epidemiological cohort study, Dresden, Germany) were genotyped for 5-HTTLPR/rs25531, grouped into SS/SLG/SLA/LGLA/LGLG vs. LALA, and provided ratings on negative affect items, depression and anxiety (Patient-Reported Outcomes Measurement Information System) eight times a day over 4 days. Multilevel regression models did not reveal an association of 5-HTTLPR genotype and inertia of negative affect, nor associations with inertia of anxiety or depression. Inertia of negative affect seems not to be a psychological mechanism through which 5-HTTLPR acts on psychopathology.
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Affiliation(s)
- T. M. Ollmann
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany
| | - E. Seidl
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany
| | - J. Venz
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany
- Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - L. Pieper
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany
- Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - C. Voss
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany
| | - J. Hoyer
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany
| | - H. Kische
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany
| | - S. R. Poppenhäger
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany
| | - M. A. Schiele
- Department of Psychiatry and Psychotherapy, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - K. Domschke
- Department of Psychiatry and Psychotherapy, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Center for Basics in NeuroModulation, Medical Faculty, University of Freiburg, Freiburg, Germany
| | - K. Beesdo-Baum
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany
- Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
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Knappe S, Martini J, Muris P, Wittchen HU, Beesdo-Baum K. Progression of externalizing disorders into anxiety disorders: Longitudinal transitions in the first three decades of life. J Anxiety Disord 2022; 86:102533. [PMID: 35092927 DOI: 10.1016/j.janxdis.2022.102533] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 03/07/2021] [Revised: 12/06/2021] [Accepted: 01/09/2022] [Indexed: 01/23/2023]
Abstract
BACKGROUND There is a notable comorbidity between externalizing disorders and anxiety disorders, which may be explained by the co-occurrence of two prevalent early-onset disorders, by shared vulnerability and risk factors, or as evidence that one disorder group might be causally related to the other. AIM To investigate the longitudinal trajectories of externalizing disorders, their interplay with anxiety disorders, and putative predictors for symptom progression in youth. METHODS 1053 adolescents (14-17 years) from the general population were assessed at baseline and prospectively at 2, 4, and 10-year follow-up using a standardized interview of mental disorders (DIA-X/M-CIDI) to assess "early" (oppositional-defiant disorder, conduct disorder, ADHD) and "late" (antisocial behavior, substance use disorders) externalizing disorders as well as anxiety disorders. Longitudinal associations and predictors for symptom progression were examined using Kaplan-Meier-analyses. RESULTS Lifetime prevalence of early externalizing disorders were 9.1% and 6.4% among those with and without any anxiety disorder. A late externalizing disorder was reported by 50.3% of those with an early externalizing disorder and in 26.6% of those with any anxiety disorder. Both early (HR: 1.5, 95%CI: 1.0-2.3) and late externalizing disorders (HR: 2.1, 95%CI: 1.7-2.6) were associated with incident anxiety disorders. Higher parental rejection, lower volitional inhibition, and higher volitional avoidance predicted incident anxiety disorders among those with early externalizing disorders. DISCUSSION Early externalizing disorders likely follow a homotypic continuity (to late externalizing disorders) and/or a heterotypic continuity to anxiety disorders, and thus appear as a useful target for prevention and early intervention.
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Affiliation(s)
- Susanne Knappe
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 36, 01187 Dresden, Germany; Evangelische Hochschule Dresden (ehs), University of Applied Sciences for Social Work, Education and Nursing, Dürerstr. 25, 01307 Dresden, Germany.
| | - Julia Martini
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 36, 01187 Dresden, Germany; Department of Psychiatry & Psychotherapy, Faculty of Medicine, Carl Gustav Carus University Hospital, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany.
| | - Peter Muris
- Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
| | - Hans-Ulrich Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 36, 01187 Dresden, Germany; Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität München, Nußbaumstr. 7, 80336 Munich, Germany.
| | - Katja Beesdo-Baum
- Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Chemnitzer Str. 36, 01187 Dresden, Germany.
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Weniger M, Beesdo-Baum K, Roessner V, Hense H, Knappe S. Wie gelingt die Prävention psychischer Beschwerden? Präv Gesundheitsf 2022. [PMCID: PMC7934121 DOI: 10.1007/s11553-021-00838-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Hintergrund Emotionale und Verhaltensprobleme in der Kindheit haben oft weitreichende Folgen für die soziale, emotionale und kognitive Entwicklung, sodass ihrer Prävention ein hoher Stellenwert zukommt. Dennoch ist die Inanspruchnahme von Präventionsmaßnahmen im Kindesalter gering. Ziel In einer versorgungsepidemiologischen Implementationsstudie wird untersucht, inwiefern durch ein systematisches Screening eingebettet in U‑Untersuchungen die Identifikation von Risikokindern und die Zuweisung zu Präventionsprogrammen gelingt. Methoden Dazu ist ein Screening mittels „Strengths and Difficulties Questionnaire“ während der regulären Gesundheitsuntersuchungen (U9–U11) von ca. 3500 Kindern im Alter von 5 bis 10 Jahren in ca. 53 Arztpraxen in Dresden und 20 km Umkreis geplant. Die Eltern erhalten von der Fachkraft für Kinderheilkunde eine Rückmeldung zu den Ergebnissen und im Falle von grenzwertigen Werten auf den Subskalen „Emotionale Probleme“ und/oder „Verhaltensprobleme“ eine Empfehlung für ein indikatives Präventionsprogramm. Zu vier Messzeitpunkten werden Familien mittels standardisierter und projektspezifischer Fragebogen befragt. Zusätzlich erfolgen leitfadengestützte Interviews mit Leistungserbringern und Familien. Ergebnisse und Schlussfolgerung Es werden die Machbarkeit, Nützlichkeit und Akzeptanz eines Screenings für emotionale und Verhaltensauffälligkeiten bei Kindern und Präventionsempfehlungen in Kinderarztpraxen im Prä‑/Post-Vergleich und nach 12 Monaten evaluiert. Förderliche und hemmende Faktoren für die Inanspruchnahme werden bestimmt, um Empfehlungen für die Implementation von Präventionsangeboten in die Regelversorgung abzuleiten, um emotionale und Verhaltensauffälligkeiten frühzeitig zu erkennen und der Entwicklung psychischer Störungen vorzubeugen.
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Kische H, Zenker M, Pieper L, Beesdo-Baum K, Asselmann E. Applied relaxation and cortisol secretion: findings from a randomized controlled indicated prevention trial in adults with stress, anxiety, or depressive symptoms. Stress 2022; 25:122-133. [PMID: 35285766 DOI: 10.1080/10253890.2022.2045939] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Previous research has shown that relaxation interventions can reduce distress, anxiety, and depression. The exact mechanisms that underlie the efficacy of relaxation interventions remain unresolved. This study aimed to investigate whether applied relaxation (AR) leads to changes in cortisol secretion and whether these effects mediate fewer symptoms due to AR. Data come from a randomized controlled preventive interventional trial (N = 277) with elevated tension/distress, anxiety, or depressive symptomatology. Participants were randomized to an intervention group (IG; n = 139, received AR training), or a non-interventional control group (CG, n = 138). Psychopathological symptoms were assessed with DASS-21 and diagnoses of mental disorders via DIA-X-5. Cortisol was measured as short-term index in saliva (six times/d for 2 d at pre-, post-, and follow-up [FU] assessment) and long-term index in hair samples (once at pre-assessment and FU, respectively). Data were analyzed as pre-specified secondary analyses of the randomized controlled trial (RCT) on completer basis (n = 134 CG, n = 102 IG), using multivariable-adjusted linear regression models and mediation analyses (the DASS-21 change in the IG vs. CG with cortisol (area under the curve [AUC]) as mediator). From pre- to post-assessment, total daily salivary cortisol (AUC) decreased more strongly in the IG vs. CG (β-coefficient: -13.83, 95% confidence interval [CI]: -26.85 to -0.81), but was rendered non-significant when adjusting for pre-assessment AUC. This effect was not found for the cortisol awakening response (CAR) or hair cortisol. There was no evidence for a mediation of cortisol (AUC). These findings provide little support for the idea that cortisol reductions explain the beneficial effects of AR on mental health.
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Affiliation(s)
- Hanna Kische
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Monique Zenker
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Lars Pieper
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Katja Beesdo-Baum
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Eva Asselmann
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
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Harrewijn A, Cardinale EM, Groenewold NA, Bas-Hoogendam JM, Aghajani M, Hilbert K, Cardoner N, Porta-Casteràs D, Gosnell S, Salas R, Jackowski AP, Pan PM, Salum GA, Blair KS, Blair JR, Hammoud MZ, Milad MR, Burkhouse KL, Phan KL, Schroeder HK, Strawn JR, Beesdo-Baum K, Jahanshad N, Thomopoulos SI, Buckner R, Nielsen JA, Smoller JW, Soares JC, Mwangi B, Wu MJ, Zunta-Soares GB, Assaf M, Diefenbach GJ, Brambilla P, Maggioni E, Hofmann D, Straube T, Andreescu C, Berta R, Tamburo E, Price RB, Manfro GG, Agosta F, Canu E, Cividini C, Filippi M, Kostić M, Munjiza Jovanovic A, Alberton BAV, Benson B, Freitag GF, Filippi CA, Gold AL, Leibenluft E, Ringlein GV, Werwath KE, Zwiebel H, Zugman A, Grabe HJ, Van der Auwera S, Wittfeld K, Völzke H, Bülow R, Balderston NL, Ernst M, Grillon C, Mujica-Parodi LR, van Nieuwenhuizen H, Critchley HD, Makovac E, Mancini M, Meeten F, Ottaviani C, Ball TM, Fonzo GA, Paulus MP, Stein MB, Gur RE, Gur RC, Kaczkurkin AN, Larsen B, Satterthwaite TD, Harper J, Myers M, Perino MT, Sylvester CM, Yu Q, Lueken U, Veltman DJ, Thompson PM, Stein DJ, Van der Wee NJA, Winkler AM, Pine DS. Cortical and subcortical brain structure in generalized anxiety disorder: findings from 28 research sites in the ENIGMA-Anxiety Working Group. Transl Psychiatry 2021; 11:502. [PMID: 34599145 PMCID: PMC8486763 DOI: 10.1038/s41398-021-01622-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 09/02/2021] [Accepted: 09/14/2021] [Indexed: 12/22/2022] Open
Abstract
The goal of this study was to compare brain structure between individuals with generalized anxiety disorder (GAD) and healthy controls. Previous studies have generated inconsistent findings, possibly due to small sample sizes, or clinical/analytic heterogeneity. To address these concerns, we combined data from 28 research sites worldwide through the ENIGMA-Anxiety Working Group, using a single, pre-registered mega-analysis. Structural magnetic resonance imaging data from children and adults (5-90 years) were processed using FreeSurfer. The main analysis included the regional and vertex-wise cortical thickness, cortical surface area, and subcortical volume as dependent variables, and GAD, age, age-squared, sex, and their interactions as independent variables. Nuisance variables included IQ, years of education, medication use, comorbidities, and global brain measures. The main analysis (1020 individuals with GAD and 2999 healthy controls) included random slopes per site and random intercepts per scanner. A secondary analysis (1112 individuals with GAD and 3282 healthy controls) included fixed slopes and random intercepts per scanner with the same variables. The main analysis showed no effect of GAD on brain structure, nor interactions involving GAD, age, or sex. The secondary analysis showed increased volume in the right ventral diencephalon in male individuals with GAD compared to male healthy controls, whereas female individuals with GAD did not differ from female healthy controls. This mega-analysis combining worldwide data showed that differences in brain structure related to GAD are small, possibly reflecting heterogeneity or those structural alterations are not a major component of its pathophysiology.
