446 results on '"ME Beutel"'
Search Results
2. Verbesserung kognitiver Performance und psychischem Funktionsniveau nach verhaltenstherapeutischer Behandlung von Patienten mit Internetsucht
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M Dreier, ME Beutel, K Wölfling, and KW Müller
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- 2019
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3. Cue Reactivity bei Internetbezogenen Störungen
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L Vinzenz, L Mader, ME Beutel, KW Müller, A Kessler, L Scherer, and K Wölfling
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Chemistry ,Cue reactivity ,Neuroscience - Published
- 2019
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4. Phänomenologie suchtartiger Social Media Nutzung
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M Dreier, KW Müller, ME Beutel, L Scherer, Matthias Brand, K Wölfling, L Mader, and Elisa Wegmann
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- 2019
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5. Maladaptive Persönlichkeitsmerkmale als Risikofaktoren für internetbezogene Störungen
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M Dreier, L Mader, L Scherer, K Wölfling, KW Müller, and ME Beutel
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- 2019
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6. Deviante Nutzung von Online-Pornografie und Kindheitstraumata – Eine vergleichende Betrachtung mit Verhaltenssüchten
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KW Müller, ME Beutel, and C Marx
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- 2019
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7. Insecure peer attachment predicts problematic internet use in German adolescents
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Iris Reiner, J Hardt, ME Beutel, K Wölfling, Ana Nanette Tibubos, and KW Müller
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German ,Internet use ,language ,Psychology ,Social psychology ,Peer attachment ,language.human_language - Published
- 2019
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8. Über Free-to-Play-Spiele und die Verhaltenssucht
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KW Müller, ME Beutel, K Wölfling, and M Dreier
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- 2017
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9. Personality traits in patients with active and controlled acromegaly: A cross sectional multi-center study
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Christian J. Strasburger, Christof Schöfl, R Zwerenz, A Dixius, Matthias M. Weber, Michael Droste, Anca Zimmermann, ME Beutel, Ursula Plöckinger, and J Honneger
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medicine.medical_specialty ,business.industry ,Endocrinology, Diabetes and Metabolism ,General Medicine ,medicine.disease ,Endocrinology ,Multi center study ,Acromegaly ,Internal Medicine ,Medicine ,In patient ,Big Five personality traits ,business ,Psychiatry - Published
- 2014
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10. Loneliness and social anxiety in the general population over time - results of a cross-lagged panel analysis.
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Reinwarth AC, Beutel ME, Schmidt P, Wild PS, Münzel T, König J, Konstantinides SV, Schattenberg JM, Lackner KJ, Schuster AK, Tüscher O, and Geschke K
- Abstract
Background: Loneliness has become a major public health issue of the recent decades due to its severe impact on health and mortality. Little is known about the relation between loneliness and social anxiety. This study aimed (1) to explore levels of loneliness and social anxiety in the general population, and (2) to assess whether and how loneliness affects symptoms of social anxiety and vice versa over a period of five years., Methods: The study combined data from the baseline assessment and the five-year follow-up of the population-based Gutenberg Health Study. Data of N = 15 010 participants at baseline ( M
age = 55.01, s.d.age = 11.10) were analyzed. Multiple regression analyses with loneliness and symptoms of social anxiety at follow-up including sociodemographic, physical illnesses, and mental health indicators at baseline were used to test relevant covariates. Effects of loneliness on symptoms of social anxiety over five years and vice versa were analyzed by autoregressive cross-lagged structural equation models., Results: At baseline, 1076 participants (7.41%) showed symptoms of social anxiety and 1537 (10.48%) participants reported feelings of loneliness. Controlling for relevant covariates, symptoms of social anxiety had a small significant effect on loneliness five years later (standardized estimate of 0.164, p < 0.001). Vice versa, there was no significant effect of loneliness on symptoms of social anxiety taking relevant covariates into account., Conclusions: Findings provided evidence that symptoms of social anxiety are predictive for loneliness. Thus, prevention and intervention efforts for loneliness need to address symptoms of social anxiety.- Published
- 2024
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11. Prevalence of current suicidal thoughts and lifetime suicide attempts in individuals with cancer and other chronic diseases in Germany: Evidence for differential associations from a representative community cohort.
