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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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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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Dierberger H, Pieper L, Jung M, Schulze M. Rotation of liquid-preserved artificial insemination doses on roller benches affects sperm quality during storage in stallions. Reprod Domest Anim 2023; 58:1413-1419. [PMID: 37596825 DOI: 10.1111/rda.14456] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 07/27/2023] [Accepted: 08/03/2023] [Indexed: 08/20/2023]
Abstract
Appropriate stallion semen handling is of great importance in equine artificial insemination (AI) industry. Optimal treatment of AI doses is aiming for best sperm preservation by excluding strong environmental influences and adding media that favour sperm survival. One method widely used in stallion sperm handling is the rotation of liquid-preserved semen samples on roller benches during storage. As previous studies in boars give rise to the fact that rotation should not be considered beneficial for spermatozoa anymore, the present study investigated the influence of continuous rotation of diluted stallion AI portions on sperm quality. Ejaculates (n = 15) were collected at a German AI centre and diluted with the two extenders EquiPlus and Gent (Minitüb GmbH) to a final concentration of 50 × 106 sperm/mL. Afterwards, samples were placed separately on roller benches at 5°C in the dark, obtaining a rotation frequency of 5 revolutions per minute (rpm) and 36 rpm for four consecutive days following a split-sample design. Both groups were analysed daily in comparison to a control group (0 rpm) with an extended spectrum of spermatological methods including computer-assisted sperm analysis and flow cytometry. Statistical analyses were based on the calculation of generalized linear mixed models for each sperm parameter. The research revealed a decrease in sperm quality parameters of rotated samples compared to non-rotated control groups, visible in total sperm motility (p < .001), decreased thermo-resistance (p < .01) and a drop in pH (p < .001). Interestingly, no differences (p > .05) were detected between rotation frequencies of 5 and 36 rpm. We conclude that the fertilizing capacity of stallion semen was negatively affected by rotation during storage in vitro, irrespective of the rotation frequency. Further studies need to investigate whether field fertility in horses is similarly affected by semen rotation on roller benches in vivo.
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Affiliation(s)
- H Dierberger
- Institute for Reproduction of Farm Animals Schönow, Bernau, Germany
| | - L Pieper
- Institute for Reproduction of Farm Animals Schönow, Bernau, Germany
| | - M Jung
- Institute for Reproduction of Farm Animals Schönow, Bernau, Germany
| | - M Schulze
- Institute for Reproduction of Farm Animals Schönow, Bernau, Germany
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Dierberger H, Pieper L, Jung M, Schulze M. Assessment of the stallion sperm acrosome in two different extenders: Spermac stain in comparison with PNA/PSA/PI triple-staining. Reprod Domest Anim 2023; 58:1330-1333. [PMID: 37399072 DOI: 10.1111/rda.14426] [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] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 06/21/2023] [Accepted: 06/28/2023] [Indexed: 07/05/2023]
Abstract
Since the stallion acrosome is very small compared to other species and cannot be properly assessed without additional staining, several labelling techniques were developed to facilitate its assessment. The aim of this study was to compare the Spermac stain (Minitüb GmbH) and a PNA/PSA/PI triple-staining detected by flow cytometry with regard to method agreement for detecting non-intact acrosomes within two different extenders. For this purpose, eighteen stallion ejaculates were split in half and diluted with the semen extenders EquiPlus or Gent (Minitüb GmbH) to a final concentration of 50 × 106 sperm/mL, respectively. Subsequently, 126 semen samples were stained with both methods between 4 and 240 h (mean: 63.8 ± 48.9 h) after semen collection. Calculated Intraclass correlation coefficients revealed excellent correlations between both methods for EquiPlus (r = .77, p < .001) and fair correlations for Gent (r = .49, p < .001). Interestingly, flow cytometry detected more non-intact acrosomes in EquiPlus than in Gent (p < .001), whereas the Spermac stain showed no differences (p = .902) between extenders. The poorer method agreement in Gent could be caused by egg yolk artefacts, which made interpretation difficult, so flow cytometry might be preferred. The differences in detected non-intact acrosomes between extenders highlighted the importance of establishing adapted laboratory protocols for different extender types in order to generate comparable results.
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Affiliation(s)
- H Dierberger
- Institute for Reproduction of Farm Animals Schönow, Bernau, Germany
| | - L Pieper
- Institute for Reproduction of Farm Animals Schönow, Bernau, Germany
| | - M Jung
- Institute for Reproduction of Farm Animals Schönow, Bernau, Germany
| | - M Schulze
- Institute for Reproduction of Farm Animals Schönow, Bernau, 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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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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Neidenbach R, Freilinger S, Stöcker F, Ewert P, Nagdyman N, Oberhoffer-Fritz R, Pieper L, Kaemmerer H, Hager A. Clinical aspects and targeted inspiratory muscle training in children and adolescents with Fontan circulation: a randomized controlled trial. Cardiovasc Diagn Ther 2023; 13:11-24. [PMID: 36864956 PMCID: PMC9971296 DOI: 10.21037/cdt-22-308] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 12/23/2022] [Indexed: 02/21/2023]
Abstract
Background Since 1968, thousands of patients with a morphologically or functionally univentricular heart have been treated with a total cavopulmonary connection/Fontan operation. Because of the resulting passive pulmonary perfusion, blood flow is assisted by the pressure shift during respiration. Respiratory training is known to improve exercise capacity and cardiopulmonary function. However, there are limited data on whether respiratory training can also improve physical performance after Fontan surgery. The aim of the present study was to clarify the effects of six months of daily home-based inspiratory muscle training (IMT) aimed at increasing physical performance by strengthening respiratory muscles, improving lung function and peripheral oxygenation. Methods In this non-blinded randomized controlled trial, the effects of IMT on lung capacity and exercise capacity were measured in a large cohort of 40 Fontan patients (25% female; 12.3±2.2 years) who were under regular follow-up by the outpatient clinic of the Department of Congenital Heart Defects and Pediatric Cardiology of the German Heart Center Munich. After a lung function test and a cardiopulmonary exercise test, patients were randomly assigned in a parallel arm design to either an intervention group (IG) or a control group (CG) via stratified and computer-generated letter randomization from May 2014 to May 2015. The IG completed a daily, telephone-monitored IMT of three sets of 30 repetitions for six months with an inspiratory resistive training device (POWERbreathe medic®), the CG continued their usual daily activities without an IMT until the second examination within the timeframe of November 2014 until November 2015. Results After six months of IMT, lung capacity values in the IG (n=18) did not increase significantly compared to the CG [n=19; ΔFVC: IG: 0.21±0.16 l vs. CG 0.22±0.31 l; P=0.946 (CI: -0.16, 0.17); ΔFEV1: CG: 0.14±0.30 vs. IG: 0.17±0.20 P=0.707 (CI: -0.20, 0.14)]. Exercise capacity did not improve significantly, yet the maximum workload achieved trended to improve with an increase of 14% in the IG vs. 6.5% in the CG [P=0.113 (CI: -15.8, 1.76)]. There was a significant increase of oxygen saturation at rest in the IG compared to the CG [IG: 3.31%±4.09% vs. CG: 0.17%±2.92%, P=0.014 (CI: -5.60, -0.68)]. Compared to the CG, the mean oxygen saturation at peak exercise no longer dropped below 90% in the IG. This observation is thus not statistically significant, yet of clinical relevance. Conclusions The results of this study show benefits of an IMT in young Fontan patients. Even if some data are not statistically significant, they may still be clinically relevant and may contribute to a multidisciplinary approach in patient care. IMT should therefore be an additional target and integrated into the training program to improve the prognosis of Fontan patients. Trial Registration German Clinical Trials Register; DRKS.de; registration ID: DRKS00030340.
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Affiliation(s)
- Rhoia Neidenbach
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Centre Munich, Technical University Munich, Munich, Germany;,Chair of Preventive Pediatrics, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany;,Department of Sports Medicine, Exercise Physiology and Prevention, Institute of Sport Science, University of Vienna, Vienna, Austria
| | - Sebastian Freilinger
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Centre Munich, Technical University Munich, Munich, Germany;,Chair of Preventive Pediatrics, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Fabian Stöcker
- Chair of Preventive Pediatrics, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Peter Ewert
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Centre Munich, Technical University Munich, Munich, Germany
| | - Nicole Nagdyman
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Centre Munich, Technical University Munich, Munich, Germany
| | - Renate Oberhoffer-Fritz
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Centre Munich, Technical University Munich, Munich, Germany;,Chair of Preventive Pediatrics, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Lars Pieper
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Centre Munich, Technical University Munich, Munich, Germany
| | - Harald Kaemmerer
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Centre Munich, Technical University Munich, Munich, Germany
| | - Alfred Hager
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Centre Munich, Technical University Munich, Munich, Germany
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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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Schmitt R, Pieper L, Borchardt S, Swinkels J, Gelfert CC, Staufenbiel R. Effects of a single transdermal administration of flunixin meglumine in early postpartum Holstein Friesian dairy cows: Part 2. Milk yield, culling risk, and reproductive performance. J Dairy Sci 2022; 106:641-652. [DOI: 10.3168/jds.2022-21995] [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: 02/21/2022] [Accepted: 08/12/2022] [Indexed: 11/13/2022]
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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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12
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Freiberger A, Beckmann J, Freilinger S, Kaemmerer H, Huber M, Nagdyman N, Ewert P, Pieper L, Deppe C, Kuschel B, Andonian C. Psychosocial well-being in postpartum women with congenital heart disease. Cardiovasc Diagn Ther 2022; 12:389-399. [PMID: 36033219 PMCID: PMC9412213 DOI: 10.21037/cdt-22-213] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 07/21/2022] [Indexed: 11/06/2022]
Abstract
Background Improved treatment options for congenital heart disease (CHD) lead to a growing number of women with CHD at reproductive age. Due to physical and psychological burden, pregnancies in women with CHD often count for high-risk. Resulting emotional distress can adversely impact pregnancy, motherhood and fetal health. The present study aims to retrospectively investigate mental outcomes and indices of adjustment in women with CHD before, during and after pregnancy. The novel concept of illness identity is applied to explain how patients experience and integrate their CHD into their identities. Methods Patient-reported outcome measures on mental functioning and illness identity were assessed in a sample of 121 postpartum women with CHD [mean age: 42.7±9.2 (range, 27-81) years] at the German Heart Centre Munich between August and November 2021 in a cross-sectional design. Descriptive analyses, correlations and linear regression models were calculated. Results Retrospectively assessed prevalence of emotional distress before giving birth was high (47.0%) and peaked shortly after childbirth in terms of elevated symptoms of postpartum depression and trauma. During the course of maternity, emotional distress decreased significantly (24.1%, P<0.001). Overall, postpartum women demonstrated high scores in functional illness identity states (i.e., acceptance and enrichment) and low scores in dysfunctional states (i.e., rejection and engulfment). CHD severity was not directly associated with mental outcomes (P>0.05), whereas maternal cardiovascular risk, according to the WHO classification, was significantly associated with a higher prevalence of postpartum trauma (t=2.485, P=0.015). Conclusions Postpartum mental health problems, such as (postpartum) depression, anxiety, and posttraumatic stress can become a serious burden which might be detrimental to the mother's well-being and her infant's development. Present findings emphasise the urgent need for a holistic approach focusing on pregnant women with CHD starting at the prepartum stage to prevent adverse consequences and promote maternal well-being. Illness identity might become an important target construct for clinical practice as it may positively and enduringly influence mental well-being of pregnant women with CHD.