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Affiliation(s)
- Anita Harrewijn
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA.
| | - Elise M Cardinale
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Nynke A Groenewold
- Department of Psychiatry & Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Janna Marie Bas-Hoogendam
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
- Department of Developmental and Educational Psychology, Institute of Psychology, Leiden University, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden, The Netherlands
| | - Moji Aghajani
- Department of Psychiatry, Amsterdam UMC, location VUMC, Amsterdam, The Netherlands
- Department of Research & Innovation, GGZ InGeest, Amsterdam, The Netherlands
| | - Kevin Hilbert
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Narcis Cardoner
- Department of Mental Health, University Hospital Parc Taulí-I3PT, Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Carlos III Health Institute, Madrid, Spain
| | - Daniel Porta-Casteràs
- Department of Mental Health, University Hospital Parc Taulí-I3PT, Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Carlos III Health Institute, Madrid, Spain
| | - Savannah Gosnell
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Ramiro Salas
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Andrea P Jackowski
- LiNC, Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Pedro M Pan
- LiNC, Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Giovanni A Salum
- Section on Negative Affect and Social Processes, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Karina S Blair
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, USA
| | - James R Blair
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Mira Z Hammoud
- Department of Psychiatry, NYU School of Medicine, New York University, New York, NY, USA
| | - Mohammed R Milad
- Department of Psychiatry, NYU School of Medicine, New York University, New York, NY, USA
| | - Katie L Burkhouse
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - K Luan Phan
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, OH, USA
| | - Heidi K Schroeder
- Department of Psychiatry & Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, USA
| | - Jeffrey R Strawn
- Department of Psychiatry & Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, USA
| | - Katja Beesdo-Baum
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Neda Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Sophia I Thomopoulos
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Randy Buckner
- Center for Brain Science & Department of Psychology, Harvard University, Cambridge, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Jared A Nielsen
- Center for Brain Science & Department of Psychology, Harvard University, Cambridge, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Psychology Department & Neuroscience Center, Brigham Young University, Provo, USA
| | - Jordan W Smoller
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Jair C Soares
- Center Of Excellence On Mood Disorders, Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Benson Mwangi
- Center Of Excellence On Mood Disorders, Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Mon-Ju Wu
- Center Of Excellence On Mood Disorders, Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Giovana B Zunta-Soares
- Center Of Excellence On Mood Disorders, Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Michal Assaf
- Olin Neuropsychiatry Research Center, Institute of Living, Hartford Hospital, Hartford, CT, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Gretchen J Diefenbach
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Anxiety Disorders Center, Institute of Living, Hartford Hospital, Hartford, CT, USA
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Eleonora Maggioni
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - David Hofmann
- Institute of Medical Psychology and Systems Neuroscience, University of Muenster, Muenster, Germany
| | - Thomas Straube
- Institute of Medical Psychology and Systems Neuroscience, University of Muenster, Muenster, Germany
| | - Carmen Andreescu
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Rachel Berta
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Erica Tamburo
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Rebecca B Price
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Department Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Gisele G Manfro
- Anxiety Disorder Program, Hospital de Clínicas de Porto Alegre, Department of Psychiatry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Federica Agosta
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Elisa Canu
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Camilla Cividini
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Massimo Filippi
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neurophysiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Milutin Kostić
- Institute of Mental Health, University of Belgrade, Belgrade, Serbia
- Department of Psychiatry, School of Medicine, University of Belgrade, Belgrade, Serbia
| | | | - Bianca A V Alberton
- Graduate Program in Electrical and Computer Engineering, Universidade Tecnológica Federal do Paraná, Curitiba, Puerto Rico, Brazil
| | - Brenda Benson
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Gabrielle F Freitag
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Courtney A Filippi
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Andrea L Gold
- Department of Psychiatry and Human Behavior, Brown University Warren Alpert Medical School, Providence, RI, USA
| | - Ellen Leibenluft
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Grace V Ringlein
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Kathryn E Werwath
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Hannah Zwiebel
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - André Zugman
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Hans J Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Greifswald, Germany
| | - Sandra Van der Auwera
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Greifswald, Germany
| | - Katharina Wittfeld
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Greifswald, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Robin Bülow
- Institute for Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Nicholas L Balderston
- Center for Neuromodulation in Depression and Stress, University of Pennsylvania, Philadelphia, PA, USA
| | - Monique Ernst
- Section on Neurobiology of Fear and Anxiety, National Institute of Mental Health, Bethesda, MD, USA
| | - Christian Grillon
- Section on Neurobiology of Fear and Anxiety, National Institute of Mental Health, Bethesda, MD, USA
| | | | | | - Hugo D Critchley
- Department of Neuroscience, Brighton and Sussex Medical School, University of Sussex, Brighton, UK
| | - Elena Makovac
- Centre for Neuroimaging Science, Kings College London, London, UK
| | - Matteo Mancini
- Department of Neuroscience, Brighton and Sussex Medical School, University of Sussex, Brighton, UK
| | - Frances Meeten
- School of Psychology, University of Sussex, Brighton, UK
| | - Cristina Ottaviani
- Department of Psychology, Sapienza University of Rome, Rome, Italy
- IRCCS Santa Lucia Foundation, Rome, Italy
| | - Tali M Ball
- Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Gregory A Fonzo
- Department of Psychiatry and Behavioral Sciences, The University of Texas at Austin Dell Medical School, Austin, TX, USA
| | | | - Murray B Stein
- Department of Psychiatry, School of Medicine and Herbert Wertheim School of Public Health, University of California, San Diego, La Jolla, CA, USA
| | - Raquel E Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Ruben C Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Bart Larsen
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Jennifer Harper
- Department of Psychiatry, Washington University, St. Louis, MO, USA
| | - Michael Myers
- Department of Psychiatry, Washington University, St. Louis, MO, USA
| | - Michael T Perino
- Department of Psychiatry, Washington University, St. Louis, MO, USA
| | - Chad M Sylvester
- Department of Psychiatry, Washington University, St. Louis, MO, USA
| | - Qiongru Yu
- Department of Psychiatry, Washington University, St. Louis, MO, USA
| | - Ulrike Lueken
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Dick J Veltman
- Department of Psychiatry, Amsterdam UMC, location VUMC, Amsterdam, The Netherlands
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Dan J Stein
- South African Medical Research Council Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry & Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Nic J A Van der Wee
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden, The Netherlands
| | - Anderson M Winkler
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Daniel S Pine
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
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22
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Kische H, Hannemann A, Voss C, Nauck M, Völzke H, Pieper L, Beesdo-Baum K, Arnold A. Lack of Significant Association between Sex Hormone Concentrations and Atopic Dermatitis in Adolescents and Adults in Two Population-Based Studies. J Invest Dermatol 2021; 142:486-489.e4. [PMID: 34314741 DOI: 10.1016/j.jid.2021.07.133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 06/21/2021] [Accepted: 07/13/2021] [Indexed: 01/30/2023]
Affiliation(s)
- Hanna Kische
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
| | - Anke Hannemann
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, University of Greifswald, Greifswald, Germany; German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, University Medicine Greifswald, University of Greifswald, Greifswald, Germany
| | - Catharina Voss
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, University of Greifswald, Greifswald, Germany; German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, University Medicine Greifswald, University of Greifswald, Greifswald, Germany
| | - Henry Völzke
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, University Medicine Greifswald, University of Greifswald, Greifswald, Germany; Institute for Community Medicine, University Medicine Greifswald, University of Greifswald, Greifswald, Germany
| | - Lars Pieper
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Katja Beesdo-Baum
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Andreas Arnold
- Clinic of Dermatology, University Medicine Greifswald, University of Greifswald, Greifswald, Germany
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23
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Zenker M, Venz J, Koenig J, Voss C, Beesdo-Baum K, Pieper L. Evidence for the association between physiological and emotional states in adolescents and young adults without psychopathology under ecologically valid conditions. Psychophysiology 2021; 58:e13902. [PMID: 34286859 DOI: 10.1111/psyp.13902] [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: 10/16/2020] [Revised: 06/20/2021] [Accepted: 06/29/2021] [Indexed: 11/29/2022]
Abstract
Well-powered studies on the physiological concomitants underlying affect and its regulation during emerging adulthood are warranted to provide novel insight into mental health. The association between autonomic nervous system activity and emotional states occurring under natural conditions in daily life was investigated in individuals (N = 549, age 14-21, females 45.6%) without any lifetime mental disorder from an epidemiological cohort study in Germany. Using ecological momentary assessment, mood and optimism/pessimism were assessed over 4 days simultaneously with continuous heart rate monitoring. Lower vagal activity was found in mood states accompanied by high arousal (wakefulness, mania) and greater vagal activity in mood states with low arousal (calmness, pessimism). Findings illustrate important associations between autonomic nervous system activity and mood in youth under ecologically valid conditions. Vagal activity presents a prominent pathway by which mood may influence physiological function or vice versa. In contrast to commonly performed laboratory assessments, the ambulatory assessment in participants' daily life allows an application of the results to the field.
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Affiliation(s)
- Monique Zenker
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - John Venz
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Julian Koenig
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty, University of Cologne, Cologne, Germany.,Clinic and Polyclinic for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Cologne, Cologne, Germany
| | - Catharina Voss
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Katja Beesdo-Baum
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Lars Pieper
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
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24
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Perkonigg A, Strehle J, Beesdo-Baum K, Lorenz L, Hoyer J, Venz J, Maercker A. Reliability and Validity of a German Standardized Diagnostic Interview Module for ICD-11 Adjustment Disorder. J Trauma Stress 2021; 34:275-286. [PMID: 33151596 DOI: 10.1002/jts.22597] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 07/30/2020] [Accepted: 08/04/2020] [Indexed: 02/04/2023]
Abstract
The ICD-11 includes a new definition of adjustment disorder (AjD). The present study aimed to examine interrater reliability, internal consistency, and construct validity of a new diagnostic interview module to assess ICD-11 AjD. Data from two studies that used a standardized diagnostic interview assessment (i.e., DIA-X/M-CIDI and updated DIA-X-5) were used. For interrater reliability, agreement indicators (i.e., κ) were calculated using data from the DIA-X-5 test-retest study (N = 60). To examine internal consistency and construct validity, Cronbach's alpha values and the Kuder-Richardson correlation coefficient were computed along with confirmatory factor and latent class analyses (LCA), using data from the Zurich Adjustment Disorder Study (N = 330). Interrater reliability analyses found an adjusted kappa of 0.807 for the ICD-11 AjD diagnosis. Few items from the impairment criterion of the diagnostic algorithm performed poorly. The internal consistency was acceptable, Cronbach's αs = .43-.80; the lower-bound estimate resulted from the two-item preoccupation symptom pattern. However, both items were significantly associated, OR = 3.14, 95% CI [1.97, 4.99]. Regarding LCA results, a two-class model was favored. We found that 94.3% of all ICD-11 AjD cases belonged to Class 2, OR = 23.69, 95% CI [7.15, 79.54], which was associated with subjectively rated distress, OR = 2.18, 95% CI [1.57, 3.02], and the external measure of the Brief Symptom Inventory global severity index, OR = 2.18, 95% CI [1.57, 3.02]. Overall, the new AjD interview module provided a reliable, valid assessment of the ICD-11 diagnosis; confirmation by other studies is needed.