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Schwinn T, Paul RH, Hirschmiller J, Brähler E, Wiltink J, Zwerenz R, O'Connor RC, Wild PS, Münzel T, König J, Geschke K, Moehler M, Konstantinides S, Justenhoven C, Lackner KJ, Pfeiffer N, Beutel ME, and Ernst M
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- Humans, Male, Female, Middle Aged, Germany epidemiology, Prevalence, Chronic Disease epidemiology, Chronic Disease psychology, Aged, Cross-Sectional Studies, Prospective Studies, Adult, Risk Factors, Sex Factors, Surveys and Questionnaires, Cohort Studies, Suicide, Attempted statistics & numerical data, Suicide, Attempted psychology, Suicidal Ideation, Neoplasms psychology, Neoplasms epidemiology
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Background: Research indicates an elevated risk for suicidal thoughts and behaviors (STBs) among individuals with cancer, but community-based studies on the prevalence of STBs in comparison to the general population and other chronic diseases are lacking., Methods: Data was drawn from the representative population-based, prospective Gutenberg Health Study (GHS). Participants (N = 12,382; age: M = 59.5, SD = 10.8; 48.9 % women) completed highly standardized medical assessments and validated questionnaires such as the PHQ-9. In addition to prevalence estimates (stratified by STBs and gender), logistic regression models were calculated (controlling for confounders)., Results: The sample included 1910 individuals with cancer, 8.2 % of whom reported current suicidal thoughts and 2.0 % reported lifetime suicide attempts. There was neither a significant association between a cancer diagnosis and suicidal thoughts (p = .077) nor suicide attempts (p = .17) in models adjusting for age, gender, and income. Other chronic diseases were linked to suicidal thoughts and attempts only in men., Limitations: Although the investigation of the two kinds of STB are a strength of the study, the items' different time frames complicate comparisons. In addition, the cross-sectional design limits the ability to understand observed relationships and to identify periods of risk., Conclusion: This study expands the evidence base regarding the vulnerability to STBs in individuals with cancer, including long-term survivors. It highlights their heterogeneity, differential risk factors underlying suicidal thoughts and attempts, and the relevance of other (contextual) factors shaping an individual's susceptibility to suicidal crises., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. This work is part of the dissertation of the first author., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)
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- 2024
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12. Erhöhtes Risiko für Suizidversuche bei Nachkommen von Vertriebenen – Ein epidemiologischer Beitrag zur Untersuchung transgenerationaler Folgen von Fluchterfahrungen.
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Heller A, Beutel ME, Brähler E, and Ernst M
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- 2024
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13. [Institutionalised Pre-School Childcare and Reported Maltreatment: A Survey in East Germany].
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Helmert C, McLaren T, Fleischer T, Ulke C, Altweck L, Hahm S, Muehlan H, Kriechel L, Beutel ME, Schmidt S, Schomerus G, Brähler E, and Speerforck S
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Child abuse increases the risk of adult mental health problems. Limited research explores the association of early institutional childhood care in the GDR with experienced childhood abuse and mediates anxiety and depression in adulthood. The sample includes N=1743 individuals born in the GDR (1949-1983). In multi-group path analyses (stratified men/women), we analysed the influence of pre-school care as a predictor and experienced child abuse (CTS) as a mediator variable for anxiety (GAD-7) and depression (PHQ-9) in adulthood. There are no direct effects of pre-school care on anxiety and depression. Childhood trauma significantly affected current mental health (women β=0.253-0.610; men β=0.092-0.439). Analyses suggest no link between early institutional care and childhood abuse. Considering other contextual factors in childcare is crucial for establishing population-wide prevention strategies for child safety., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)
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- 2024
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14. Perceived Control as a Potential Protective Factor for Suicidal Thoughts and Behaviors in Cancer Patients and Survivors: A Systematic Review With Meta-Analysis.