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Affiliation(s)
- Annika Freiberger
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center, Technical University Munich, Munich, Germany
| | - Jürgen Beckmann
- Department of Sport and Health Sciences, Chair of Sport Psychology, Technical University, Munich, Germany.,School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, QLD, Australia.,Health Research Institute, University of Limerick, Limerick, Ireland
| | - Sebastian Freilinger
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center, Technical University Munich, Munich, Germany
| | - Harald Kaemmerer
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center, Technical University Munich, Munich, Germany
| | - Maximilian Huber
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center, Technical University Munich, Munich, Germany
| | - Nicole Nagdyman
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center, Technical University Munich, Munich, Germany
| | - Peter Ewert
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center, Technical University Munich, Munich, Germany
| | - Lars Pieper
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center, Technical University Munich, Munich, Germany
| | - Charlotte Deppe
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Germany
| | - Bettina Kuschel
- Department of Gynecology and Obstetrics, Klinikum Rechts der Isar Technical University Munich, Munich, Germany
| | - Caroline Andonian
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center, Technical University Munich, Munich, Germany.,Department of Sport and Health Sciences, Chair of Sport Psychology, Technical University, Munich, Germany
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Andonian C, Beckmann J, Mayer O, Ewert P, Freiberger A, Huber M, Kaemmerer H, Kurschat C, Lagler F, Nagdyman N, Pieper L, Regenbogen C, Freilinger S. Quality of life in patients with Fabry's disease: a cross-sectional study of 86 adults. Cardiovasc Diagn Ther 2022; 12:426-435. [PMID: 36033224 PMCID: PMC9412216 DOI: 10.21037/cdt-22-215] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 07/18/2022] [Indexed: 11/29/2022]
Abstract
Background Fabry disease (FD) is a multi-organ disorder associated with severe physical and psychological impairments, particularly in adulthood. To date, comprehensive data on the psychological burden of FD are lacking. The present study assessed quality of life (QOL) in a representative cohort of adults with FD. Methods Patient-reported outcome measures were retrospectively analyzed in 86 adults with FD (49.6±16.6 years; 62.8% female) and compared to adults with congenital heart defects (ACHD) which is another lifelong disease and affliction. QOL was assessed using the European Quality of Life 5 Dimensions 5 Levels questionnaire (EQ-5D-5L). Results Subjects affected by FD reported an overall reduced QOL (EQ-VAS: 71.8±20.0). Most frequently reported complaints occurred within the dimensions pain/discomfort (69.7%), daily activities (48.9%) and anxiety/depression (45.4%). Compared to ACHD, individuals with FD scored significantly lower in the areas of pain/discomfort, usual activities and mobility (all P<0.05). Older age and female sex were particularly associated with diminished QOL (P=0.05). Conclusions Patients with FD are at high risk for impaired QOL. They require additional support to cope with disease-related challenges. Increased attention should be directed towards improving their subjective well-being to potentially increase their QOL and long-term health outcomes.
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Affiliation(s)
- Caroline Andonian
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technical University Munich, Munich, Germany.,Department of Sport and Health Sciences, Chair of Sport Psychology, Technical University Munich, Munich, Germany.,Department of Psychosomatic Medicine and Psychotherapy, University Hospital Rechts der Isar, Technical University Munich, Munich, Germany
| | - Jürgen Beckmann
- Department of Sport and Health Sciences, Chair of Sport Psychology, Technical University Munich, Munich, Germany.,School of Human Movement and Nutrition Sciences, University of Queensland, Queensland, Australia.,Health Research Institute, University of Limerick, Limerick, Ireland
| | - Oliver Mayer
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technical University Munich, Munich, Germany
| | - Peter Ewert
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technical University Munich, Munich, Germany
| | - Annika Freiberger
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technical University Munich, Munich, Germany
| | - Maximilian Huber
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technical University Munich, Munich, Germany
| | - Harald Kaemmerer
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technical University Munich, Munich, Germany
| | - Christine Kurschat
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Florian Lagler
- Institute for Hereditary Metabolic Diseases, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Nicole Nagdyman
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technical University Munich, Munich, Germany
| | - Lars Pieper
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technical University Munich, Munich, Germany
| | - Claudia Regenbogen
- Department of Nephrology, Technical University of Munich, School of Medicine, Klinikum Rechts der Isar, Munich, Germany
| | - Sebastian Freilinger
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technical University Munich, Munich, Germany.,Department of Sport and Health Sciences, Chair of Preventive Pediatrics, Technical University of Munich, Munich, Germany
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14
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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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15
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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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16
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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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Schmitt R, Pieper L, Borchardt S, Swinkels JM, Gelfert CC, Staufenbiel R. Effects of a single transdermal administration of flunixin meglumine in early postpartum Holstein Friesian dairy cows: Part 1. Inflammatory and metabolic markers, uterine health, and indicators of pain. J Dairy Sci 2022; 106:624-640. [PMID: 35033349 DOI: 10.3168/jds.2021-20555] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 11/17/2021] [Indexed: 11/19/2022]
Abstract
The objectives of this study were to assess the effects of a single transdermal administration of flunixin meglumine (FM) in early postpartum Holstein Friesian dairy cows on serum concentrations of inflammatory and metabolic markers, uterine health, and indicators of pain. The hypothesis was that the anti-inflammatory, antipyretic, and analgetic effects of the pharmaceutic agent would reduce systemic inflammation, resulting in improved metabolic and inflammatory profile, diminished incidence of metritis, and reduced expression of pain. A total of 500 cows (153 primiparous, 347 multiparous) from 3 different commercial dairy farms in the northeast of Germany were included in a randomized controlled clinical trial. Farms were preselected based on high haptoglobin concentrations in their fresh lactating cows. Cows were excluded if they had experienced dystocia, stillbirth, or twin birth, or if they showed any signs of milk fever, retained fetal membranes, or fever (>40°C). The cows were treated once with either FM (3.33 mg/kg) or a placebo as control (CON) through transdermal administration between 24 to 36 h postpartum (d 2). General health examinations were performed (daily from d 2-8 and additionally on d 15 postpartum), vaginal discharge was assessed using the Metricheck device (d 8 and 15 postpartum) and serum samples were analyzed for inflammatory and metabolic markers (d 2, 4, and 6 postpartum). Effects of treatment, parity, sampling day, and their interactions were evaluated using mixed effects models. Primiparous cows treated with FM showed lower serum haptoglobin concentrations (0.90 ± 0.08 vs. 1.17 ± 0.07 g/L; ± standard error of the mean) and higher serum albumin concentrations (35.5 ± 0.31 vs. 34.8 ± 0.31 g/L) on d 6 postpartum. They also had a lower risk for purulent vaginal discharge with or without a fever compared with CON cows on d 15 postpartum (odds ratio for CON vs. FM: 1.63, 95% CI: 1.26-2.00), and body temperature was lower throughout the first 15 d in milk (39.1 ± 0.11 vs. 39.2 ± 0.11°C). Multiparous cows treated with FM had lower serum β-hydroxybutyrate concentrations on d 4 postpartum (0.71 ± 0.05 vs. 0.78 ± 0.05 mmol/L) and d 6 postpartum (0.74 ± 0.05 vs. 0.80 ± 0.05 mmol/L). Regardless of parity, FM-treated cows were significantly less likely to abduct their tail from their body (14.3 vs. 23.6%) and show an arched back (27.9 vs. 39.7%) on the day after treatment compared with CON cows. It can be concluded that FM treatment slightly reduced inflammation and diminished the risk for metritis in primiparous cows, improved metabolic profile in multiparous cows, and reduced expressions of pain in all cows.
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Affiliation(s)
- R Schmitt
- Ruminant and Swine Clinic, Free University of Berlin, Germany 14163.
| | - L Pieper
- Department of Farm Animal Surgery, Vetsuisse Faculty, University of Zürich, Switzerland 8057
| | - S Borchardt
- Clinic for Animal Reproduction, Free University of Berlin, Germany 14163
| | - J M Swinkels
- Global Ruminants Business Unit, MSD Animal Health, Boxmeer, the Netherlands 5831
| | - C-C Gelfert
- Intervet GesmbH, MSD Animal Health, Vienna, Austria 1210
| | - R Staufenbiel
- Ruminant and Swine Clinic, Free University of Berlin, Germany 14163
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18
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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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Huntgeburth M, Hohmann C, Ewert P, Freilinger S, Nagdyman N, Neidenbach R, Pieper L, Pieringer F, Lennerz C, Kaemmerer H, Kolb C. Implantable loop recorder for monitoring patients with congenital heart disease. Cardiovasc Diagn Ther 2021; 11:1334-1343. [PMID: 35070802 PMCID: PMC8748482 DOI: 10.21037/cdt-20-677] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 07/30/2020] [Accepted: 11/16/2020] [Indexed: 10/23/2023]
Abstract
BACKGROUND Patients with congenital heart defects (CHD) are prone to residua, sequels and complications from the underlying anomaly, where cardiac arrhythmias are one of the major causes for hospitalization, morbidity and mortality. The importance of the subcutaneous implantable loop recorder (ILR) for the detection and documentation of significant arrhythmias has increased over the last years. To date, however, there is little data on ILR use in the CHD population. METHODS In this single center, retrospective observational study, all CHD-patients with an ILR were identified who were under care of the German Heart Center Munich between February 2015 and January 2019. The primary endpoint of the study was the detection or exclusion of significant arrhythmias during follow-up in CHD-patients who had received an ILR. The secondary endpoint was to determine whether ILR findings influenced patient management, defined as initiation or adjustment of medication, cardioversion, electrophysiologic study, catheter ablation, or implantation of cardiac implantable electronic devices (CIEDs) such as pacemakers (PM) or implantable cardioverter-defibrillators. RESULTS An ILR was implanted in 33 CHD-patients (mean age, 43±20 years; 42.4% female) with CHD. During a mean observation period of 697±433 days, clinically relevant arrhythmias, correlating with the patients' complaints and symptoms, were detected in 19 patients (59.4%), encompassing supraventricular tachycardia (n=10), supraventricular or ventricular ectopic beats (n=10), non-sustained ventricular tachycardia (n=2), ventricular tachycardia (n=2), and bradycardia (n=2). In 9 patients (28.1%) the detected arrhythmia was considered an event requiring treatment. Treatment modalities included catheter ablation (n=5), modification of antiarrhythmic drug regime (n=2), adaptation of anticoagulation therapy (n=2), or implantation of a subcutaneous ICD (n=1). Regarding the occurrence of cardiac arrhythmias or a related need for therapeutic intervention, no significant differences were identified with respect to WHO functional class, the presence of pulmonary arterial hypertension or reduced resting peripheral oxygen saturation. CONCLUSIONS In symptomatic CHD-patients at risk for life-threatening cardiac events, ILR has a considerable complementary diagnostic value for the detection and differentiation of benign and malignant arrhythmias. Considering the overall low risk of complications, ILR implantation should be considered in patients with CHD of any complexity who need medium or long-term arrhythmia monitoring, especially if short-term Holter monitoring cannot provide sufficient diagnostic certainty.