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Affiliation(s)
- Axel Perkonigg
- University of Zurich, Department of Psychology, Psychopathology and Clinical Intervention, Zurich, Switzerland
| | - Jens Strehle
- Technische Universität Dresden, Institute of Clinical Psychology and Psychotherapy, Dresden, Germany
| | - Katja Beesdo-Baum
- Technische Universität Dresden, Institute of Clinical Psychology and Psychotherapy, Dresden, Germany.,Technische Universität Dresden, Behavioral Epidemiology & Center for Clinical Epidemiology and Longitudinal Studies, Dresden, Germany
| | - Louisa Lorenz
- University of Zurich, Department of Psychology, Psychopathology and Clinical Intervention, Zurich, Switzerland
| | - Jana Hoyer
- Technische Universität Dresden, Institute of Clinical Psychology and Psychotherapy, Dresden, Germany.,Technische Universität Dresden, Behavioral Epidemiology & Center for Clinical Epidemiology and Longitudinal Studies, Dresden, Germany
| | - John Venz
- Technische Universität Dresden, Institute of Clinical Psychology and Psychotherapy, Dresden, Germany.,Technische Universität Dresden, Behavioral Epidemiology & Center for Clinical Epidemiology and Longitudinal Studies, Dresden, Germany
| | - Andreas Maercker
- University of Zurich, Department of Psychology, Psychopathology and Clinical Intervention, Zurich, Switzerland
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25
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Kische H, Ollmann TM, Voss C, Hoyer J, Rückert F, Pieper L, Kirschbaum C, Beesdo-Baum K. Associations of saliva cortisol and hair cortisol with generalized anxiety, social anxiety, and major depressive disorder: An epidemiological cohort study in adolescents and young adults. Psychoneuroendocrinology 2021; 126:105167. [PMID: 33592366 DOI: 10.1016/j.psyneuen.2021.105167] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 02/04/2021] [Accepted: 02/04/2021] [Indexed: 01/04/2023]
Abstract
OBJECTIVES Most of the observed associations of generalized anxiety disorder (GAD), social anxiety disorder (SAD) and major depressive disorder (MDD) with cortisol concentrations came from clinical and adult study samples, with inconsistent findings, partly due to method variance. We examined cross-sectional and longitudinal associations between GAD, SAD and MDD with saliva and hair cortisol as well as hair cortisol change in a population-based sample of adolescents and young adults, considering relevant co-factors. DESIGN Epidemiological cohort study in Dresden, Germany. Data of 1050 individuals (mean age: 17.2 years) assessed at baseline (11/2015-12/2016) and of 605 individuals assessed at 1-year follow-up (FU1) are used. METHODS Multivariable regression models were implemented to assess cross-sectional and longitudinal associations of DSM-5 defined 12-month diagnoses of GAD, SAD, and MDD, with short-term (saliva cortisol: cortisol awakening response (CAR) and area under the curve (AUC) as total cortisol) and long-term (hair cortisol) cortisol indices. Multivariable models were adjusted for age or "tanner" stage, waist circumference, tobacco and alcohol consumption, physical inactivity, and hair cortisol dependent confounder. Sex-specific analyses were additionally conducted. RESULTS Cross-sectional analyses revealed positive associations between SAD and baseline saliva cortisol in multivariable models (CAR: β-coefficient: 0.12; 95% CI: 0.01; 0.23) but could not be confirmed after adjusting for "tanner" stage or comorbid depression. Cross-sectional analyses concerning GAD and MDD in the full baseline sample yielded no significant associations. Sex-specific linear models revealed a significant inverse cross-sectional association between MDD (β-coefficient: - 2.21; 95% CI: - 3.64; - 0.79) as well as SAD (β-coefficient: - 2.21; 95% CI: - 4.03; - 0.38) with baseline hair cortisol in males, but not in females. In longitudinal analyses, no significant associations were found in the fully adjusted model, except for a positive association between hair cortisol change between baseline and FU1 and FU1-SAD (OR: 1.07; 95% CI: 1.02; 1.12). CONCLUSIONS Results confirmed sex-specificity and the role of pubertal development in the association between cortisol with SAD and MDD, while no association emerged regarding cortisol and GAD. Future research in adolescents focusing on the role of cortisol in the pathogenesis of anxiety and depressive disorders would benefit from considering factors like sex-specificity and puberty development as well as comorbidity.
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Affiliation(s)
- Hanna Kische
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
| | - Theresa Magdalena Ollmann
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Catharina Voss
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Jana Hoyer
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Centre for Obesity, Städtisches Klinikum Dresden, Dresden, Germany
| | - Frank Rückert
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Lars Pieper
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Clemens Kirschbaum
- Department of Biopsychology, Technische Universität Dresden, Dresden, Germany
| | - Katja Beesdo-Baum
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
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26
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Walther A, Wehrli S, Kische H, Penz M, Wekenborg M, Gao W, Rothe N, Beesdo-Baum K, Kirschbaum C. Depressive symptoms are not associated with long-term integrated testosterone concentrations in hair. World J Biol Psychiatry 2021; 22:288-300. [PMID: 32657193 DOI: 10.1080/15622975.2020.1795253] [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] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The association between depressive symptomatology and endogenous testosterone levels is inconclusive. Large inter- and intra-individual testosterone differences suggest point measurements from saliva or serum to be inadequate to map basal testosterone concentrations highlighting the potential for long-term integrated testosterone levels from hair. METHODS Using data from a prospective cohort study, a total of 578 participants (74% female) provided complete data on depressive symptomatology, clinical features, and hair samples for quantification of testosterone concentrations at baseline. Available data of three annual follow-up examinations were used for longitudinal analyses. RESULTS Correlation analysis showed in both, men and women, hair testosterone across all the four time points not to be significantly related to depressive symptoms. Examined clinical features were not associated with testosterone levels, except for having a current diagnosis of a psychological disorder, which was associated with reduced testosterone levels in men, but not in women. Acceptable model fit for an autoregressive cross-lagged panel analysis emerged only for the female subsample suggesting inverse cross-relations for the prediction of testosterone by depressive symptomatology and vice versa. CONCLUSIONS Findings from this study add to the literature by showing no association between long-term integrated testosterone in hair and depressive symptomatology in men and women.
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Affiliation(s)
- A Walther
- Department of Biopsychology, TU Dresden, Dresden, Germany.,Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland
| | - S Wehrli
- Department of Biopsychology, TU Dresden, Dresden, Germany.,Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland
| | - H Kische
- Department of Behavioral Epidemiology, TU Dresden, Dresden, Germany
| | - M Penz
- University Hospital Dresden Clinic and Polyclinic for Psychotherapy and Psychosomatics, Dresden, Germany
| | - M Wekenborg
- Department of Biopsychology, TU Dresden, Dresden, Germany
| | - W Gao
- Department of Biopsychology, TU Dresden, Dresden, Germany
| | - N Rothe
- Department of Biopsychology, TU Dresden, Dresden, Germany
| | - K Beesdo-Baum
- Department of Behavioral Epidemiology, TU Dresden, Dresden, Germany
| | - C Kirschbaum
- Department of Biopsychology, TU Dresden, Dresden, Germany
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27
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Heinz I, Baldofski S, Beesdo-Baum K, Knappe S, Kohls E, Rummel-Kluge C. "Doctor, my back hurts and I cannot sleep." Depression in primary care patients: Reasons for consultation and perceived depression stigma. PLoS One 2021; 16:e0248069. [PMID: 33667268 PMCID: PMC7935275 DOI: 10.1371/journal.pone.0248069] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 02/18/2021] [Indexed: 12/03/2022] Open
Abstract
Background General practitioners (GPs) play a significant role in depression care. Recognition of depression is crucial for adequate treatment but is impeded by a high portion of depressed patients only reporting physical symptoms to their GP. Among the many reasons for this phenomenon is mental health stigma. We investigated how patients with depression differed from patients without depression regarding the types and number of complaints presented to their GP, as well as their depression stigma. For the subgroup of patients with depression, potential associations between perceived depression stigma and number and types of presented complaints were investigated to see if these might reflect the patient’s intention to conceal mental health symptoms due to fear of being stigmatized by others. Further, we investigated if perceived depression stigma is related to depression treatment. Methods Data on depressive symptoms (assessed by the Depression Screening Questionnaire; DSQ), depression stigma (assessed by the Depressions Stigma Scale; DSS), type of complaints reported to the GP and treatment-related factors were collected from 3,563 unselected primary care patients of 253 GPs in a cross-sectional epidemiological study (“VERA study”) in six different German regions. Data of a total of 3,069 patients was used for analysis on complaints reported to the GP (subsample of the VERA study), and for 2,682 out of 3,069 patients data on a stigma questionnaire was available. Results Nearly half of the primary care patients with depression (42.2%) reported only physical complaints to their GP. Compared to patients without a depression diagnosis, patients with depression reported twice as many complaints to their GP with a mean of 2.02 (1.33) vs. 1.2 (0.69), including a more frequent combination of physical and mental symptoms (28.8% vs. 3.5%). Patients with depression showed higher total stigma compared to patients without depression, Mdn = 48 (IQR 40–54) vs. Mdn = 46.3 (IQR 29–53), due to higher perceived stigma, Mdn = 27 (IQR 21–32) vs. Mdn = 25.9 (IQR 20–29). Perceived stigma was associated with male gender (beta -.14, p = .005) and a lack of pharmacological treatment (beta -.14, p = .021) in patients with a depression diagnosis. Conclusion The number of complaints presented to the GP might function as a marker to actively explore depression in primary care patients, in particular when both physical and mental symptoms are reported. Perceived depression stigma should also be addressed especially in male patients. Further research should clarify the role of perceived stigma as a potential inhibitor of pharmacological treatment of depression in primary care.