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Hirschmiller J, Schmeckenbecher J, Schwinn T, Wiltink J, Brähler E, Kapusta N, Zwerenz R, Beutel ME, and Ernst M
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- Humans, Self Efficacy, Suicidal Ideation, Neoplasms psychology, Cancer Survivors psychology, Protective Factors
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Objective: Individuals affected by cancer have an elevated risk of experiencing suicidal crises. Aligning established suicide theories with social-cognitive theories, perceived control and related constructs emerge as potential protective factors for suicidal thoughts and behaviors in cancer patients. As perceived control is potentially modifiable, it holds great potential for prevention and intervention efforts. We aimed to comprehensively synthesize the evidence on perceived control and its link with suicidal thoughts and behaviors in cancer patients., Methods: The search term and procedures were registered in PROSPERO (CRD42023391048). We systematically searched the databases PubMed/MEDLINE, CINAHL, PsycInfo, Web-of-Science Core Collection, Cochrane Library, adding a grey literature search. In addition to the narrative review, pooled effect sizes, moderation and subgroup analysis were calculated., Results: The systematic search yielded 1986 original reports of which 36 were included in the systematic review and 25 in the meta-analysis. Demoralization, help-/hopelessness, and self-efficacy were the most commonly studied facets of control, showing a relatively large, pooled correlation with suicidal ideation overall (r = 0.45, [95% CI = 0.38-0.52], Q = 346.15, p < 0.01, I
2 = 91.2%) and across operationalisations (demoralisation: r = 52; hopelessness: r = 45; self-efficacy: r = 0.40). Moderation analyses revealed no effect of cancer stages; but more directly cancer-associated variables (demoralisation, hopelessness) were more closely related to suicidal ideation (QM = 5.40, p = 0.02) than general self-efficacy., Conclusion: The findings underscore the pivotal role of perceived control in shaping severe distress in cancer patients. More studies are needed examining perceived control in a narrower sense., (© 2024 The Author(s). Psycho‐Oncology published by John Wiley & Sons Ltd.)- Published
- 2024
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15. Assessment of psychological resilience in a large cohort of the general population: Validation and norm values of the RS-5.
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Reinwarth AC, Hahad O, Ghaemi Kerahrodi J, Brähler E, Lieb K, Gilan D, Zahn D, Chalabi J, Schuster AK, Schepers M, Lackner KJ, Schattenberg JM, Ruf W, Wild PS, Daiber A, Michal M, Beutel ME, and Münzel T
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- Humans, Female, Male, Middle Aged, Aged, Adult, Aged, 80 and over, Cohort Studies, Surveys and Questionnaires, Anxiety psychology, Anxiety epidemiology, Depression epidemiology, Depression psychology, Reference Values, Resilience, Psychological, Psychometrics methods
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Background: Psychological resilience is known as a protective factor against mental health disorders for which valid measures are indispensable. The present work aims to evaluate the Resilience Scale-5 (RS-5) psychometrically, and provide norm values., Methods: Data from the Gutenberg Health Study (GHS), encompassing 7,496 participants aged 25 to 86, spanning the years 2017 to 2022, was used. Selectivity, item difficulty, internal consistency, construct and factor validity, as well as factorial invariance were tested. Additionally, correlations and associations with depression, anxiety, and sociodemographic factors were determined. Furthermore, norm values were provided., Results: The RS-5 displayed robust psychometric properties. Participants reported an average resilience score of 28.94 (SD = 5.53, median = 30, IQR = 6, range = 5-35), with those aged ≥75 exhibiting the highest resilience levels (M = 30.21, SD = 5.75, median = 32, IQR = 7). The RS-5 displayed a very good model fit, affirming measurement invariance across sex and age decades. Construct validity found support through anticipated intercorrelations with related psychological constructs. Significant correlations (p < .001) linked higher resilience with female gender, advanced age, higher education, elevated household income, and diminished psychological distress., Conclusion: The RS-5 emerged as a reliable and economic instrument for assessing psychological resilience in individuals aged 25 to 86. The study unraveled distinct sociodemographic characteristics