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Affiliation(s)
- Michael Huntgeburth
- Center for Adults with Congenital Heart Disease, Clinic III for Internal Medicine, Department of Cardiology, Heart Center, Medical Faculty, University Hospital of Cologne, Cologne, Germany
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technical University of Munich, Munich, Germany
| | - Christopher Hohmann
- Center for Adults with Congenital Heart Disease, Clinic III for Internal Medicine, Department of Cardiology, Heart Center, Medical Faculty, University Hospital of Cologne, Cologne, Germany
| | - Peter Ewert
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technical University of Munich, Munich, Germany
| | - Sebastian Freilinger
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technical University of Munich, Munich, Germany
| | - Nicole Nagdyman
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technical University of Munich, Munich, Germany
| | - Rhoia Neidenbach
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technical University of Munich, Munich, Germany
| | - Lars Pieper
- Chair of Behavioural Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technical University of Dresden, Dresden, Germany
| | - Felix Pieringer
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technical University of Munich, Munich, Germany
| | - Carsten Lennerz
- Department of Electrophysiology, German Heart Center Munich, Technical University of Munich, Munich, Germany
| | - Harald Kaemmerer
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technical University of Munich, Munich, Germany
| | - Christof Kolb
- Department of Electrophysiology, German Heart Center Munich, Technical University of Munich, Munich, Germany
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Freilinger S, Andonian C, Beckmann J, Ewert P, Kaemmerer H, Lang N, Nagdyman N, Oberhoffer-Fritz R, Pieper L, Schelling J, von Scheidt F, Neidenbach R. Differences in the experiences and perceptions of men and women with congenital heart defects: A call for gender-sensitive, specialized, and integrative care. International Journal of Cardiology Congenital Heart Disease 2021. [DOI: 10.1016/j.ijcchd.2021.100185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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21
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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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22
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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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23
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Andonian CS, Freilinger S, Achenbach S, Ewert P, Gundlach U, Hoerer J, Kaemmerer H, Pieper L, Weyand M, Neidenbach RC, Beckmann J. 'Well-being paradox' revisited: a cross-sectional study of quality of life in over 4000 adults with congenital heart disease. BMJ Open 2021; 11:e049531. [PMID: 34158308 PMCID: PMC8220527 DOI: 10.1136/bmjopen-2021-049531] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE The present cross-sectional study investigated quality of life (QOL) in a large cohort of German adults with congenital heart disease (ACHDs) in association with patient-related and clinical variables. DESIGN Cross-sectional survey. PARTICIPANTS Between 2016 and 2019, a representative sample of 4014 adults with various forms of congenital heart defect (CHD) was retrospectively analysed. Inclusion criteria were confirmed diagnosis of CHD; participant aged 18 years and older; and necessary physical, cognitive and language capabilities to complete self-report questionnaires. PRIMARY AND SECONDARY OUTCOME MEASURES QOL was assessed using the 5-level EQ-5D version (EQ-5D-5L). Sociodemographic and medical information was obtained by a self-devised questionnaire. Associations of QOL with patient-reported clinical and sociodemographic variables were quantified using multiple regression analysis and multiple ordinal logit models. RESULTS Overall, ACHDs (41.8±17.2 years, 46.5% female) reported a good QOL comparable to German population norms. The most frequently reported complaints occurred in the dimensions pain/discomfort (mean: 16.3, SD: p<0.001) and anxiety/depression (mean: 14.3, p<0.001). QOL differed significantly within ACHD subgroups, with patients affected by pretricuspid shunt lesions indicating the most significant impairments (p<0.001). Older age, female sex, medication intake and the presence of comorbidities were associated with significant reductions in QOL (p<0.001). CHD severity was positively associated with QOL within the dimensions of self-care (OR 0.148, 95% CI 0.04 to 0.58) and mobility (OR 0.384, 95% CI 0.19 to 0.76). CONCLUSION Current findings temper widely held assumptions among clinicians and confirm that ACHDs experience a generally good QOL. However, specific subgroups may require additional support to cope with disease-related challenges. The negative correlation of QOL with age is especially alarming as the population of ACHDs is expected to grow older in the future. TRIAL REGISTRATION NUMBER DRKS00017699; Results.
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Affiliation(s)
- Caroline Sophie Andonian
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technical University Munich, Munich, Germany
- Department of Sport and Health Sciences, Chair of Sport Psychology, Technical University Munich, Munich, Germany
| | - Sebastian Freilinger
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technical University Munich, Munich, Germany
| | | | - Peter Ewert
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technical University Munich, Munich, Germany
| | - Ulrike Gundlach
- Department of Cardiology, University of Erlangen, Erlangen, Germany
| | - Jürgen Hoerer
- Department for Congenital and Pediatric Heart Surgery, German Heart Center Munich, Technical University Munich, Munich, Germany
| | - Harald Kaemmerer
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technical University Munich, Munich, Germany
| | - Lars Pieper
- Department of Behavioral Epidemiology, Technical University of Dresden, Dresden, Germany
| | - Michael Weyand
- Department of Cardiac Surgery, University of Erlangen, Erlangen, Germany
| | - Rhoia Clara Neidenbach
- Sports Medicine, Exercise Physiology and Prevention, Department of Sport Science, University of Vienna, Vienna, Austria
| | - Jürgen Beckmann
- Department of Sport and Health Sciences, Chair of Sport Psychology, Technical University Munich, Munich, Germany
- School of Human Movement and Nutrition Sciences, University of Queensland, Queensland, Brisbane, Australia
- Health Research Institute, University of Limerick, Limerick, Ireland
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24
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Neidenbach R, Achenbach S, Andonian C, Bauer UMM, Ewert P, Freilinger S, Gundlach U, Kaemmerer AS, Nagdyman N, Nebel K, Oberhoffer R, Pieper L, Reinhard W, Sanftenberg L, von Scheidt F, Schelling J, Seidel L, Weyand M, Kaemmerer H. Systematic assessment of health care perception in adults with congenital heart disease in Germany. Cardiovasc Diagn Ther 2021; 11:481-491. [PMID: 33968627 PMCID: PMC8102265 DOI: 10.21037/cdt-20-825] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 09/26/2020] [Accepted: 12/18/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND The number of adults with congenital heart disease (ACHD) is steadily rising due to increased survival rate and improved medical resources. Accordingly, more than 330,000 ACHD are currently living in Germany. Almost all of them require lifelong specialized medical follow-up for their chronic heart disease, often accompanied by residua, sequelae, or comorbidities. Primary care physicians (PCPs) are a crucial factor in directing patients to ACHD specialists or specialized institutions, but despite all efforts, the number of ACHD under specialized care is low, the lost-to-follow-up rate is high, and the morbidity and mortality is substantial. The present cross-sectional study was designed to systematically characterize the health care of ACHD from a patient perspective, including (I) use of medical care by ACHD, (II) medical counselling needs, and (III) perceived satisfaction with health care. METHODS The German-wide analysis was based on a 25-item questionnaire designed to address different aspects of medical status and health issues of ACHD from their own perspective, performed between May of 2017 and July of 2020. RESULTS A total of 4,008 ACHD (52% female; mean age 41.9±17.2 years) completed the questionnaire. The majority of ACHD (3,524, 87.9%) reported, that they consulted their PCP for non-cardiac health problems, and 49.7% (n=1,991) consulted their PCP also for medical problems associated with the underlying CHD. Almost all ACHD reported a need for medical advice concerning exercise capacity and daily life activities, occupational skills, pregnancy, rehabilitation, genetic counselling, insurance, and retirement. A total of 1,840 (45.9%) patients were not aware of the existence of certified ACHD specialists or centers. Moreover, 2,552 (67.6%) of those surveyed were uninformed about patient organizations for ACHD. CONCLUSIONS The present study demonstrates that ACHD are largely uninformed about the ACHD care structures available nationwide, although the patients have a great need for specialized follow-up, advice, and care.
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Affiliation(s)
- Rhoia Neidenbach
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technical University Munich, Germany
- Department of Sports Medicine, Exercise Physiology and Prevention, Institute of Sport Science, University of Vienna, Austria
| | - Stephan Achenbach
- Department of Cardiology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Germany
| | - Caroline Andonian
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technical University Munich, Germany
| | - Ulrike M. M. Bauer
- Competence Network for Congenital Heart Defects, National Register for Congenital Heart Defects, Berlin, Germany
| | - Peter Ewert
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technical University Munich, Germany
| | - Sebastian Freilinger
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technical University Munich, Germany
| | - Ulrike Gundlach
- Department of Cardiology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Germany
| | - Ann-Sophie Kaemmerer
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technical University Munich, Germany
| | - Nicole Nagdyman
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technical University Munich, Germany
| | - Kathrin Nebel
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technical University Munich, Germany
| | - Renate Oberhoffer
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technical University Munich, Germany
- Department of Preventive Pediatrics, Department of Sport and Health Sciences, Technical University of Munich, Germany
| | - Lars Pieper
- Department of Behavioral Epidemiology, Technical University of Dresden, Germany
| | - Wibke Reinhard
- Department of Cardiovascular Diseases, German Heart Center Munich, Technical University Munich, Germany
| | - Linda Sanftenberg
- Institute of General Practice, Ludwig-Maximilians-University Munich, Germany
| | - Fabian von Scheidt
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technical University Munich, Germany
| | | | - Lavinia Seidel
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technical University Munich, Germany
| | - Michael Weyand
- Department of Cardiac Surgery, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Harald Kaemmerer
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technical University Munich, Germany
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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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Andonian C, Freilinger S, Achenbach S, Ewert P, Gundlach U, Kaemmerer H, Nagdyman N, Neidenbach RC, Pieper L, Schelling J, Weyand M, Beckmann J. Quality of life in patients with Marfan syndrome: a cross-sectional study of 102 adult patients. Cardiovasc Diagn Ther 2021; 11:602-610. [PMID: 33968637 DOI: 10.21037/cdt-20-692] [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] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background Marfan syndrome (MFS) is a genetically determined multiorgan disease that leads to severe physiological and psychological impairments in adult life. Little consensus exists regarding quality of life (QOL) in individuals with MFS. The present study sought to investigate QOL in a representative cohort of adults with MFS. Methods Patient-reported outcome measures from a representative sample of 102 adults with MFS (39.3±13.1 years of age; 40.2% female) were retrospectively analyzed and compared with those from adults with different congenital heart defects (CHD), at the German Heart Center Munich. QOL was assessed using the updated five-level version of the EQ-5D. Results Differences between both populations were analyzed. Subjects affected by MFS reported an overall reduced QOL. Compared to CHD patients, individuals with MFS scored significantly lower in the dimensions of pain/discomfort, anxiety/depression, mobility and usual activities (P<0.05). Conclusions Patients with MFS are at high risk for impaired QOL, especially in mental and physical domains. Psychosocial consequences of MFS cost resources for both, patients and professionals. Current findings highlight the great importance of additional psychological support to cope with disease-related challenges. Increased attention should be directed towards enhancing their subjective wellbeing to potentially improve their QOL and long-term health outcomes.