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Affiliation(s)
- Ines Heinz
- Department of Psychiatry and Psychotherapy, Medical Faculty, University Leipzig, Leipzig, Germany
- German Alliance Against Depression, Leipzig, Germany
- * E-mail:
| | - Sabrina Baldofski
- Department of Psychiatry and Psychotherapy, Medical Faculty, University Leipzig, Leipzig, Germany
| | - Katja Beesdo-Baum
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
- Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Dresden, Germany
| | - Susanne Knappe
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
- Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Dresden, Germany
| | - Elisabeth Kohls
- Department of Psychiatry and Psychotherapy, Medical Faculty, University Leipzig, Leipzig, Germany
| | - Christine Rummel-Kluge
- Department of Psychiatry and Psychotherapy, Medical Faculty, University Leipzig, Leipzig, Germany
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Seidl E, Venz J, Ollmann TM, Voss C, Hoyer J, Pieper L, Beesdo-Baum K. How current and past anxiety disorders affect daily life in adolescents and young adults from the general population-An epidemiological study with ecological momentary assessment. Depress Anxiety 2021; 38:272-285. [PMID: 33406283 DOI: 10.1002/da.23133] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 03/20/2020] [Revised: 11/07/2020] [Accepted: 12/18/2020] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Prior research indicated, based on retrospective assessments of symptomatology, that 25% of individuals with "remitted" anxiety disorders (AD) experience a relapse. The present study used ecological momentary assessment (EMA) to examine how ADs affect everyday life among community adolescents and young adults with current or remitted AD compared to healthy controls and to each other. METHODS Data come from the baseline assessment of the epidemiological Behavior and Mind Health study, conducted in Dresden (Germany) from 11/2015-12/2016. The sub-sample analyzed (n = 648, age 14-21) consisted of 65 participants with current DSM-5 AD-diagnosis, 52 participants with lifetime AD-diagnosis but not within the last 6 months (remitted), and 531 healthy controls (no psychopathology; healthy controls [HC]). EMA of various constructs took place 8 times a day for 4 days. RESULTS The highest levels of symptoms were reported by those with current AD, followed by remitted AD and HC. Regression analyses revealed significantly worse mood, self-efficacy, quality of life and sleep-quality and more experiential avoidance, stress, negative thoughts and pessimism in remitted and current AD compared to HC. Current AD additional differed significantly from HC in optimism and positive thoughts. Furthermore, individuals with remitted AD without comorbidities differed significantly from HC on five out of 16 constructs. CONCLUSION Not only current but also remitted AD is associated with diverse negative experiences in everyday life, which cannot merely be explained by comorbidities. As the remaining burden and impairment in individuals with remitted AD might contribute to relapse, interventions might be targeted to improve mental health.
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Affiliation(s)
- Esther Seidl
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - John Venz
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Theresa Magdalena Ollmann
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Catharina Voss
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Jana Hoyer
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Lars Pieper
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Katja Beesdo-Baum
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
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Ollmann TM, Voss C, Venz J, Seidl E, Hoyer J, Kische H, Pieper L, Schiele MA, Domschke K, Beesdo-Baum K. The interaction of 5-HTT variation, recent stress, and resilience on current anxiety levels in adolescents and young adults from the general population. Depress Anxiety 2021; 38:318-327. [PMID: 33058370 DOI: 10.1002/da.23101] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 05/02/2020] [Revised: 08/11/2020] [Accepted: 09/09/2020] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Previous work on gene-environment (GxE) interplay concerning anxiety has focused on the interaction of 5-HTTLPR with childhood adversities or traumatic events whereas the impact of recent stressors is understudied, as is the integration of resilience. The current study aimed to investigate the interactive effect of 5-HTTLPR and recent stress on anxiety in adolescents considering resilience as buffer of a GxE risk constellation. METHOD In a random population-based sample of 14-21 years old from Dresden, Germany, (N = 1180; genotyped = 942) recent stress (Daily Hassles [DH] Scale, Perceived Stress Scale, Screening Scale of the Trier Inventory for the Assessment of Chronic Stress), resilience (Connor-Davidson resilience scale) and anxiety (Patient Reported Outcome Measurement Information System Anxiety Short Form) were assessed via questionnaire in 2015 or 2016. RESULTS Fractional regression models revealed that resilience interacted with recent stress in form of DH as well as recent chronic stress and 5-HTTLPR regarding anxiety. Participants carrying the more active LA LA genotype reported consistently higher levels of anxiety when experiencing more DH or more recent chronic stress and having low levels of resilience. When the resilience scores were high, LA LA carriers reported the lowest anxiety scores despite DH or recent chronic stress. CONCLUSION Findings revealed an interactive relationship between 5-HTTLPR genotype and recent stress suggesting resilience to function as an additional dimension buffering the impact of a GxE risk constellation. Early interventions to build resilience may be useful to prevent an escalation of distress and associated unfavorable health outcomes.
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Affiliation(s)
- Theresa M Ollmann
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Catharina Voss
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - John Venz
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Institute of Clinical Psychology and Psychotherapy, Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany
| | - Esther Seidl
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Jana Hoyer
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Hanna Kische
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Lars Pieper
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Institute of Clinical Psychology and Psychotherapy, Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany
| | - Miriam A Schiele
- Department of Psychiatry and Psychotherapy, University of Freiburg, Freiburg, Germany
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, University of Freiburg, Freiburg, Germany.,Faculty of Medicine, Center for Basics in NeuroModulation, University of Freiburg, Freiburg, Germany
| | - Katja Beesdo-Baum
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Institute of Clinical Psychology and Psychotherapy, Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany
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Voss C, Hoyer J, Venz J, Pieper L, Beesdo-Baum K. Non-suicidal self-injury and its co-occurrence with suicidal behavior: An epidemiological-study among adolescents and young adults. Acta Psychiatr Scand 2020; 142:496-508. [PMID: 32979220 DOI: 10.1111/acps.13237] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [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: 03/17/2020] [Revised: 08/13/2020] [Accepted: 09/17/2020] [Indexed: 01/17/2023]
Abstract
OBJECTIVE Non-suicidal self-injury (NSSI) comprising thoughts and behaviors is common and often co-occurring with suicidal behavior like ideation, plan, and attempt. As limited data are available for adolescents and young adults, this study aims to present prevalence estimates for lifetime NSSI, its co-occurrence with suicidal behavior, conditional probabilities and their association with socio-demographic characteristics, severity characteristics of suicidal behavior, and health service utilization. METHOD The epidemiological Behavior and Mind Health (BeMIND) study assessed in 2015/16 a random-community sample of N = 1180 aged 14-21 years from Dresden, Germany, regarding lifetime NSSI via self-administered questionnaire and suicidal behaviors via standardized interview. RESULTS Any lifetime NSSI was reported by 19.3% (thoughts: 18.0%, behaviors: 13.6%) of the sample with higher prevalence in females (OR = 2.7, 95% CI 1.9-3.8, P < 0.001). Lifetime prevalence of co-occurring NSSI and suicidal behavior was 7.7%. Females had a 3.3- to 8.8-fold odds of co-occurrence than males. Among those with any NSSI, 39.6% endorsed suicidal behavior, and 66.3% of those with any suicidal behavior reported NSSI. 42.3% of those with any NSSI reported to have used mental healthcare services at any time during their life with higher rates in those with co-occurring suicidal behavior (62.3%). CONCLUSION Non-suicidal self-injury and co-occurring suicidal behavior is common in adolescents and young adults-especially females. The limited utilization of mental healthcare services underpins the need for improving recognition of NSSI and suicidal behavior as well as the accessibility of mental healthcare services during adolescence and emerging adulthood.
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Affiliation(s)
- C Voss
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - J Hoyer
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - J Venz
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany
| | - L Pieper
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany
| | - K Beesdo-Baum
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany
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Hoyer J, Voss C, Strehle J, Venz J, Pieper L, Wittchen HU, Ehrlich S, Beesdo-Baum K. Correction to: Test-retest reliability of the computer-assisted DIA-X-5 interview for mental disorders. BMC Psychiatry 2020; 20:364. [PMID: 32646488 PMCID: PMC7346456 DOI: 10.1186/s12888-020-02762-2] [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] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
An amendment to this paper has been published and can be accessed via the original article.
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Affiliation(s)
- Jana Hoyer
- grid.4488.00000 0001 2111 7257Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany ,grid.4488.00000 0001 2111 7257Behavioral Epidemiology, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Catharina Voss
- grid.4488.00000 0001 2111 7257Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany ,grid.4488.00000 0001 2111 7257Behavioral Epidemiology, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Jens Strehle
- grid.4488.00000 0001 2111 7257Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany ,grid.4488.00000 0001 2111 7257Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Dresden, Germany
| | - John Venz
- grid.4488.00000 0001 2111 7257Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany ,grid.4488.00000 0001 2111 7257Behavioral Epidemiology, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany ,grid.4488.00000 0001 2111 7257Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Dresden, Germany
| | - Lars Pieper
- grid.4488.00000 0001 2111 7257Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany ,grid.4488.00000 0001 2111 7257Behavioral Epidemiology, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany ,grid.4488.00000 0001 2111 7257Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Dresden, Germany
| | - Hans-Ulrich Wittchen
- grid.5252.00000 0004 1936 973XDepartment of Psychiatry & Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany
| | - Stefan Ehrlich
- grid.4488.00000 0001 2111 7257Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany ,grid.4488.00000 0001 2111 7257Eating Disorders Research and Treatment Center, Deartment of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Katja Beesdo-Baum
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany. .,Behavioral Epidemiology, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany. .,Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Dresden, Germany.
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Hoyer J, Voss C, Strehle J, Venz J, Pieper L, Wittchen HU, Ehrlich S, Beesdo-Baum K. Test-retest reliability of the computer-assisted DIA-X-5 interview for mental disorders. BMC Psychiatry 2020; 20:280. [PMID: 32503463 PMCID: PMC7275419 DOI: 10.1186/s12888-020-02653-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 05/04/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND There is a need of comprehensive standardized diagnostic assessment tools of psychopathology that match recent changes in diagnostic classification systems, such as the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Therefore, the computer-assisted DIA-X-5 was developed and its test-retest reliability was explored. The DIA-X-5 is based on the DIA-X/M-CIDI (Diagnostisches Expertensystem für psychische Störungen/Munich-Composite International Diagnostic Interview) which referred to the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). METHODS A convenience sample (N = 60, age: 15-67) was interviewed twice with the computer-assisted DIA-X-5 interview, on average nine days apart, by trained and blinded interviewers. The DIA-X-5 is a standardized instrument for research purposes covering symptoms, syndromes and diagnoses from eleven classes of mental disorders according to the DSM-5 with matching F codes of the 10th edition of the International Classification of Diseases (ICD-10). RESULTS Kappa values ranged from 0.90 for post-traumatic stress disorder to 0.30 for social anxiety disorder. For age of onset and age of recency, test-retest reliability as measured by intra-class correlation was satisfying with values above 0.90 for most disorders. CONCLUSIONS Test-retest reliability of the DIA-X-5 syndromes and diagnoses were comparable to those of previous DSM-IV/DIA-X diagnoses for most disorders. Due to low case numbers for some diagnoses, further research in larger samples is required.
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Affiliation(s)
- Jana Hoyer
- grid.4488.00000 0001 2111 7257Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany ,grid.4488.00000 0001 2111 7257Behavioral Epidemiology, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Catharina Voss
- grid.4488.00000 0001 2111 7257Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany ,grid.4488.00000 0001 2111 7257Behavioral Epidemiology, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Jens Strehle
- grid.4488.00000 0001 2111 7257Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany ,grid.4488.00000 0001 2111 7257Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Dresden, Germany
| | - John Venz
- grid.4488.00000 0001 2111 7257Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany ,grid.4488.00000 0001 2111 7257Behavioral Epidemiology, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany ,grid.4488.00000 0001 2111 7257Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Dresden, Germany
| | - Lars Pieper
- grid.4488.00000 0001 2111 7257Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany ,grid.4488.00000 0001 2111 7257Behavioral Epidemiology, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany ,grid.4488.00000 0001 2111 7257Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Dresden, Germany
| | - Hans-Ulrich Wittchen
- grid.5252.00000 0004 1936 973XDepartment of Psychiatry & Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany
| | - Stefan Ehrlich
- grid.4488.00000 0001 2111 7257Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany ,grid.4488.00000 0001 2111 7257Eating Disorders Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Katja Beesdo-Baum
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany. .,Behavioral Epidemiology, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany. .,Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Dresden, Germany.