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Affiliation(s)
- Caroline Andonian
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technical University Munich, Munich, Germany.,Department of Sport and Health Sciences, Chair of Sport Psychology, Technical University Munich, Munich, Germany.,Sigmund Freud University, Vienna, Austria
| | - Sebastian Freilinger
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technical University Munich, Munich, Germany
| | - Stefan Achenbach
- Department of Cardiology, University of Erlangen, Erlangen, Germany
| | - Peter Ewert
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technical University Munich, Munich, Germany
| | - Ulrike Gundlach
- Department of Cardiology, University of Erlangen, Erlangen, Germany
| | - Harald Kaemmerer
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technical University Munich, Munich, Germany
| | - Nicole Nagdyman
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technical University Munich, Munich, Germany
| | - Rhoia Clara Neidenbach
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technical University Munich, Munich, Germany
| | - Lars Pieper
- Department of Behavioral Epidemiology, Technical University of Dresden, Dresden, Germany
| | - Jörg Schelling
- Faculty of Medicine, Ludwig Maximilians University (LMU) of Munich, Munich, Germany
| | - Michael Weyand
- Department of Cardiology, University of Erlangen, Erlangen, Germany
| | - Jürgen Beckmann
- Department of Sport and Health Sciences, Chair of Sport Psychology, Technical University Munich, Munich, Germany.,School of Human Movement and Nutrition Sciences, University of Queensland, Australia.,Health Research Institute, University of Limerick, Limerick, Ireland
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27
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Kaemmerer AS, Freilinger S, Andonian C, Ewert P, Havasi K, Nagdyman N, Pieper L, Nebel K, Seidel L, Neidenbach R, Nemes A. Provision of medical health care for adults with congenital heart disease associated with aortic involvement. Cardiovasc Diagn Ther 2021; 11:518-528. [PMID: 33968630 DOI: 10.21037/cdt-20-359] [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] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Background All patients with congenital heart disease (CHD) are chronically ill from their cardiac disease. Despite the increasing evidence that aortic alterations are becoming relevant, the importance of aortopathy in CHD has long been underestimated. This study was conducted to determine the health status of patients and/or the provision of health services of adults with CHD (ACHD) with manifest aortopathy or at risk thereof. Methods In a questionnaire-based cross-sectional survey, the "real life"-care of ACHD was analysed, comparing patients with risk of developing aortopathy and/or manifest aortopathy. Results Of the 563 enrolled ACHD (49.6% female, mean age 35.8±12.1, 18-86 years) 56.8% (n=320) had a risk of developing aortopathy and/or manifest aortopathy. Of the 320 patients at risk, 187 (33.2% of the total number) had a proven aortopathy. Within this subgroup, the basic medical care for CHD-independent medical problems was given by primary medical care providers [family doctors/general practitioners (GP) in 89.4% (n=286), internists in 13.4% (n=43), physicians of another specialty in 2.5% (n=8)]. Almost all primary medical care providers knew about the CHD of their patients. Even for CHD-specific health problems, the basic medical care of risk patients was provided by a family doctor or GP in 56.6% (n=181) and by an internist in 18.4% (n=59). 30.0% (n=96) primarily consulted another specialist, including cardiologists. Only 32.8% of ACHD at risk had ever been referred to a CHD specialist by a GP for cardiac problems related to their CHD. In contrast, the need for advice was high for ACHD with aortopathy and related mainly to physical activity, employment and education, pregnancy, rehabilitation or health and life insurance. Only 35.5% of patients at risk indicated that their information on specific care structures for ACHD was sufficient, and a further 38.1% of patients were aware of patient organizations. Conclusions Even today, aortic involvement in ACHD is an often-overlooked condition, although considerable negative effects on morbidity and mortality exist. As aortopathy gains in importance with increasing age and complexity of CHD, almost all affected ACHD need lifelong medical advice and access to modern, scientifically based care concepts. According to the study-results, primary care providers and also patients are mostly insufficiently informed about the specialized ACHD facilities. The future goal is therefore to create a better awareness of CHD problems among both primary care physicians and the patients concerned.
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Affiliation(s)
- Ann-Sophie Kaemmerer
- Department of Congenital Heart Disease and Paediatric Cardiology, German Heart Centre Munich, Technical University Munich, Munich, Germany.,Department of Medicine and Cardiology Center, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Sebastian Freilinger
- Department of Congenital Heart Disease and Paediatric Cardiology, German Heart Centre Munich, Technical University Munich, Munich, Germany
| | - Caroline Andonian
- Department of Congenital Heart Disease and Paediatric Cardiology, German Heart Centre Munich, Technical University Munich, Munich, Germany
| | - Peter Ewert
- Department of Congenital Heart Disease and Paediatric Cardiology, German Heart Centre Munich, Technical University Munich, Munich, Germany
| | - Kalman Havasi
- Department of Medicine and Cardiology Center, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Nicole Nagdyman
- Department of Congenital Heart Disease and Paediatric Cardiology, German Heart Centre Munich, Technical University Munich, Munich, Germany
| | - Lars Pieper
- Department of Behavioural Epidemiology, Technical University of Dresden, Dresden, Germany
| | - Kathrin Nebel
- Department of Congenital Heart Disease and Paediatric Cardiology, German Heart Centre Munich, Technical University Munich, Munich, Germany
| | - Lavinia Seidel
- Department of Congenital Heart Disease and Paediatric Cardiology, German Heart Centre Munich, Technical University Munich, Munich, Germany
| | - Rhoia Neidenbach
- Department of Congenital Heart Disease and Paediatric Cardiology, German Heart Centre Munich, Technical University Munich, Munich, Germany
| | - Attila Nemes
- Department of Medicine and Cardiology Center, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
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28
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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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Beesdo‐Baum K, Voss C, Venz J, Hoyer J, Berwanger J, Kische H, Ollmann TM, Pieper L. The Behavior and Mind Health (BeMIND) study: Methods, design and baseline sample characteristics of a cohort study among adolescents and young adults. Int J Methods Psychiatr Res 2020; 29:e1804. [PMID: 31808242 PMCID: PMC7051848 DOI: 10.1002/mpr.1804] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 04/14/2019] [Accepted: 08/16/2019] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES The Behavior and Mind Health (BeMIND) study is a population-based cohort study of adolescents and young adults from Dresden, Germany. The aim is to investigate psychological and behavioral factors linked to a range of mental disorders and health behaviors and their interaction with social-environmental and genetic/biologic factors. METHODS A random sample of 14-21 year olds was drawn from the population registry in 2015. The baseline investigation was completed 11/2015-12/2016 (N = 1,180). Assessments include standardized diagnostic interview, cognitive-affective tasks, questionnaires, biosamples, and ecologic momentary assessment in real life with combined actigraphic/geographic monitoring. In the family study component, parents completed similar assessments and provided information on child's early development. RESULTS The participation rate (minimum response proportion) was 21.7%; the cooperation rate was 43.4%. Acceptance and completion of study components were high. General health data indicate that more than 80% reported no or only mild impairment due to mental or somatic health problems in the past year; about 20% ever sought treatment for mental health problems or chronic somatic illnesses, respectively. CONCLUSIONS Data from BeMIND baseline and follow-up investigations will provide novel insights into contributors to health and disease as adolescents grow into adulthood.
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Affiliation(s)
- Katja Beesdo‐Baum
- Behavioral Epidemiology, Institute of Clinical Psychology and PsychotherapyTechnische Universität DresdenDresdenGermany
- Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Institute of Clinical Psychology and PsychotherapyTechnische Universität DresdenDresdenGermany
| | - Catharina Voss
- Behavioral Epidemiology, Institute of Clinical Psychology and PsychotherapyTechnische Universität DresdenDresdenGermany
| | - John Venz
- Behavioral Epidemiology, Institute of Clinical Psychology and PsychotherapyTechnische Universität DresdenDresdenGermany
- Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Institute of Clinical Psychology and PsychotherapyTechnische Universität DresdenDresdenGermany
| | - Jana Hoyer
- Behavioral Epidemiology, Institute of Clinical Psychology and PsychotherapyTechnische Universität DresdenDresdenGermany
| | - Johanna Berwanger
- Behavioral Epidemiology, Institute of Clinical Psychology and PsychotherapyTechnische Universität DresdenDresdenGermany
| | - Hanna Kische
- Behavioral Epidemiology, Institute of Clinical Psychology and PsychotherapyTechnische Universität DresdenDresdenGermany
| | - Theresa Magdalena Ollmann
- Behavioral Epidemiology, Institute of Clinical Psychology and PsychotherapyTechnische Universität DresdenDresdenGermany
| | - Lars Pieper
- Behavioral Epidemiology, Institute of Clinical Psychology and PsychotherapyTechnische Universität DresdenDresdenGermany
- Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Institute of Clinical Psychology and PsychotherapyTechnische Universität DresdenDresdenGermany
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Ghazisaeedi F, Ciesinski L, Bednorz C, Johanns V, Pieper L, Tedin K, Wieler LH, Günther S. Phenotypic zinc resistance does not correlate with antimicrobial multi-resistance in fecal E. coli isolates of piglets. Gut Pathog 2020; 12:4. [PMID: 31988666 PMCID: PMC6972033 DOI: 10.1186/s13099-019-0342-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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: 07/07/2019] [Accepted: 12/23/2019] [Indexed: 02/07/2023] Open
Abstract
Background Following the ban on antimicrobial usage for growth promotion in animal husbandry in the EU, non-antimicrobial agents including heavy metal ions (e.g. zinc and copper), prebiotics or probiotics have been suggested as alternatives. Zinc has extensively been used in pig farming, particularly during weaning of piglets to improve animal health and growth rates. Recent studies, however, have suggested that high dietary zinc feeding during weaning of piglets increases the proportion of multi-drug resistant E. coli in the gut, contraindicating the appropriateness of zinc as an alternative. The underlying mechanisms of zinc effects on resistant bacteria remains unclear, but co-selection processes could be involved. In this study, we determined whether E. coli isolates from intestinal contents of piglets that had been supplemented with high concentrations of zinc acquired a higher tolerance towards zinc, and whether multi-drug resistant isolates tolerated higher zinc concentrations. In addition, we compared phenotypic zinc and copper resistance of E. coli isolates for possible correlation between phenotypic resistance/tolerance to different bivalent ionic metals. Results We screened phenotypic zinc/copper tolerance of 210 isolates (including antimicrobial resistant, multi-drug resistant, and non-resistant E. coli) selected from two, independent zinc-feeding animal trials by determining a zinc/copper minimal inhibitory concentration (Merlin, Bornheim-Hersel, Germany). In both trials, groups of piglets were supplemented either with high dietary zinc (> 2000 ppm) or control (50–70 ppm, background) concentrations. Our observations showed that high concentration zinc exposure did not have an effect on either zinc or copper phenotypic tolerance of E. coli isolates from the animals. No significant association was found between antimicrobial resistance and phenotypic zinc/copper tolerance of the same isolates. Conclusion Our findings argue against a co-selection mechanism of antimicrobial drug-resistance and zinc tolerance after dietary zinc supplementation in weaning piglets. An explanation for an increase in multi-drug resistant isolates from piglets with high zinc dietary feeding could be that resistant bacteria to antimicrobial agents are more persistent to stresses such as zinc or copper exposure.
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Affiliation(s)
- Fereshteh Ghazisaeedi
- 1Institute of Microbiology and Epizootics, Freie Universität Berlin, Robert-von-Ostertag-Str. 7-13, 14163 Berlin, Germany
| | - L Ciesinski
- 1Institute of Microbiology and Epizootics, Freie Universität Berlin, Robert-von-Ostertag-Str. 7-13, 14163 Berlin, Germany
| | - C Bednorz
- 2Institute of Chemical Physiology, Ludwig-Maximilians-Universität, Veterinärstr. 13, 80539 Munich, Germany
| | - V Johanns
- 3Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany
| | - L Pieper
- 4Institute of Veterinary Epidemiology and Biostatistics, Freie Universität Berlin, Königsweg 67, 14163 Berlin, Germany
| | - K Tedin
- 1Institute of Microbiology and Epizootics, Freie Universität Berlin, Robert-von-Ostertag-Str. 7-13, 14163 Berlin, Germany
| | - L H Wieler
- 1Institute of Microbiology and Epizootics, Freie Universität Berlin, Robert-von-Ostertag-Str. 7-13, 14163 Berlin, Germany.,3Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany
| | - Sebastian Günther
- 1Institute of Microbiology and Epizootics, Freie Universität Berlin, Robert-von-Ostertag-Str. 7-13, 14163 Berlin, Germany.,5Institute of Pharmacy, University of Greifswald, Friedrich-Ludwig-Jahn-Straße 17, 17489 Greifswald, Germany
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Neidenbach R, Achenbach S, Andonian C, Beckmann J, Biber S, Dittrich S, Ewert P, Freilinger S, Huntgeburth M, Nagdyman N, Oberhoffer R, Pieper L, von Kodolitsch Y, Weyand M, Bauer UMM, Kaemmerer H. [Medical care of adults with congenital heart diseases : Present and future]. Herz 2019; 44:553-572. [PMID: 31263905 DOI: 10.1007/s00059-019-4820-9] [Citation(s) in RCA: 5] [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] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Congenital heart diseases (CHD) are the most common types of congenital organ defects. Thanks to medical progress in congenital cardiology and heart surgery, most children with CHD reach adulthood. Despite primarily successful treatment residual and subsequent conditions as well as (non)cardiac comorbidities can influence the chronic course of the disease and lead to a higher morbidity and mortality. Adults with congenital heart disease (ACHD) in Germany are not tied to the healthcare structure despite the great need for aftercare. According to the results of the medical care of ACHD (MC-ACHD) study, ACHD centers and specialists in Germany are insufficiently perceived despite increased complication rates and the great need for specialist guidance. General practitioners and patients are not adequately informed about existing ACHD facilities. A better awareness of the ACHD problem should be created at the level of primary medical supply in order to optimize care and to reduce morbidity and mortality. Improved future-oriented patient care includes lifelong regular follow-up and the possibility of interdisciplinary, integrated medical care of CHD.
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Affiliation(s)
- R Neidenbach
- Klinik für angeborene Herzfehler und Kinderkardiologie, Deutsches Herzzentrum München, Lazarettstr. 36, 80636, München, Deutschland.
| | - S Achenbach
- Medizinische Klinik 2, Kardiologie und Angiologie, Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Deutschland
| | - C Andonian
- Lehrstuhl für Sportpsychologie, Fakultät für Sport- und Gesundheitswissenschaften, Technische Universität München, Georg-Brauchle-Ring 60-62, 80992, München, Deutschland
| | - J Beckmann
- Lehrstuhl für Sportpsychologie, Fakultät für Sport- und Gesundheitswissenschaften, Technische Universität München, Georg-Brauchle-Ring 60-62, 80992, München, Deutschland
| | - S Biber
- Lehrstuhl für Sportpsychologie, Fakultät für Sport- und Gesundheitswissenschaften, Technische Universität München, Georg-Brauchle-Ring 60-62, 80992, München, Deutschland
| | - S Dittrich
- Medizinische Klinik 2, Kardiologie und Angiologie, Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Deutschland
| | - P Ewert
- Klinik für angeborene Herzfehler und Kinderkardiologie, Deutsches Herzzentrum München, Lazarettstr. 36, 80636, München, Deutschland
| | - S Freilinger
- Klinik für angeborene Herzfehler und Kinderkardiologie, Deutsches Herzzentrum München, Lazarettstr. 36, 80636, München, Deutschland
| | - M Huntgeburth
- Klinik III für Innere Medizin, Zentrum für Erwachsene mit angeborenen Herzfehlern (EMAH), Herzzentrum, Universitätsklinikum Köln, Kerpener Str. 62, 50937, Köln, Deutschland
| | - N Nagdyman
- Klinik für angeborene Herzfehler und Kinderkardiologie, Deutsches Herzzentrum München, Lazarettstr. 36, 80636, München, Deutschland
| | - R Oberhoffer
- Lehrstuhl für Präventive Pädiatrie, Technische Universität München, Georg-Brauchle-Ring 60/62, 80992, München, Deutschland
| | - L Pieper
- Professur für behaviorale Epidemiologie, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Deutschland
| | - Y von Kodolitsch
- Universitäres Herzzentrum Hamburg, Klinik und Poliklinik für Allgemeine und Interventionelle Kardiologie, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland
| | - M Weyand
- Medizinische Klinik 2, Kardiologie und Angiologie, Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Deutschland
| | - U M M Bauer
- Nationales Register für angeborene Herzfehler, Berlin, Deutschland
| | - H Kaemmerer
- Klinik für angeborene Herzfehler und Kinderkardiologie, Deutsches Herzzentrum München, Lazarettstr. 36, 80636, München, Deutschland.
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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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Biber S, Andonian C, Beckmann J, Ewert P, Freilinger S, Nagdyman N, Kaemmerer H, Oberhoffer R, Pieper L, Neidenbach RC. Current research status on the psychological situation of parents of children with congenital heart disease. Cardiovasc Diagn Ther 2019; 9:S369-S376. [PMID: 31737543 DOI: 10.21037/cdt.2019.07.07] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Congenital heart diseases (CHD) are a leading cause of morbidity in children with a high impact on the psychological health of parents. Possible short-term and long-term psychological problems among parents are addressed in the current paper. The diagnosis of CHD paired with subsequent surgical and interventional treatment and prolonged hospital stays cause acute psychological distress and can lead to posttraumatic stress disorders (PTSD). As the disease course progresses, the impact on parents' health tends to decrease, but the risk of developing long-term psychological issues remains high. Studies have focused mainly on stress and other distressing symptoms without explicitly addressing the effects of a CHD diagnosis on the family system. Since the social environment may play an important role in parent's life, it may be useful to conduct studies to address these issues. In particular, the psychological situation of the father and the impact of the child's disease on the different dimensions of the father's life, such as parenting skills and influences on the parental relationship, have been largely neglected. Recent research has also disregarded the impact of CHD on siblings of the affected child. Research on chronic diseases in general has shown that the children's age and severity of the disease are related to an increased level of stress. Given the severity of CHD, anxiety and depression were higher in parents with children with more severe conditions. In addition, the results suggest that a positive construction of the parent-child relationship (attachment and bonding) is impaired, especially in mothers. Mothers reported worries and concerns about the challenging tasks they would face after learning about their child's CHD and how they can deal with their child's needs. It has also been shown that the child's illness has a negative impact on the whole family system, including the parent's relationship. Impairments on the parental relationship were perceived differently among mothers and fathers. Thus, there is high need for major changes to be identified, developed and implemented in the psychological care of parents with chronically ill children. So far, research has focused more on the psychological status of parents with chronically ill children, but less research has closely examined the effects of a child's CHD on its parent's mental health even though there is a high demand in additional support. A holistic treatment approach should include professional parental support, especially during children's hospitalization, information on the home care resources and services (especially respite services) and psychological support for parents.
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Affiliation(s)
- Sabina Biber
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Caroline Andonian
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany.,Department of Paediatric Cardiology and Congenital Heart Defects, German Heart Centre Munich, Munich, Germany
| | - Jürgen Beckmann
- Department of Paediatric Cardiology and Congenital Heart Defects, German Heart Centre Munich, Munich, Germany.,School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia
| | - Peter Ewert
- Department of Paediatric Cardiology and Congenital Heart Defects, German Heart Centre Munich, Munich, Germany
| | - Sebastian Freilinger
- Department of Paediatric Cardiology and Congenital Heart Defects, German Heart Centre Munich, Munich, Germany
| | - Nicole Nagdyman
- Department of Paediatric Cardiology and Congenital Heart Defects, German Heart Centre Munich, Munich, Germany
| | - Harald Kaemmerer
- Department of Paediatric Cardiology and Congenital Heart Defects, German Heart Centre Munich, Munich, Germany
| | - Renate Oberhoffer
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany.,Department of Paediatric Cardiology and Congenital Heart Defects, German Heart Centre Munich, Munich, Germany
| | - Lars Pieper
- Faculty of Psychology, Institute of Clinical Psychology and Psychotherapy, Technical University Dresden, Germany
| | - Rhoia Clara Neidenbach
- Department of Paediatric Cardiology and Congenital Heart Defects, German Heart Centre Munich, Munich, Germany
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Andonian C, Langer F, Beckmann J, Bischoff G, Ewert P, Freilinger S, Kaemmerer H, Oberhoffer R, Pieper L, Neidenbach RC. Overweight and obesity: an emerging problem in patients with congenital heart disease. Cardiovasc Diagn Ther 2019; 9:S360-S368. [PMID: 31737542 DOI: 10.21037/cdt.2019.02.02] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Due to technological and medical advances the population of adults with congenital heart disease (ACHD) is constantly growing. Worldwide, congenital heart disease (CHD) affects 1.35-1.5 million children each year and the number of ACHD meanwhile exceeds the number of CHD children. It has been found that a substantial number of ACHD present problematic health behaviors, such as physical inactivity and bad nutritional habits. Recent studies document alarming rates of overweight and obesity among CHD patients which may consequently lead to further health complications in this population. The present article focuses on the distinct psychosocial effects resulting from the diagnosis of CHD and their impact on developing disordered eating patterns and excess weight. It seeks to identify unique risk factors and relevant explanations associated with the increasing prevalence of obesity among CHD patients. This review suggests a vital need to establish clinical guidelines for nutrition and weight management in this patient population as part of a holistic treatment approach.