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Martini J, Beesdo-Baum K, Garthus-Niegel S, Wittchen HU. The course of panic disorder during the peripartum period and the risk for adverse child development: A prospective-longitudinal study. J Affect Disord 2020; 266:722-730. [PMID: 32217255 DOI: 10.1016/j.jad.2020.01.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 10/12/2018] [Revised: 12/20/2019] [Accepted: 01/03/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Panic disorders during pregnancy and after delivery may have detrimental effects for mother and child, but no firm conclusions regarding the course and outcomes of peripartum panic disorders can be drawn from previous studies. METHODS N = 306 women were repeatedly interviewed with the Composite International Diagnostic Interview for Women. Social support and partnership quality, gestational outcomes, duration of breastfeeding, regulatory disorders, maternal bonding and parenting style were assessed via medical and maternal reports. Standardized observations of neuropsychological development, infant temperament and attachment were conducted 4 and 16 months after delivery. RESULTS Women reported heterogenous courses of panic disorders, and panic disorders/panic attacks were commonly observed during the early stages of pregnancy. Women with peripartum panic disorders presented with a worse psychosocial situation (e.g., lower social support). Clear behavioral differences (temperament, attachment) in infants of women with panic disorders as compared to women with no anxiety and depressive disorder could not be detected in this study, but differences concerning gestational outcomes, duration of breastfeeding, maternal parenting, and bonding as well as regulatory problems in infants were identified. LIMITATIONS This prospective-longitudinal multi-wave study is restricted by the relative small sizes of the particular groups that limit the power to detect group differences. CONCLUSIONS Heterogenous courses and outcomes of perinatal panic disorders require intensive monitoring of affected mother-infant-dyads who may benefit from early targeted interventions to prevent an escalation of dyadic problems.
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Affiliation(s)
- Julia Martini
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Department of Psychiatry & Psychotherapy, Faculty of Medicine, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany.
| | - Katja Beesdo-Baum
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Department of Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany
| | - Susan Garthus-Niegel
- Institute and Outpatient Clinics of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany; Department of Child Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Hans-Ulrich Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Department of Psychiatry & Psychotherapy, Ludwig Maximilans Universitaet Munich, Munich, Germany
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Miché M, Studerus E, Meyer AH, Gloster AT, Beesdo-Baum K, Wittchen HU, Lieb R. Prospective prediction of suicide attempts in community adolescents and young adults, using regression methods and machine learning. J Affect Disord 2020; 265:570-578. [PMID: 31786028 DOI: 10.1016/j.jad.2019.11.093] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [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: 05/03/2019] [Revised: 09/20/2019] [Accepted: 11/12/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND The use of machine learning (ML) algorithms to study suicidality has recently been recommended. Our aim was to explore whether ML approaches have the potential to improve the prediction of suicide attempt (SA) risk. Using the epidemiological multiwave prospective-longitudinal Early Developmental Stages of Psychopathology (EDSP) data set, we compared four algorithms-logistic regression, lasso, ridge, and random forest-in predicting a future SA in a community sample of adolescents and young adults. METHODS The EDSP Study prospectively assessed, over the course of 10 years, adolescents and young adults aged 14-24 years at baseline. Of 3021 subjects, 2797 were eligible for prospective analyses because they participated in at least one of the three follow-up assessments. Sixteen baseline predictors, all selected a priori from the literature, were used to predict follow-up SAs. Model performance was assessed using repeated nested 10-fold cross-validation. As the main measure of predictive performance we used the area under the curve (AUC). RESULTS The mean AUCs of the four predictive models, logistic regression, lasso, ridge, and random forest, were 0.828, 0.826, 0.829, and 0.824, respectively. CONCLUSIONS Based on our comparison, each algorithm performed equally well in distinguishing between a future SA case and a non-SA case in community adolescents and young adults. When choosing an algorithm, different considerations, however, such as ease of implementation, might in some instances lead to one algorithm being prioritized over another. Further research and replication studies are required in this regard.
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Affiliation(s)
- Marcel Miché
- University of Basel, Department of Psychology, Division of Clinical Psychology and Epidemiology, Basel, Switzerland
| | - Erich Studerus
- University of Basel, Department of Psychology, Division of Personality and Developmental Psychology, Basel, Switzerland
| | - Andrea Hans Meyer
- University of Basel, Department of Psychology, Division of Clinical Psychology and Epidemiology, Basel, Switzerland
| | - Andrew Thomas Gloster
- University of Basel, Department of Psychology, Division of Clinical Psychology and Intervention Science, Basel, Switzerland
| | - Katja Beesdo-Baum
- Technische Universitaet Dresden, Behavioral Epidemiology, Dresden, Germany; Technische Universitaet Dresden, Institute of Clinical Psychology and Psychotherapy, Dresden, Germany
| | - Hans-Ulrich Wittchen
- Technische Universitaet Dresden, Institute of Clinical Psychology and Psychotherapy, Dresden, Germany; Ludwig Maximilians University Munich, Department of Psychiatry and Psychotherapy, Munich, Germany
| | - Roselind Lieb
- University of Basel, Department of Psychology, Division of Clinical Psychology and Epidemiology, Basel, Switzerland.
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Wittchen HUW, Beesdo-Baum K. International Journal of Methods in Psychiatric Research transitions to open access. Int J Methods Psychiatr Res 2020; 29:e1817. [PMID: 32108405 PMCID: PMC7051835 DOI: 10.1002/mpr.1817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Voss C, Ollmann TM, Miché M, Venz J, Hoyer J, Pieper L, Höfler M, Beesdo-Baum K. Prevalence, Onset, and Course of Suicidal Behavior Among Adolescents and Young Adults in Germany. JAMA Netw Open 2019; 2:e1914386. [PMID: 31664450 PMCID: PMC6824228 DOI: 10.1001/jamanetworkopen.2019.14386] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 09/12/2019] [Indexed: 12/24/2022] Open
Abstract
Importance Suicidal behavior is a leading cause of death among adolescents and young adults. In light of the ideation-to-action framework, the delineation of frequency and temporal characteristics of such behavior during this developmental period is crucial. Objectives To provide lifetime and 12-month prevalence estimates of suicidal behavior, including ideation, plan, and attempt, in adolescents and young adults of the general population, and to provide information about age at onset, temporal characteristics of suicidal behavior, including duration (number of years between onset and last occurrence) and frequency (number of episodes), and transition patterns across suicidal behaviors. Design, Setting, and Participants A cross-sectional epidemiological study was conducted in a random community sample of 1180 adolescents and young adults aged 14 to 21 years assessed in 2015 to 2016 in Dresden, Germany. Data analysis was performed from October 2018 to March 2019. Main Outcomes and Measures Lifetime and 12-month suicidal behavior (ideation, plan, and attempt) were assessed with a standardized diagnostic interview (Munich-Composite International Diagnostic Interview) by trained clinical interviewers. The onset, frequency, and duration of suicidal behavior were assessed by questionnaire. Results Of the 1180 participants (495 male [weighted percentage, 51.7%]; mean [SD] age, 17.9 [2.3] years), 130 participants (10.7%; 95% CI, 9.0%-12.8%), 65 participants (5.0%; 95% CI, 3.9%-6.5%), and 41 participants (3.4%; 95% CI, 2.4%-4.7%) reported lifetime suicidal ideation, plan, and attempt, respectively. Any lifetime suicidal behavior was reported by 138 participants (11.5%; 95% CI, 9.7%-13.7%). Age-specific cumulative incidence estimates indicated an increase in suicidal behavior during adolescence, starting at age 10 years (<1%), increasing slightly until the age of 12 years (2.2%), and then increasing sharply thereafter until age 20 years (13.5%). There were different patterns among female and male participants for ideation, plan, and attempt, with an overall higher incidence among female participants for ideation (hazard ratio, 1.51; 95% CI, 1.02-2.22; P = .04), for plan (hazard ratio, 3.31; 95% CI, 1.72-6.36; P < .001), and, among those older than 14 years, for attempt (hazard ratio, 3.07; 95% CI, 1.11-8.49; P = .03). Of those with suicidal ideation, 66.0% reported persistent or recurrent ideation over more than 1 year with 75.0% reporting more than 1 episode. Of the participants with lifetime suicidal ideation, 47.0% reported a suicide plan and 23.9% reported a suicide attempt. The transition to suicide plan or attempt occurred mainly in the year of onset of suicidal ideation or plan; of those who transitioned, 74.9% transitioned from ideation to plan, 71.2% transitioned from ideation to attempt, and 85.4% transitioned from plan to attempt in the same year. Conclusions and Relevance There is an urgent public health need for timely identification of suicidal behavior in adolescents and young adults to terminate persistent or recurrent suicidal tendencies and to interrupt the ideation-to-action transition.
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Affiliation(s)
- Catharina Voss
- Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Theresa M. Ollmann
- Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Marcel Miché
- Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Basel, Switzerland
| | - John Venz
- Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
- Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Dresden, Germany
| | - Jana Hoyer
- Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Lars Pieper
- Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
- Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Dresden, Germany
| | - Michael Höfler
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
- Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Dresden, Germany
| | - Katja Beesdo-Baum
- Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
- Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Dresden, Germany
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Angst J, Rössler W, Ajdacic-Gross V, Angst F, Wittchen HU, Lieb R, Beesdo-Baum K, Asselmann E, Merikangas KR, Cui L, Andrade LH, Viana MC, Lamers F, Penninx BW, de Azevedo Cardoso T, Jansen K, Dias de Mattos Souza L, Azevedo da Silva R, Kapczinski F, Grobler C, Gholam-Rezaee M, Preisig M, Vandeleur CL. Differences between unipolar mania and bipolar-I disorder: Evidence from nine epidemiological studies. Bipolar Disord 2019; 21:437-448. [PMID: 30475430 DOI: 10.1111/bdi.12732] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [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: 12/16/2022]
Abstract
OBJECTIVES Although clinical evidence suggests important differences between unipolar mania and bipolar-I disorder (BP-I), epidemiological data are limited. Combining data from nine population-based studies, we compared subjects with mania (M) or mania with mild depression (Md) to those with BP-I with both manic and depressive episodes with respect to demographic and clinical characteristics in order to highlight differences. METHODS Participants were compared for gender, age, age at onset of mania, psychiatric comorbidity, temperament, and family history of mental disorders. Generalized linear mixed models with adjustment for sex and age as well as for each study source were applied. Analyses were performed for the pooled adult and adolescent samples, separately. RESULTS Within the included cohorts, 109 adults and 195 adolescents were diagnosed with M/Md and 323 adults and 182 adolescents with BP-I. In both adult and adolescent samples, there was a male preponderance in M/Md, whereas lifetime generalized anxiety and/panic disorders and suicide attempts were less common in M/Md than in BP-I. Furthermore, adults with mania revealed bulimia/binge eating and drug use disorders less frequently than those with BP-I. CONCLUSIONS The significant differences found in gender and comorbidity between mania and BP-I suggest that unipolar mania, despite its low prevalence, should be established as a separate diagnosis both for clinical and research purposes. In clinical settings, the rarer occurrence of suicide attempts, anxiety, and drug use disorders among individuals with unipolar mania may facilitate successful treatment of the disorder and lead to a more favorable course than that of BP-I disorder.