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Affiliation(s)
- Caroline Andonian
- Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich, Technical University Munich, Munich, Germany.,Technical University Munich, Munich, Germany.,Sigmund Freud University, Vienna, Austria
| | - Fabian Langer
- Department of Clinical Nutrition and Preventive Medicine, Hospital Barmherzige Brüder, Munich, Germany
| | - Jürgen Beckmann
- Technical University Munich, Munich, Germany.,University of Queensland, Brisbane, Australia
| | - Gert Bischoff
- Department of Clinical Nutrition and Preventive Medicine, Hospital Barmherzige Brüder, Munich, Germany
| | - Peter Ewert
- Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich, Technical University Munich, Munich, Germany
| | - Sebastian Freilinger
- Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich, Technical University Munich, Munich, Germany
| | - Harald Kaemmerer
- Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich, Technical University Munich, Munich, Germany
| | - Renate Oberhoffer
- Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich, Technical University Munich, Munich, Germany.,Technical University Munich, Munich, Germany
| | - Lars Pieper
- Department of Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany
| | - Rhoia Clara Neidenbach
- Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich, Technical University Munich, Munich, Germany.,Technical University Munich, Munich, Germany
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Neidenbach RC, Oberhoffer R, Pieper L, Freilinger S, Ewert P, Kaemmerer H, Nagdyman N, Hager A, Müller J. The value of hand grip strength (HGS) as a diagnostic and prognostic biomarker in congenital heart disease. Cardiovasc Diagn Ther 2019; 9:S187-S197. [PMID: 31737527 DOI: 10.21037/cdt.2019.09.16] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Background In patients with congenital heart disease (CHD), there is little data on the diagnostic and prognostic relevance of hand grip strength (HGS) for clinical assignment, while in the general population the loss of muscle strength and mass is an important risk factor in cardiovascular disease which is conversely associated with morbidity and all-cause mortality. This study aimed to assess the degree of muscle dysfunction using HGS as a biomarker in a large group of patients with CHD who often develop muscle dysfunction. Methods In total, 385 patients (27.6±13.1 years, 43% female) were included and assigned to 5 diagnostic groups: complex anomalies (n=131), left heart anomalies/aortopathies (n=107), right heart/pulmonary artery anomalies (n=92), primary left to-right-shunts (n=42) and miscellaneous CHD (n=13). Patients with Fontan circulation, chronic cyanosis, morphologic right systemic ventricle, arterial switch operation, or Ebstein's anomaly were analyzed separately. A control group (CG) consisted of 124 healthy individuals (30.1±12.1 years, 42% female). HGS was measured with a Jamar Hydraulic Hand Dynamometer. Results HGS was reduced in CHD patients compared to controls (35.2±14.6 versus 43.7±14.4 kg). Most impairments were present in females (26.1±7.6 kg). Patients with cyanosis had lower HGS values compared to acyanotic CHD patients (P=0.03). Patients with left heart lesions had the highest HSG values (40.7±14.7 kg), while patients with primary left-to-right shunt lesions had the lowest HSG values (30.9±11.3 kg). Within specific groups of cardiac anomalies, patients with Fontan circulation showed the lowest (P=0.033) and patients with a morphologic right system ventricle showed higher results (P=0.004). The late mid-term survival was favorable, and 7 patients (1.8%) died in a median interval of 422 days (range, 206-1,824 days) after HGS-testing. Conclusions This study provides the most comprehensive data on the use of HGS in CHD to date. Grip strength is an easily applicable, repeatedly usable and a cost-effective diagnostic tool to gain a quick, quantifiable assessment of the patient's current muscle function as an expression of cardiac fitness. Considering the low number of patients who died in the observation period, HGS may not be a suitable tool for survival assessment or identification of patients at risk. However, HGS is well suited to determine muscle function and strength and thereby to identify and to follow-up patients who have an increased cardiovascular risk.
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Affiliation(s)
- Rhoia Clara Neidenbach
- Department of Congenital Heart Defects and Pediatric Cardiology, German Heart Centre Munich, Technical University Munich, Munich, Germany
| | - Renate Oberhoffer
- Department of Congenital Heart Defects and Pediatric Cardiology, German Heart Centre Munich, Technical University Munich, Munich, Germany.,Institute of Preventive Pediatrics, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Lars Pieper
- Department of Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany
| | - Sebastian Freilinger
- Department of Congenital Heart Defects and Pediatric Cardiology, German Heart Centre Munich, Technical University Munich, Munich, Germany
| | - Peter Ewert
- Department of Congenital Heart Defects and Pediatric Cardiology, German Heart Centre Munich, Technical University Munich, Munich, Germany
| | - Harald Kaemmerer
- Department of Congenital Heart Defects and Pediatric Cardiology, German Heart Centre Munich, Technical University Munich, Munich, Germany
| | - Nicole Nagdyman
- Department of Congenital Heart Defects and Pediatric Cardiology, German Heart Centre Munich, Technical University Munich, Munich, Germany
| | - Alfred Hager
- Department of Congenital Heart Defects and Pediatric Cardiology, German Heart Centre Munich, Technical University Munich, Munich, Germany
| | - Jan Müller
- Institute of Preventive Pediatrics, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
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40
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Grammer TB, Dressel A, Gergei I, Kleber ME, Laufs U, Scharnagl H, Nixdorff U, Klotsche J, Pieper L, Pittrow D, Silber S, Wittchen HU, März W. Cardiovascular risk algorithms in primary care: Results from the DETECT study. Sci Rep 2019; 9:1101. [PMID: 30705337 PMCID: PMC6355969 DOI: 10.1038/s41598-018-37092-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 11/30/2018] [Indexed: 12/11/2022] Open
Abstract
Guidelines for prevention of cardiovascular diseases use risk scores to guide the intensity of treatment. A comparison of these scores in a German population has not been performed. We have evaluated the correlation, discrimination and calibration of ten commonly used risk equations in primary care in 4044 participants of the DETECT (Diabetes and Cardiovascular Risk Evaluation: Targets and Essential Data for Commitment of Treatment) study. The risk equations correlate well with each other. All risk equations have a similar discriminatory power. Absolute risks differ widely, in part due to the components of clinical endpoints predicted: The risk equations produced median risks between 8.4% and 2.0%. With three out of 10 risk scores calculated and observed risks well coincided. At a risk threshold of 10 percent in 10 years, the ACC/AHA atherosclerotic cardiovascular disease (ASCVD) equation has a sensitivity to identify future CVD events of approximately 80%, with the highest specificity (69%) and positive predictive value (17%) among all the equations. Due to the most precise calibration over a wide range of risks, the large age range covered and the combined endpoint including non-fatal and fatal events, the ASCVD equation provides valid risk prediction for primary prevention in Germany.
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Affiliation(s)
- Tanja B Grammer
- University of Heidelberg, Mannheim Medical Faculty, Mannheim Institute of Public Health, Social and Preventive Medicine, Mannheim, Germany. .,University of Heidelberg, Mannheim Medical Faculty, Department of Internal Medicine V (Nephrology, Hypertensiology, Rheumatology, Endocrinology, Diabetology), Mannheim, Germany.
| | - Alexander Dressel
- University of Heidelberg, Mannheim Medical Faculty, Department of Internal Medicine V (Nephrology, Hypertensiology, Rheumatology, Endocrinology, Diabetology), Mannheim, Germany
| | - Ingrid Gergei
- University of Heidelberg, Mannheim Medical Faculty, Department of Internal Medicine V (Nephrology, Hypertensiology, Rheumatology, Endocrinology, Diabetology), Mannheim, Germany
| | - Marcus E Kleber
- University of Heidelberg, Mannheim Medical Faculty, Department of Internal Medicine V (Nephrology, Hypertensiology, Rheumatology, Endocrinology, Diabetology), Mannheim, Germany
| | - Ulrich Laufs
- Clinic and Polyclinic of Cardiology, University Clinic Leipzig, Leipzig, Germany
| | - Hubert Scharnagl
- Medical University of Graz, Clinical Institute of Medical and Chemical Laboratory Diagnostics, Graz, Austria
| | - Uwe Nixdorff
- European Prevention Center, EPC GmbH, Düsseldorf, Germany.
| | - Jens Klotsche
- German Research Center of Rheumatology Berlin, Leibnitz Institute, Berlin, Germany
| | - Lars Pieper
- Charité Universitätsmedizin Berlin, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - David Pittrow
- Technical University Dresden, Medical Faculty, Institute of Clinical Pharmacology, Dresden, Germany
| | | | - Hans-Ulrich Wittchen
- Technical University Dresden, Institute of Clinical Psychology and Psychotherapy, Dresden, Germany.,Max-Planck- Institute of Psychiatry, Munich, Germany
| | - Winfried März
- University of Heidelberg, Mannheim Medical Faculty, Department of Internal Medicine V (Nephrology, Hypertensiology, Rheumatology, Endocrinology, Diabetology), Mannheim, Germany.,Medical University of Graz, Clinical Institute of Medical and Chemical Laboratory Diagnostics, Graz, Austria.,Synlab Services GmbH, Synlab Academy, Mannheim, Augsburg, Germany
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41
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Stöckle SD, Müller E, Winter JC, Sponder G, Aschenbach JR, Pieper L, Gehlen H. Dose-dependent effects of magnesium supplementation on serum and intracellular magnesium concentrations in healthy horses. PFERDEHEILKUNDE 2019. [DOI: 10.21836/pem20190605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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42
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Andonian C, Beckmann J, Biber S, Ewert P, Freilinger S, Kaemmerer H, Oberhoffer R, Pieper L, Neidenbach RC. Current research status on the psychological situation of adults with congenital heart disease. Cardiovasc Diagn Ther 2018; 8:799-804. [PMID: 30740327 PMCID: PMC6331374 DOI: 10.21037/cdt.2018.12.06] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [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: 11/16/2018] [Accepted: 12/12/2018] [Indexed: 12/29/2022]
Abstract
Due to technological and medical advances the population of adults with congenital heart disease (ACHD) is growing. Worldwide, congenital heart disease (CHD) affects 1.35-1.5 million children each year and more than 90% reach adulthood. Given the heterogeneity of CHD, survivors are faced with not only complex medical but also psychological challenges which may manifest in mental health problems, such as depression, anxiety and posttraumatic stress disorder. This review focuses on the emotional dimension of CHD. More precisely, it summarizes the present state of research on the prevalence of emotional distress in ACHD. Theoretical models provide a framework for possible explanations of mental health issues in ACHD. Additionally, the review examines the relation between psychological processes and overall health considering the latest scientific findings on coping with chronic illness (illness identity). There is still insufficient knowledge on the psychosocial treatment of mental health issues in the growing population of ACHD. This review suggests a vital need to further investigate the psychological situation of ACHD on a large-scale basis in order to establish a holistic treatment approach to accommodate the patients' special needs.
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Affiliation(s)
- Caroline Andonian
- Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich, Technical University Munich, Munich, Germany
- Technical University Munich, Munich, Germany
| | - Jürgen Beckmann
- Technical University Munich, Munich, Germany
- University of Queensland, Brisbane, Australia
| | | | - Peter Ewert
- Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich, Technical University Munich, Munich, Germany
| | - Sebastian Freilinger
- Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich, Technical University Munich, Munich, Germany
| | - Harald Kaemmerer
- Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich, Technical University Munich, Munich, Germany
| | - Renate Oberhoffer
- Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich, Technical University Munich, Munich, Germany
- Technical University Munich, Munich, Germany
| | - Lars Pieper
- Chair of Behavioral Epidemiology, Institute for Clinical Psychology and Psychotherapy, Technical University Dresden, Dresden, Germany
| | - Rhoia Clara Neidenbach
- Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich, Technical University Munich, Munich, Germany
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43
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Neidenbach R, Niwa K, Oto O, Oechslin E, Aboulhosn J, Celermajer D, Schelling J, Pieper L, Sanftenberg L, Oberhoffer R, de Haan F, Weyand M, Achenbach S, Schlensak C, Lossnitzer D, Nagdyman N, von Kodolitsch Y, Kallfelz HC, Pittrow D, Bauer UMM, Ewert P, Meinertz T, Kaemmerer H. Improving medical care and prevention in adults with congenital heart disease-reflections on a global problem-part II: infective endocarditis, pulmonary hypertension, pulmonary arterial hypertension and aortopathy. Cardiovasc Diagn Ther 2018; 8:716-724. [PMID: 30740319 DOI: 10.21037/cdt.2018.10.16] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Despite relevant residua and sequels, follow-up care of adults with congenital heart disease (ACHD) is too often not performed by/in specialized and/or certified physicians or centers although major problems in the long-term course may develop. The most relevant encompass heart failure, cardiac arrhythmias, heart valve disorders, pulmonary vascular disease, infective endocarditis (IE), aortopathy and non-cardiac comorbidities. The present publication emphasizes current data on IE, pulmonary and pulmonary arterial hypertension and aortopathy in ACHD and underlines the deep need of an experienced follow-up care by specialized and/or certified physicians or centers, as treatment regimens from acquired heart disease can not be necessarily transmitted to CHD. Moreover, the need of primary and secondary medical prevention becomes increasingly important in order to reduce the burden of disease as well as the socioeconomic burden and costs in this particular patient group.
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Affiliation(s)
- Rhoia Neidenbach
- Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich, Technical University Munich, Munich, Germany
| | - Koichiro Niwa
- Department of Cardiology, Cardiovascular Center, St. Luke's International Hospital, Tokyo, Japan
| | - Oeztekin Oto
- Dokuz Eylul University Hospital air Esref Cad, İzmir, Turkey
| | - Erwin Oechslin
- Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University Health Network, Toronto General Hospital, University of Toronto, Toronto, CA, Canada
| | - Jamil Aboulhosn
- Ahmanson/UCLA Adult Congenital Heart Disease Center, Los Angeles, USA
| | - David Celermajer
- Central Clinical School Heart Research Institute C39 - Royal Prince Alfred Hospital, The University of Sydney, NSW, Australia
| | - Joerg Schelling
- Institute of General Practice and Family Medicine, University Hospital of Ludwig-Maximilians-University Munich, Munich, Germany
| | - Lars Pieper
- Behavioral Epidemiology, Institute for Clinical Psychology und Psychotherapy, Technical University Dresden, Dresden, Germany
| | - Linda Sanftenberg
- Institute of General Practice and Family Medicine, University Hospital of Ludwig-Maximilians-University Munich, Munich, Germany
| | - Renate Oberhoffer
- Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich, Technical University Munich, Munich, Germany.,Preventive Pediatrics, Technical University Munich, Munich, Germany
| | | | - Michael Weyand
- Department of Cardiac Surgery, University of Erlangen, Erlangen, Germany
| | | | - Christian Schlensak
- Clinic for Thorax-, Heart- and Vessel Surgery, German Heart Competence Center, Tübingen, Germany
| | | | - Nicole Nagdyman
- Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich, Technical University Munich, Munich, Germany
| | - Yskert von Kodolitsch
- University Heart Center Hamburg, University Clinic Hamburg-Eppendorf, Hamburg, Germany
| | - Hans-Carlo Kallfelz
- Clinic for Pediatric Cardiology und Intensive medicine, Medical School Hannover, Hannover, Germany
| | - David Pittrow
- Institute for Clinical Pharmacology, Medical Faculty, Technical University Carl Gustav Carus, Dresden, Germany
| | | | - Peter Ewert
- Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich, Technical University Munich, Munich, Germany
| | - Thomas Meinertz
- University Heart Center Hamburg, University Clinic Hamburg-Eppendorf, Hamburg, Germany
| | - Harald Kaemmerer
- Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich, Technical University Munich, Munich, Germany
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44
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Neidenbach R, Niwa K, Oto O, Oechslin E, Aboulhosn J, Celermajer D, Schelling J, Pieper L, Sanftenberg L, Oberhoffer R, de Haan F, Weyand M, Achenbach S, Schlensak C, Lossnitzer D, Nagdyman N, von Kodolitsch Y, Kallfelz HC, Pittrow D, Bauer UMM, Ewert P, Meinertz T, Kaemmerer H. Improving medical care and prevention in adults with congenital heart disease-reflections on a global problem-part I: development of congenital cardiology, epidemiology, clinical aspects, heart failure, cardiac arrhythmia. Cardiovasc Diagn Ther 2018; 8:705-715. [PMID: 30740318 DOI: 10.21037/cdt.2018.10.15] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Today most patients with congenital heart defects (CHD) survive into adulthood. Unfortunately, despite relevant residua and sequels, follow-up care of adults with congenital heart disease (ACHD) is not performed in specialized and/or certified physicians or centres. Major problems in the long-term course encompass heart failure, cardiac arrhythmias, heart valve disorders, pulmonary vascular disease, infective endocarditis, aortopathy and non-cardiac comorbidities. Many of them manifest themselves differently from acquired heart disease and therapy regimens from general cardiology cannot be transferred directly to CHD. It should be noted that even simple, postoperative heart defects that were until recently considered to be harmless can lead to problems with age, a fact that had not been expected so far. The treatment of ACHD has many special features and requires special expertise. Thereby, it is important that treatment regimens from acquired heart disease are not necessarily transmitted to CHD. While primary care physicians have the important and responsible task to set the course for adequate diagnosis and treatment early and to refer patients to appropriate care in specialized ACHD-facilities, they should actively encourage ACHD to pursue follow-up care in specialized facilities who can provide responsible and advanced advice. This medical update emphasizes the current data on epidemiology, heart failure and cardiac arrhythmia in ACHD.
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Affiliation(s)
- Rhoia Neidenbach
- Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich, Technical University Munich, Munich, Germany
| | - Koichiro Niwa
- Department of Cardiology, Cardiovascular Center, St Luke's International Hospital, Tokyo, Japan
| | - Oeztekin Oto
- Dokuz Eylul University Hospital air Esref Cad, Izmir, Turkey
| | - Erwin Oechslin
- Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University Health Network, Toronto General Hospital, and University of Toronto, Toronto, Ontario, Canada
| | - Jamil Aboulhosn
- Ahmanson/UCLA Adult Congenital Heart Disease Center, Los Angeles, USA
| | - David Celermajer
- Central Clinical School Heart Research Institute C39 - Royal Prince Alfred Hospital, The University of Sydney, NSW 2006, Australia
| | - Joerg Schelling
- Institute of General Practice and Family Medicine, University Hospital of Ludwig-Maximilians-University Munich, Munich, Germany
| | - Lars Pieper
- Chair of Behavioral Epidemiology, Institute for Clinical Psychology und Psychotherapy, Technical University Dresden, Dresden, Germany
| | - Linda Sanftenberg
- Institute of General Practice and Family Medicine, University Hospital of Ludwig-Maximilians-University Munich, Munich, Germany
| | - Renate Oberhoffer
- Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich, Technical University Munich, Munich, Germany.,Preventive Pediatrics, Technical University Munich, Munich, Germany
| | | | - Michael Weyand
- Department of Cardiac Surgery, University of Erlangen, Erlangen, Germany
| | | | - Christian Schlensak
- Clinic for Thorax-, Heart- and Vessel Surgery, German Heart Competence Center, Tübingen, Germany
| | | | - Nicole Nagdyman
- Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich, Technical University Munich, Munich, Germany
| | - Yskert von Kodolitsch
- University Heart Center Hamburg, University Clinic Hamburg-Eppendorf, Hamburg, Germany
| | - Hans-Carlo Kallfelz
- Clinic for Pediatric Cardiology und Intensive medicine, Medical School Hannover, Hannover, Germany
| | - David Pittrow
- Institute for Clinical Pharmacology, Medical Faculty, Technical University Carl Gustav Carus, Dresden, Germany
| | | | - Peter Ewert
- Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich, Technical University Munich, Munich, Germany
| | - Thomas Meinertz
- University Heart Center Hamburg, University Clinic Hamburg-Eppendorf, Hamburg, Germany
| | - Harald Kaemmerer
- Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich, Technical University Munich, Munich, Germany
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45
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Kische H, Hoyer J, Pieper L, Venz J, Klotsche J, März W, Koch-Gromus U, Pittrow D, Lehnert H, Silber S, Stalla GK, Zeiher AM, Wittchen HU, Haring R. Testosterone is not associated with traits of optimism or pessimism: Observational evidence from the prospective DETECT study. PLoS One 2018; 13:e0207870. [PMID: 30496216 PMCID: PMC6264867 DOI: 10.1371/journal.pone.0207870] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 11/06/2018] [Indexed: 11/18/2022] Open
Abstract
Background Previous experimental research on testosterone (T) and psychological traits is inconclusive. Thus, we performed the first large-scale observational study of the association between T and dispositional optimism / pessimism. Methods We used prospective data from 6,493 primary-care patients (3,840 women) of the DETECT study (Diabetes Cardiovascular Risk-Evaluation: Targets and Essential Data for Commitment of Treatment), including repeated immunoassay-based measurement of serum T and optimism / pessimism assessed by the revised Life-Orientation Test (LOT-R). Cross-sectional and longitudinal associations of baseline T and one-year change in T with optimism and pessimism were investigated using age- and multivariable-adjusted regression models. Results Cross-sectional analyses showed no association of T with optimism or pessimism in both sexes. Longitudinal analyses also showed no association of baseline T with optimism or pessimism at four-year follow-up. Multivariable analyses of total LOT-R score yielded similarly non-significant results (β-coefficient per unit change in T for men: -0.01 (95% CI: -0.24–0.22), women: 0.08 (-0.03–0.20)). Furthermore, change in T was not related to optimism or pessimism at four-year follow-up. Conclusions The present observational study of a large-scale prospective sample showed no association of T with optimism or pessimism. Integrating further experimental and interventional evidence from alternative methodological approaches would strengthen this conclusion and establish stronger evidence about the potential hormonal basis of psychological traits.