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Affiliation(s)
- Jules Angst
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Wulf Rössler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.,Laboratory of Neuroscience (LIM 27), Institute of Psychiatry, University of São Paulo, São Paulo, Brazil.,Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Vladeta Ajdacic-Gross
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Felix Angst
- Rehabilitation Clinic, Bad Zurzach, Switzerland
| | - Hans Ulrich Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Psychiatric University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Rosalind Lieb
- Max Planck Institute of Psychiatry, Munich, Germany.,Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Basel, Switzerland
| | - Katja Beesdo-Baum
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Eva Asselmann
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Kathleen R Merikangas
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, Maryland
| | - Lihong Cui
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, Maryland
| | - Laura H Andrade
- Section of Psychiatric Epidemiology (LIM 23), Department and Institute of Psychiatry, School of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Maria C Viana
- Department of Social Medicine, Postgraduate Program in Public Health, Federal University of Espírito Santo, Vitória, Brazil
| | - Femke Lamers
- Department of Psychiatry and Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, The Netherlands
| | - Brenda Wjh Penninx
- Department of Psychiatry and Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, The Netherlands
| | | | - Karen Jansen
- Health and Behavior Graduate Program, Catholic University of Pelotas, Pelotas, Brazil
| | | | | | - Flavio Kapczinski
- Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Christoffel Grobler
- Elizabeth Donkin Hospital, Port Elizabeth, South Africa.,Nelson Mandela University, Port Elizabeth, South Africa
| | - Mehdi Gholam-Rezaee
- Department of Psychiatry, University Hospital of Lausanne, Prilly, Switzerland
| | - Martin Preisig
- Department of Psychiatry, University Hospital of Lausanne, Prilly, Switzerland
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38
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Beesdo-Baum K, Knappe S, Einsle F, Knothe L, Wieder G, Venz J, Rummel-Kluge C, Heinz I, Koburger N, Schouler-Ocak M, Wilbertz T, Unger HP, Walter U, Hein J, Hegerl U, Lieb R, Pfennig A, Schmitt J, Hoyer J, Wittchen HU, Bergmann A. [How frequently are depressive disorders recognized in primary care patients? : A cross-sectional epidemiological study in Germany]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2019; 61:52-64. [PMID: 29189872 DOI: 10.1007/s00103-017-2662-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Primary care physicians (PCPs) play a crucial role for guideline-oriented intervention in patients with depression. OBJECTIVES Based on a diagnostic screening questionnaire, this study investigates the sensitivity of PCPs to recognize patients with depression as well as the factors facilitating recognition and concordant diagnostic decisions. METHOD In a cross-sectional epidemiological study in six regions of Germany, 3563 unselected patients filled in questionnaires on mental and physical complaints and were diagnostically evaluated by their PCP (N = 253). The patient reports on an established Depression-Screening-Questionnaire (DSQ), which allows the approximate derivation of an ICD-10 depression diagnosis, were compared with the physician diagnosis (N = 3211). In a subsample of discordant cases a comprehensive standardized clinical-diagnostic interview (DIA-X/CIDI) was applied. RESULTS On the study day, the prevalence of ICD-10 depression was 14.3% according to the DSQ and 10.7% according to the physician diagnosis. Half of the patients identified by DSQ were diagnosed with depression by their physician and two thirds were recognized as mental disorder cases. More severe depression symptomatology and the persistent presence of main depression symptoms were related to better recognition and concordant diagnostic decisions. Diagnostic validation interviews confirmed the DSQ diagnosis in the majority of the false-negative cases. Indications for at least a previous history of depression were found in up to 70% of false-positive cases. CONCLUSION Given the high prevalence of depression in primary care patients, there is continued need to improve the recognition and diagnosis of these patients to assure guideline-oriented treatment.
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Affiliation(s)
- Katja Beesdo-Baum
- Institut für Klinische Psychologie und Psychotherapie, Behaviorale Epidemiologie & Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Deutschland.
- Behaviorale Epidemiologie, Technische Universität Dresden, Dresden, Deutschland.
- Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Dresden, Deutschland.
| | - Susanne Knappe
- Institut für Klinische Psychologie und Psychotherapie, Behaviorale Epidemiologie & Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Deutschland
| | - Franziska Einsle
- Institut für Klinische Psychologie und Psychotherapie, Behaviorale Epidemiologie & Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Deutschland
| | - Lisa Knothe
- Institut für Klinische Psychologie und Psychotherapie, Behaviorale Epidemiologie & Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Deutschland
- Behaviorale Epidemiologie, Technische Universität Dresden, Dresden, Deutschland
| | - Gesine Wieder
- Institut für Klinische Psychologie und Psychotherapie, Behaviorale Epidemiologie & Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Deutschland
- Behaviorale Epidemiologie, Technische Universität Dresden, Dresden, Deutschland
| | - John Venz
- Institut für Klinische Psychologie und Psychotherapie, Behaviorale Epidemiologie & Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Deutschland
- Behaviorale Epidemiologie, Technische Universität Dresden, Dresden, Deutschland
- Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Dresden, Deutschland
| | - Christine Rummel-Kluge
- Stiftung Deutsche Depressionshilfe, Leipzig, Deutschland
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Leipzig, Leipzig, Deutschland
| | - Ines Heinz
- Deutsches Bündnis gegen Depression e.V., Leipzig, Deutschland
| | - Nicole Koburger
- Leipziger Bündnis gegen Depression e.V., Leipzig, Deutschland
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Leipzig, Leipzig, Deutschland
| | - Meryam Schouler-Ocak
- Psychiatrische Universitätsklinik der Charité im St. Hedwig-Krankenhaus, Berlin, Deutschland
| | - Theresia Wilbertz
- Psychiatrische Universitätsklinik der Charité im St. Hedwig-Krankenhaus, Berlin, Deutschland
| | - Hans-Peter Unger
- Harburger Bündnis gegen Depression e.V., Asklepios Klinik Harburg, Hamburg, Deutschland
| | - Ulrich Walter
- Akademie für Suizidprävention des Gesundheitsnetz Osthessen e.V., Fulda, Deutschland
| | - Joachim Hein
- Münchner Bündnis gegen Depression e.V., München, Deutschland
| | - Ulrich Hegerl
- Stiftung Deutsche Depressionshilfe, Leipzig, Deutschland
- Deutsches Bündnis gegen Depression e.V., Leipzig, Deutschland
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Leipzig, Leipzig, Deutschland
| | - Roselind Lieb
- Klinische Psychologie und Epidemiologie, Fakultät für Psychologie, Universität Basel, Basel, Schweiz
| | - Andrea Pfennig
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Medizinische Fakultät Carl-Gustav Carus, Technische Universität Dresden, Dresden, Deutschland
| | - Jochen Schmitt
- Zentrum für Evidenzbasierte Gesundheitsversorgung (ZEGV), Medizinische Fakultät Carl-Gustav Carus, Technische Universität Dresden, Dresden, Deutschland
| | - Jürgen Hoyer
- Institut für Klinische Psychologie und Psychotherapie, Behaviorale Epidemiologie & Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Deutschland
| | - Hans-Ulrich Wittchen
- Institut für Klinische Psychologie und Psychotherapie, Behaviorale Epidemiologie & Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Deutschland
- Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Dresden, Deutschland
- Klinik für Psychiatrie und Psychotherapie, Ludwig-Maximilians-Universität München, München, Deutschland
| | - Antje Bergmann
- Allgemeinmedizin, Medizinische Fakultät Carl-Gustav Carus, Technische Universität Dresden, Dresden, Deutschland
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Asselmann E, Kische H, Haring R, Hertel J, Schmidt CO, Nauck M, Beesdo-Baum K, Grabe HJ, Pané-Farré CA. Prospective associations of androgens and sex hormone-binding globulin with 12-month, lifetime and incident anxiety and depressive disorders in men and women from the general population. J Affect Disord 2019; 245:905-911. [PMID: 30699875 DOI: 10.1016/j.jad.2018.11.052] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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: 05/22/2018] [Revised: 10/05/2018] [Accepted: 11/03/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND Findings on associations of androgens and sex hormone-binding globulin (SHBG) with anxiety and depressive disorders in the general population remain inconclusive. METHODS We used data of n = 993 men and n = 980 women from the Study of Health in Pomerania (SHIP, a prospective-longitudinal general population study from northeastern Germany). Immunoassay-measured serum concentrations of total testosterone, androstenedione and SHBG were assessed when participants were aged 20-80. 12-month, lifetime and incident DSM-IV anxiety and depressive disorders were assessed with the DIA-X/M-CIDI at 10-year follow-up, when participants were aged 29-89. Logistic regressions were adjusted for age, smoking, alcohol consumption, physical activity, waist circumference, hypertension and oral contraceptive use (women only) at baseline and follow-up interval. RESULTS In men and women, androgens and SHBG were not associated significantly with incident anxiety and depressive disorders. In men, higher total testosterone predicted any 12-month (OR = 1.46) and lifetime (OR = 1.34) anxiety disorder, lifetime social phobia (OR = 2.15), and 12-month (OR = 1.48) and lifetime (OR = 1.39) specific phobia, but neither 12-month nor lifetime depression. Moreover, androstenedione in men interacted with age in predicting lifetime anxiety disorders (OR = 0.98): Higher androstenedione more strongly predicted lifetime anxiety in younger vs. older men. These findings, however, did not survive correction for multiple testing. In women, androgens and SHBG were not associated significantly with 12-month and lifetime anxiety and depressive disorders. LIMITATIONS The follow-up period was relatively long and other factors might have affected the examined associations. CONCLUSIONS Higher serum total testosterone in men and androstenedione in younger men may relate to an increased risk of anxiety disorders.
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Affiliation(s)
- Eva Asselmann
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany; Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
| | - Hanna Kische
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Robin Haring
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Johannes Hertel
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | | | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany; German Centre for Cardiovascular Research, Partner Site Greifswald, University Medicine Greifswald, Greifswald, Germany
| | - Katja Beesdo-Baum
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Hans-Jörgen Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Christiane A Pané-Farré
- Department of Physiological and Clinical Psychology, University of Greifswald, Greifswald, Germany
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Trautmann S, Beesdo-Baum K. The Treatment of Depression in Primary Care. Dtsch Arztebl Int 2018; 114:721-728. [PMID: 29143731 DOI: 10.3238/arztebl.2017.0721] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 09/28/2016] [Accepted: 07/11/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND General practitioners play a key role in the care of patients with depressive disorders. We studied the frequency and type of treatment of depressive disorders in primary care. METHODS In a cross-sectional epidemiological study on a particular day in six different regions in Germany, 253 physicians and 3563 unselected patients were asked to fill in a questionnaire assessing the diagnosis and treatment of depression. A total of 3431 usable patient data sets and 3211 sets of usable data from both the patient and the physician were subjected to further analysis. RESULTS 68.0% of the 490 patients in primary care who were classified as depressed according to the Depression Screening Questionnaire received treatment from their general practitioner or in other care settings; the probability of being treated by the general practitioner was higher for patients whose diagnosis was recognized by the general practitioner (92.8%) than for the remaining depressed patients (47.8%). On the day of data recording, 54.1% of the depressed patients were under treatment by the general practitioner and 21.2% had been referred to specialized treatment. Approximately 60% of the depressed patients were not being treated, as recommended in the guidelines, with antidepressant drugs, psychotherapy, or both. The likelihood of being treated in conformity with the guidelines depended on whether or not the general practitioner had made the diagnosis of depression (odds ratio [OR] = 7.5; 95% confidence interval = [4.9; 11.6]; p <0,001); it was also higher if the general practitioner had an additional qualification in psychotherapy (OR = 1.9; [1.1; 3.4]; p = 0.022). CONCLUSION The finding that a relevant proportion of patients with depressive disorders in primary care are inadequately treated indicates the need to improve general practitioners' ability to diagnose these conditions and determine the indication for treatment.
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Affiliation(s)
- Sebastian Trautmann
- Institute of Clinical Psychology and Psychotherapy, TU Dresden; Behavioral Epidemiology, TU Dresden; Center for Clinical Epidemiology and Longitudinal Studies, TU Dresden
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41
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Asselmann E, Hertel J, Schmidt CO, Homuth G, Nauck M, Beesdo-Baum K, Grabe HJ, Pané-Farré CA. Interplay between RGS2 and childhood adversities in predicting anxiety and depressive disorders: Findings from a general population sample. Depress Anxiety 2018; 35:1104-1113. [PMID: 30107643 DOI: 10.1002/da.22812] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 05/24/2018] [Accepted: 06/13/2018] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND It remains unresolved whether childhood adversities interact with genetic variation in regulator of G-protein signaling 2 (RGS2) rs4606 in predicting various anxiety and depressive disorders and whether diagnostic specificity exists in these interactions. METHODS The genotype of RGS2 rs4606 was determined for N = 2,263 adults with European ancestry from the Study of Health in Pomerania. Lifetime anxiety and depressive disorders according to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, were assessed with the Munich Composite International Diagnostic Interview (DIA-X/M-CIDI). Childhood adversities were assessed with the Childhood Trauma Questionnaire (CTQ, when participants were aged 29-89). RESULTS Logistic regressions adjusted for sex and age revealed that rs4606 interacted with total childhood adversity in predicting each diagnostic outcome except for panic disorder and generalized anxiety disorder, uncorrected and corrected for multiple testing (odds ratio [OR] = 1.06-1.16). That is, carriers of the GG (vs. CC/CG) genotype were at decreased risk for anxiety and/or depression in the presence of low, but at increased risk in the presence of high total childhood adversity. Respective gene-environment (G × E) interactions were found for (a) comorbid anxiety and depressive disorders (OR = 1.13), but neither pure anxiety nor pure depressive disorders and (b) pure/temporally primary anxiety disorders (OR = 1.07), but not pure/temporally primary depressive disorders. The G × E interaction remained associated with depressive disorders after introducing pure/temporally primary anxiety disorders as additional predictor (OR = 1.09). CONCLUSIONS rs4606 alters the risk of developing a range of anxiety but also depressive disorders after childhood adversities. A complex risk pattern of genotype, environmental factors, and preexisting anxiety contributes to subsequent depression development.
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Affiliation(s)
- Eva Asselmann
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Department of Psychology, Faculty of Life Sciences, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Johannes Hertel
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | | | - Georg Homuth
- Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany.,German Centre for Cardiovascular Research, Partner Site Greifswald, University Medicine, Greifswald, Germany
| | - Katja Beesdo-Baum
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Hans-Jörgen Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Christiane A Pané-Farré
- Department of Physiological and Clinical Psychology, University of Greifswald, Greifswald, Germany
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42
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Wittchen HU, Beesdo-Baum K. "Throwing out the baby with the bathwater"? Conceptual and methodological limitations of the HiTOP approach. World Psychiatry 2018; 17:298-299. [PMID: 30192104 PMCID: PMC6127812 DOI: 10.1002/wps.20561] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Affiliation(s)
- Hans-Ulrich Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität München, München, Germany
| | - Katja Beesdo-Baum
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
- Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany
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43
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Asselmann E, Hertel J, Beesdo-Baum K, Schmidt CO, Homuth G, Nauck M, Grabe HJ, Pané-Farré CA. Interplay between COMT Val158Met, childhood adversities and sex in predicting panic pathology: Findings from a general population sample. J Affect Disord 2018; 234:290-296. [PMID: 29574383 DOI: 10.1016/j.jad.2018.02.060] [Citation(s) in RCA: 12] [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: 11/21/2017] [Revised: 01/30/2018] [Accepted: 02/19/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND The single nucleotide polymorphism rs4680 of the catechol-O-methyltransferase (COMT) gene has been implicated to be involved in the etiopathogenesis of panic. However, it remains unresolved whether rs4680 modifies the risk-association between early life stress and subsequent development of panic pathology. METHODS The genotype of rs4680 was determined for n = 2242 adults with European ancestry from the Study of Health in Pomerania (SHIP, a regional longitudinal cohort study from northeastern Germany). Lifetime fearful spells, panic attacks and panic disorder were assessed according to DSM-IV in 2007-2010 (when participants were aged 29-89) using the Munich Composite International Diagnostic Interview (DIA-X/M-CIDI). Childhood adversities were assessed with the Childhood Trauma Questionnaire (CTQ). RESULTS Logistic regressions with interaction terms (adjusted for sex and age) revealed that rs4680 interacted with total childhood adversity, emotional abuse and physical abuse in predicting panic disorder: Respective childhood adversities predicted panic disorder in carriers of the Val/Met or Met/Met genotype, but not Val/Val genotype. Moreover, a 3-way interaction was found between rs4680, emotional abuse and sex in predicting panic attacks: Emotional abuse predicted panic attacks among male carriers of the Val/Val genotype and female carriers of the Val/Met or Met/Met genotype, but not among male carriers of the Val/Met or Met/Met genotype or female carriers of the Val/Val genotype. LIMITATIONS Genotype data were derived by imputation. Childhood adversities and panic were assessed retrospectively. CONCLUSIONS Especially (female) carriers of the Val/Met or Met/Met genotype of rs4680 might profit from targeted early interventions to prevent the onset of panic after childhood adversities.
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Affiliation(s)
- Eva Asselmann
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany; Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany.
| | - Johannes Hertel
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Katja Beesdo-Baum
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany
| | | | - Georg Homuth
- Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany; German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, University Medicine, Greifswald, Germany
| | - Hans-Jörgen Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Christiane A Pané-Farré
- Department of Physiological and Clinical Psychology, University of Greifswald, Greifswald Germany
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44
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Penz M, Wekenborg MK, Pieper L, Beesdo-Baum K, Walther A, Miller R, Stalder T, Kirschbaum C. The Dresden Burnout Study: Protocol of a prospective cohort study for the bio-psychological investigation of burnout. Int J Methods Psychiatr Res 2018; 27:e1613. [PMID: 29611872 PMCID: PMC6877172 DOI: 10.1002/mpr.1613] [Citation(s) in RCA: 20] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 12/21/2017] [Accepted: 01/23/2018] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVES The Dresden Burnout Study (DBS) is a 12-year longitudinal cohort study that aims to provide a description of the burnout syndrome on the basis of time and symptom criteria with a special focus on the search for biomarkers. Biological and psychosocial approaches are applied to examine the long-term course and consequences of burnout within a population-based German-speaking sample aged 18 to 68 years. METHODS Demographics and psychosocial data are generated by online assessments, including demographics and questionnaires on burnout, burnout-related constructs, work-environment, and health-related factors. The lab-based biomarker assessment includes endocrine, physiological, immunological, and epigenetic markers obtained from blood and hair samples. In addition, heart rate variability is also measured repeatedly. Within the first 2 years, the DBS collected psychosocial data from over 7,600 participants with biological data obtained from more than 800 individuals. During the following 10 years, detailed assessments of biomarkers and psychosocial factors will be collected in annual study waves. RESULTS Results will be generated during the following decade. CONCLUSION The findings of the DBS are expected to pave the road for an in-depth biopsychosocial characterization of burnout and to give insight into the long-term course and potential mental and physical health consequences of the burnout syndrome.
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Affiliation(s)
- Marlene Penz
- Institute of Biological Psychology, Technische Universität Dresden, Dresden, Germany
| | - Magdalena K Wekenborg
- Institute of Biological Psychology, Technische Universität Dresden, Dresden, Germany
| | - Lars Pieper
- Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Dresden, Germany
| | - Katja Beesdo-Baum
- Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Dresden, Germany
| | - Andreas Walther
- Institute of Biological Psychology, Technische Universität Dresden, Dresden, Germany
| | - Robert Miller
- Institute of Biological Psychology, Technische Universität Dresden, Dresden, Germany
| | - Tobias Stalder
- Institute of Biological Psychology, Technische Universität Dresden, Dresden, Germany.,Clinical Psychology, University of Siegen, Siegen, Germany
| | - Clemens Kirschbaum
- Institute of Biological Psychology, Technische Universität Dresden, Dresden, Germany
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45
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Hofer PD, Wahl K, Meyer AH, Miché M, Beesdo-Baum K, Wong SF, Grisham JR, Wittchen HU, Lieb R. Obsessive-compulsive disorder and the risk of subsequent mental disorders: A community study of adolescents and young adults. Depress Anxiety 2018; 35:339-345. [PMID: 29489041 DOI: 10.1002/da.22733] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [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: 08/07/2017] [Revised: 01/25/2018] [Accepted: 01/29/2018] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Comorbidity of obsessive-compulsive disorder (OCD) with other mental disorders has been demonstrated repeatedly. Few longitudinal studies, however, have evaluated the temporal association of prior OCD and subsequent mental disorders across the age period of highest risk for first onset of mental disorders. We examined associations between prior OCD and a broad range of subsequent mental disorders and simulated proportions of new onsets of mental disorders that could potentially be attributed to prior OCD, assuming a causal relationship. METHODS Data from 3,021 14- to 24-year-old community subjects were prospectively collected for up to 10 years. DSM-IV OCD and other DSM-IV mental disorders were assessed with the Munich-Composite International Diagnostic Interview. We used adjusted time-dependent proportional hazard models to estimate the temporal associations of prior OCD with subsequent mental disorders. RESULTS Prior OCD was associated with an increased risk of bipolar disorders (BIP; [hazard ratio, HR = 6.9, 95% confidence interval, CI, (2.8,17.3)], bulimia nervosa [HR = 6.8 (1.3,36.6)], dysthymia [HR = 4.4 (2.1,9.0)], generalized anxiety disorder (GAD; [HR = 3.4 (1.1,10.9)], and social phobia [HR = 2.9 (1.1,7.7)]). Of these outcome disorders, between 65 and 85% could be attributed to OCD in the exposed group, whereas between 1.5 and 7.7% could be attributed to OCD in the total sample. CONCLUSIONS This study provides strong evidence that prior OCD is associated with an increased risk of subsequent onset of BIP, bulimia nervosa, dysthymia, GAD, and social phobia among adolescents and young adults. Future studies should evaluate if early treatment of OCD can prevent the onset of these subsequent mental disorders.