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Affiliation(s)
- Hanna Kische
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technical University of Dresden, Dresden, Germany
| | - Jürgen Hoyer
- Institute of Clinical Psychology and Psychotherapy, Technical University of Dresden, Dresden, Germany
| | - Lars Pieper
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technical University of Dresden, Dresden, Germany
| | - John Venz
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technical University of Dresden, Dresden, Germany
| | - Jens Klotsche
- German Rheumatism Research Centre Berlin, Berlin, Germany
| | - Winfried März
- Medical Clinic V, Medical Faculty Mannheim at Heidelberg University, Heidelberg, Germany
| | - Uwe Koch-Gromus
- Department of Medical Psychology, University Medical Center Eppendorf, Hamburg, Germany
| | - David Pittrow
- Institute of Clinical Pharmacology, Medical Faculty, Technical University of Dresden, Dresden, Germany
| | - Hendrik Lehnert
- Department of Medicine I, University of Schleswig-Holstein, Lübeck, Germany
| | | | | | - Andreas M. Zeiher
- Department of Medicine III Cardiology, Goethe University Frankfurt, Frankfurt, Germany
| | - Hans-Ulrich Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technical University of Dresden, Dresden, Germany
| | - Robin Haring
- European University of Applied Sciences, Faculty of Applied Public Health, Rostock, Germany
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- * E-mail:
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46
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Neidenbach RC, Pieper L, Sanftenberg L, Schelling J, Freilinger S, Seidel L, Oberhoffer R, Nagdyman N, Ewert P, Kaemmerer H. P718Adults with congenital heart disease: lack of specific disease related medical health care from the general practitioners view. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p718] [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: 11/12/2022] Open
Affiliation(s)
- R C Neidenbach
- Deutsches Herzzentrum Technische Universitat, Department of Paediatric Cardiology and Congenital Cardiac Defects, Munich, Germany
| | - L Pieper
- Dresden University of Technology, Dresden, Germany
| | | | - J Schelling
- Ludwig-Maximilians University, Munich, Germany
| | - S Freilinger
- Deutsches Herzzentrum Technische Universitat, Department of Paediatric Cardiology and Congenital Cardiac Defects, Munich, Germany
| | - L Seidel
- Deutsches Herzzentrum Technische Universitat, Department of Paediatric Cardiology and Congenital Cardiac Defects, Munich, Germany
| | - R Oberhoffer
- Deutsches Herzzentrum Technische Universitat, Department of Paediatric Cardiology and Congenital Cardiac Defects, Munich, Germany
| | - N Nagdyman
- Deutsches Herzzentrum Technische Universitat, Department of Paediatric Cardiology and Congenital Cardiac Defects, Munich, Germany
| | - P Ewert
- Deutsches Herzzentrum Technische Universitat, Department of Paediatric Cardiology and Congenital Cardiac Defects, Munich, Germany
| | - H Kaemmerer
- Deutsches Herzzentrum Technische Universitat, Department of Paediatric Cardiology and Congenital Cardiac Defects, Munich, Germany
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47
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Neidenbach RC, Diebold I, Pieper L, Freilinger S, Oberhoffer R, Krauss A, Seidel H, Sanftenberg L, Nagdyman N, Ewert P, Kaemmerer H. P2603Adults with congenital heart defects: insufficient medical primary health care in patients with genetic disorders. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2603] [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: 11/14/2022] Open
Affiliation(s)
- R C Neidenbach
- Deutsches Herzzentrum Technische Universitat, Department of Paediatric Cardiology and Congenital Cardiac Defects, Munich, Germany
| | - I Diebold
- Deutsches Herzzentrum Technische Universitat, Department of Paediatric Cardiology and Congenital Cardiac Defects, Munich, Germany
| | - L Pieper
- Dresden University of Technology, Dresden, Germany
| | - S Freilinger
- Deutsches Herzzentrum Technische Universitat, Department of Paediatric Cardiology and Congenital Cardiac Defects, Munich, Germany
| | - R Oberhoffer
- Deutsches Herzzentrum Technische Universitat, Department of Paediatric Cardiology and Congenital Cardiac Defects, Munich, Germany
| | - A Krauss
- Deutsches Herzzentrum Technische Universitat, Department of Paediatric Cardiology and Congenital Cardiac Defects, Munich, Germany
| | - H Seidel
- Deutsches Herzzentrum Technische Universitat, Department of Paediatric Cardiology and Congenital Cardiac Defects, Munich, Germany
| | | | - N Nagdyman
- Deutsches Herzzentrum Technische Universitat, Department of Paediatric Cardiology and Congenital Cardiac Defects, Munich, Germany
| | - P Ewert
- Deutsches Herzzentrum Technische Universitat, Department of Paediatric Cardiology and Congenital Cardiac Defects, Munich, Germany
| | - H Kaemmerer
- Deutsches Herzzentrum Technische Universitat, Department of Paediatric Cardiology and Congenital Cardiac Defects, Munich, Germany
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48
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Neidenbach RC, Pieper L, Freilinger S, Nebel K, Sanftenberg L, Schelling J, Nagdyman N, Ewert P, Kaemmerer H. P717Adults with congenital heart disease: lack of specific disease related medical health care from the patients point of view. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p717] [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: 11/14/2022] Open
Affiliation(s)
- R C Neidenbach
- Deutsches Herzzentrum Technische Universitat, Department of Paediatric Cardiology and Congenital Cardiac Defects, Munich, Germany
| | - L Pieper
- Dresden University of Technology, Dresden, Germany
| | - S Freilinger
- Deutsches Herzzentrum Technische Universitat, Department of Paediatric Cardiology and Congenital Cardiac Defects, Munich, Germany
| | - K Nebel
- Deutsches Herzzentrum Technische Universitat, Department of Paediatric Cardiology and Congenital Cardiac Defects, Munich, Germany
| | | | - J Schelling
- Ludwig-Maximilians University, Munich, Germany
| | - N Nagdyman
- Deutsches Herzzentrum Technische Universitat, Department of Paediatric Cardiology and Congenital Cardiac Defects, Munich, Germany
| | - P Ewert
- Deutsches Herzzentrum Technische Universitat, Department of Paediatric Cardiology and Congenital Cardiac Defects, Munich, Germany
| | - H Kaemmerer
- Deutsches Herzzentrum Technische Universitat, Department of Paediatric Cardiology and Congenital Cardiac Defects, Munich, Germany
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49
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Venjakob PL, Pieper L, Heuwieser W, Borchardt S. Association of postpartum hypocalcemia with early-lactation milk yield, reproductive performance, and culling in dairy cows. J Dairy Sci 2018; 101:9396-9405. [PMID: 30031579 DOI: 10.3168/jds.2017-14202] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [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: 11/27/2017] [Accepted: 05/22/2018] [Indexed: 11/19/2022]
Abstract
Periparturient hypocalcemia is frequently observed and considered as a gateway disease that is associated with various health issues. The objective of this study was to evaluate the association of hypocalcemia with early-lactation milk yield, reproductive performance, and culling across a large number of different managerial systems. A prospective cohort study was conducted based on a convenience sample of 125 dairy herds from 8 federal states of Germany between February 2015 and August 2016. A blood sample was drawn from 1,709 animals within 48 h after parturition and analyzed for serum calcium concentration. After discarding cows (n = 283) with missing data, a total of 1,426 cows were considered for final analyses. The median time from calving to sampling was 14.0 h (interquartile range = 5.0-24.9 h). For each herd, a record of the herd management software was requested 150 d after the last cow was sampled. Serum calcium concentration of each cow was associated with early-lactation milk yield (Dairy Herd Improvement Association equivalent test 1 to 3), reproductive performance [days in milk (DIM) at first artificial insemination (AI), pregnancy at first AI, time to pregnancy within 150 DIM], and culling (until 60 DIM) data. Generalized linear mixed models were used to analyze continuous or categorical data. Shared frailty models were used for time to event data. Five different thresholds were used to define hypocalcemia. Thresholds ranged from 1.8 to 2.2 mmol/L using 0.1-mmol/L increments. Clinical hypocalcemia was defined as serum calcium concentration <2.0 mmol/L in combination with clinical signs (e.g., recumbency). The effect of hypocalcemia on milk yield was conditional on parity. In primiparous cows a serum calcium concentration <2.0 mmol/L (6.4% of cows were below this threshold) had no effect on milk production, whereas there was a tendency for multiparous cows with a serum calcium concentration <2.1 mmol/L (63.2% of cows were below this threshold) to produce 0.80 kg/d more milk compared with multiparous cows at or above the threshold. Multiparous cows suffering from clinical hypocalcemia produced 2.19 kg/d less milk compared with normocalcemic cows in early lactation. Calcium status was not associated with days to first insemination. Cows with a serum calcium concentration <1.9 mmol/L (34.6% of cows below this threshold) had decreased odds (odds ratio = 0.56) of pregnancy at first AI. A serum calcium concentration <1.8 mmol/L (24.1% of cows below this threshold) had a significant effect on time to pregnancy. Compared with animals with a serum calcium concentration ≥1.8 mmol/L, the hazard of becoming pregnant within 150 DIM was reduced when cows had a serum calcium concentration <1.8 mmol/L (hazard ratio = 0.68). Cows with a serum calcium concentration <2.0 mmol/L (44.3% of cows were below this threshold) had a 1.69 times greater hazard of being culled within the first 60 DIM compared with normocalcemic animals. The present study shows that the association of hypocalcemia with milk yield was conditional on parity and serum calcium concentration measured once within 48 h after calving. Considering reproductive performance and culling in early lactation, a negative effect of postpartum hypocalcemia was demonstrated.
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Affiliation(s)
- P L Venjakob
- Clinic for Animal Reproduction, Faculty of Veterinary Medicine, Freie Universität Berlin, 14163 Berlin, Germany; Veterinary practice G. Thiele, 15837 Baruth/Mark, Germany
| | - L Pieper
- Institute for Veterinary Epidemiology and Biostatistics, Faculty of Veterinary Medicine, Freie Universität Berlin, 14163 Berlin, Germany
| | - W Heuwieser
- Clinic for Animal Reproduction, Faculty of Veterinary Medicine, Freie Universität Berlin, 14163 Berlin, Germany.
| | - S Borchardt
- Clinic for Animal Reproduction, Faculty of Veterinary Medicine, Freie Universität Berlin, 14163 Berlin, Germany
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50
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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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