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Affiliation(s)
- Patrizia D Hofer
- Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Basel, Switzerland
| | - Karina Wahl
- Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Basel, Switzerland
| | - Andrea H Meyer
- Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Basel, Switzerland
| | - Marcel Miché
- Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Basel, Switzerland
| | - Katja Beesdo-Baum
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany
| | - Shiu F Wong
- School of Psychology, The University of New South Wales, Kensington, NSW, Australia
| | - Jessica R Grisham
- School of Psychology, The University of New South Wales, Kensington, NSW, Australia
| | - Hans-Ulrich Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Clinical Psychology & Psychotherapy RG, Department of Psychiatry & Psychotherapy, Ludwig Maximilians Universitaet Munich, Munich, Germany
| | - Roselind Lieb
- Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Basel, Switzerland.,Max Planck Institute of Psychiatry, Munich, Germany
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46
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Asselmann E, Wittchen HU, Lieb R, Perkonigg A, Beesdo-Baum K. Incident mental disorders in the aftermath of traumatic events: A prospective-longitudinal community study. J Affect Disord 2018; 227:82-89. [PMID: 29053980 DOI: 10.1016/j.jad.2017.10.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [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: 05/09/2017] [Revised: 09/11/2017] [Accepted: 10/01/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Few strictly prospective-longitudinal community studies examined the role of traumatic events for risk of developing a broad range of incident mental disorders over several years. METHOD A representative community sample of adolescents and young adults (n = 2797, baseline age 14-24) was prospectively examined in up to three assessment waves over up to 10 years. Traumatic events and DSM-IV mental disorders were assessed at each wave using the DIA-X/M-CIDI. Associations between traumatic events (meeting the DSM-IV A1-criterion for posttraumatic stress disorder, PTSD) or qualifying traumatic events (meeting the DSM-IV A2-criterion) at baseline and incident disorders at follow-up were tested with logistic regressions adjusted for gender and age. RESULTS While traumatic and qualifying traumatic events at baseline were related to various baseline disorders, considerably fewer associations were found in strictly prospective analyses with incident disorders at follow-up as outcomes. After adjustment for baseline disorders, only (a) the association of traumatic events with incident specific phobias (Odds Ratio, OR = 1.6) and (b) the associations of qualifying traumatic events with incident specific phobias (OR = 1.6), PTSD (OR = 2.5) and major depressive episodes (OR = 1.4) remained significant. CONCLUSION Targeted prevention and early intervention among traumatized individuals may be particularly beneficial to lower the incidence of specific phobias and MDE besides PTSD. LIMITATIONS Associations between traumatic events and incident mental disorders might be underestimated, as cases developing psychopathology immediately after trauma exposure prior to baseline were excluded in our strictly prospective analyses.
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Affiliation(s)
- Eva Asselmann
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany.
| | - Hans-Ulrich Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität München, Germany
| | - Roselind Lieb
- Max Planck Institute of Psychiatry, Munich, Germany; Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Basel, Switzerland
| | - Axel Perkonigg
- Division of Psychopathology and Clinical Intervention, Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Katja Beesdo-Baum
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany
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47
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Asselmann E, Hilbert K, Hoyer J, Wittchen HU, Lieb R, Bühringer G, Beesdo-Baum K. Self-reported volitional control in adolescents and young adults from a community cohort: Associations with current, past and future mental disorders. Psychiatry Res 2018; 260:292-299. [PMID: 29223798 DOI: 10.1016/j.psychres.2017.11.046] [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] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 11/15/2017] [Accepted: 11/16/2017] [Indexed: 12/27/2022]
Abstract
Alterations in volitional control have been found for various mental disorders. However, it remains unclear to which degree such alterations vary by type of psychopathology and constitute preceding vulnerabilities or correlates of mental disorders. DSM-IV mental disorders were assessed among adolescents and young adults from the community at baseline (age 14-24) and in up to 3 follow-up assessments over 10 years (n = 2515) using a standardized diagnostic interview (DIA-X/M-CIDI). Self-reported volitional control was assessed at second follow-up (T2) when subjects were aged 17-28 using the German version of the Short Form of the Volitional Components Inventory. Linear regressions adjusted for sex, age and lifetime disorders revealed that anxiety and affective disorders were associated with widespread alterations in self-reported volitional control (lower self regulation, higher self inhibition and volitional inhibition), while substance use disorders were specifically associated with higher volitional inhibition. Logistic regressions adjusted for sex, age and prior lifetime psychopathology revealed that lower self-reported volitional control at T2 predicted incident panic, social phobia and substance use at T3 (follow-up interval M = 4.8 years). Findings point toward at least partly disorder-specific alterations in volitional control in mental disorders, which might be antecedent vulnerability factors and thus useful to guide early recognition and prevention.
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Affiliation(s)
- Eva Asselmann
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany.
| | - Kevin Hilbert
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany
| | - Jana Hoyer
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany
| | - Hans-Ulrich Wittchen
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Roselind Lieb
- Max Planck Institute of Psychiatry, Munich, Germany; Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Basel, Switzerland
| | - Gerhard Bühringer
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Katja Beesdo-Baum
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany
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48
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Asselmann E, Wittchen HU, Lieb R, Beesdo-Baum K. Sociodemographic, clinical, and functional long-term outcomes in adolescents and young adults with mental disorders. Acta Psychiatr Scand 2018; 137:6-17. [PMID: 28861892 DOI: 10.1111/acps.12792] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [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] [Accepted: 07/26/2017] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To examine unfavorable sociodemographic, clinical, and functional long-term outcomes for a range of adolescent mental disorders. METHODS A total number of 2210 adolescents and young adults (14-24 years at baseline, T0) from a representative community sample were prospectively followed up (T1-T3) over 10 years. DSM-IV mental disorders, sociodemographic, clinical, and functional outcomes were assessed using the DIA-X/M-CIDI and its embedded assessment modules. RESULTS In (multinomial) logistic regressions adjusted for sex, age, other baseline disorders and sociodemographics, baseline anxiety, affective, substance use, somatoform and eating disorders (lifetime) predicted various unfavorable sociodemographic, clinical, and functional outcomes at T3. Particularly, strong associations were found between baseline disorders and adverse clinical outcomes at T3 (12-month diagnosis of the same/other disorder(s), drug use, suicide attempts, and help-seeking due to psychological problems). While substance use disorders were primarily associated with unfavorable sociodemographic and educational outcomes, anxiety and eating disorders were associated with unfavorable interpersonal outcomes, affective disorders with pregnancy-/childbirth-related complications and financial issues, and somatoform disorders with unfavorable educational/occupational and interpersonal outcomes. The risk of unfavorable outcomes increased with clinical severity, especially a higher number of baseline diagnoses. CONCLUSIONS Our findings emphasize the importance of effective treatment of mental disorders to prevent unfavorable long-term outcomes in various life domains.
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Affiliation(s)
- E Asselmann
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany
| | - H-U Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität München, Munich, Germany
| | - R Lieb
- Max Planck Institute of Psychiatry, Munich, Germany.,Department of Psychology, Division of Clinical Psychology and Epidemiology, University of Basel, Basel, Switzerland
| | - K Beesdo-Baum
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany
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49
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Behrendt S, Bühringer G, Höfler M, Lieb R, Beesdo-Baum K. Prediction of incidence and stability of alcohol use disorders by latent internalizing psychopathology risk profiles in adolescence and young adulthood. Drug Alcohol Depend 2017; 179:32-41. [PMID: 28750254 DOI: 10.1016/j.drugalcdep.2017.06.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [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: 11/25/2016] [Revised: 06/02/2017] [Accepted: 06/03/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Comorbid internalizing mental disorders in alcohol use disorders (AUD) can be understood as putative independent risk factors for AUD or as expressions of underlying shared psychopathology vulnerabilities. However, it remains unclear whether: 1) specific latent internalizing psychopathology risk-profiles predict AUD-incidence and 2) specific latent internalizing comorbidity-profiles in AUD predict AUD-stability. AIMS To investigate baseline latent internalizing psychopathology risk profiles as predictors of subsequent AUD-incidence and -stability in adolescents and young adults. METHODS Data from the prospective-longitudinal EDSP study (baseline age 14-24 years) were used. The study-design included up to three follow-up assessments in up to ten years. DSM-IV mental disorders were assessed with the DIA-X/M-CIDI. To investigate risk-profiles and their associations with AUD-outcomes, latent class analysis with auxiliary outcome variables was applied. RESULTS AUD-incidence: a 4-class model (N=1683) was identified (classes: normative-male [45.9%], normative-female [44.2%], internalizing [5.3%], nicotine dependence [4.5%]). Compared to the normative-female class, all other classes were associated with a higher risk of subsequent incident alcohol dependence (p<0.05). AUD-stability: a 3-class model (N=1940) was identified with only one class (11.6%) with high probabilities for baseline AUD. This class was further characterized by elevated substance use disorder (SUD) probabilities and predicted any subsequent AUD (OR 8.5, 95% CI 5.4-13.3). CONCLUSIONS An internalizing vulnerability may constitute a pathway to AUD incidence in adolescence and young adulthood. In contrast, no indication for a role of internalizing comorbidity profiles in AUD-stability was found, which may indicate a limited importance of such profiles - in contrast to SUD-related profiles - in AUD stability.
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Affiliation(s)
- Silke Behrendt
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, D-01187 Dresden, Germany.
| | - Gerhard Bühringer
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, D-01187 Dresden, Germany; IFT Institut für Therapieforschung, Parzivalstr. 25, D-80804 Munich, Germany
| | - Michael Höfler
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, D-01187 Dresden, Germany
| | - Roselind Lieb
- Department of Psychology, Division of Clinical Psychology and Epidemiology, University Basel, Missionsstr. 60-62, 4055 Basel, Switzerland
| | - Katja Beesdo-Baum
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, D-01187 Dresden, Germany; Behavioral Epidemiology, Technische Universität Dresden, Chemnitzer Str. 46, D-01187 Dresden, Germany
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50
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Voß C, Venz J, Pieper L, Frech C, Hoyer J, Beesdo-Baum K. Hilfesuche bei Jugendlichen und jungen Erwachsenen mit selbstverletzendem Verhalten. Das Gesundheitswesen 2017. [DOI: 10.1055/s-0037-1605891] [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: 10/18/2022]
Affiliation(s)
- C Voß
- TU Dresden, Behaviorale Epidemiologie, Institut für Klinische Psychologie und Psychotherapie, Dresden
| | - J Venz
- TU Dresden, Behaviorale Epidemiologie, Institut für Klinische Psychologie und Psychotherapie, Dresden
- TU Dresden, Center for Clinical Epidemiology and Longitudinal Studies, Dresden
| | - L Pieper
- TU Dresden, Behaviorale Epidemiologie, Institut für Klinische Psychologie und Psychotherapie, Dresden
- TU Dresden, Center for Clinical Epidemiology and Longitudinal Studies, Dresden
| | - C Frech
- TU Dresden, Behaviorale Epidemiologie, Institut für Klinische Psychologie und Psychotherapie, Dresden
| | - J Hoyer
- TU Dresden, Behaviorale Epidemiologie, Institut für Klinische Psychologie und Psychotherapie, Dresden
| | - K Beesdo-Baum
- TU Dresden, Behaviorale Epidemiologie, Institut für Klinische Psychologie und Psychotherapie, Dresden
- TU Dresden, Center for Clinical Epidemiology and Longitudinal Studies, Dresden
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