significantly tied to resilience levels within this cohort. In contributing recent norm values tailored to the German population, this research enhances the practical applicability of the RS-5 across diverse contexts and enriches our comprehension of the demographic nuances associated with psychological resilience., Competing Interests: Philipp S. Wild is funded by the Federal Ministry of Education and Research (BMBF 01EO1503). P.S.W. and T.M. are PIs and O.H. is a Young Scientist of the DZHK (German Center for Cardiovascular Research), Partner Site Rhine-Main, Mainz, Germany. There are no patents, products in development, or marketed products to declare. This does not alter the authors’ adherence to all of the journal policies on sharing data and materials. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The other authors A.C.R., J. G.-K., E.B., K.L., D.G., D.Z., J.C., A.K.S., M.S., K.J.L., J.M.S., W.R., A.D., M.M, and M.E.B. declare no competing interests. This does not alter our adherence to PLOS ONE policies on sharing data and materials., (Copyright: © 2024 Reinwarth et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
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- 2024
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16. Childhood trauma and differential response to long-term psychoanalytic versus cognitive-behavioural therapy for chronic depression in adults.
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Krakau L, Ernst M, Hautzinger M, Beutel ME, and Leuzinger-Bohleber M
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- Humans, Female, Male, Adult, Middle Aged, Chronic Disease, Treatment Outcome, Adult Survivors of Child Adverse Events psychology, Psychiatric Status Rating Scales, Cognitive Behavioral Therapy methods, Psychoanalytic Therapy methods
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Background: Childhood trauma is a major risk factor for chronic depression. It has been suggested that adults with chronic depression who have experienced childhood trauma may require long-term treatment owing to a breakdown of basic trust and related difficulties in developing a productive therapeutic relationship., Aims: As empirical studies have been preliminary and scarce, we studied the effects of psychoanalytic therapy (PAT) versus cognitive-behavioural therapy (CBT) for chronic depression in adults with a history of childhood trauma. In this subgroup, we expected a greater symptom reduction in PAT compared with CBT., Method: In a large trial of long-term psychotherapies for chronic depression (LAC-Study; Clinical Trial Register ISRCTN91956346), 210 adults received open-ended CBT or PAT in an out-patient setting and were examined yearly over 5 years on the Beck Depression Inventory - II (BDI-II). Based on a linear mixed model approach, we tested participant-reported childhood trauma based on the Childhood Trauma Questionnaire (CTQ) as a predictor and moderator of treatment outcome. CTQ subscales were examined exploratively., Results: Depressive symptoms decreased over time ( b = -4.55, s.e. = 0.90, 95% CI -6.32 to -2.81, T = -5.08; P < 0.001). A significant three-way interaction between childhood trauma, time and therapy group ( b = -0.05, s.e. = 0.02, 95% CI -0.09 to -0.01, T = -2.42; P = 0.016) indicated that participants with childhood trauma profited especially well from PATs., Conclusions: Our results indicate differential benefits from PAT compared with CBT among adults with chronic depression and a history of childhood trauma. The results have important implications for differential indication and policy.
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- 2024
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17. Socially isolated, but not lonely in lockdown: Exploring the role of reflective functioning as a protective factor in the early days of the COVID-19 pandemic in Germany.
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Ernst M, Brähler E, Beutel ME, Kruse J, and Andreas S
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- Humans, Germany epidemiology, Male, Female, Middle Aged, Adult, Aged, SARS-CoV-2, Surveys and Questionnaires, Young Adult, Quarantine psychology, Adolescent, Cross-Sectional Studies, COVID-19 psychology, COVID-19 prevention & control, COVID-19 epidemiology, Loneliness psychology, Social Isolation psychology, Protective Factors
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Introduction: Loneliness is a pressing public mental health issue. So far, there has been a paucity of investigations focused on the individual differences modulating this subjective feeling in the face of difficult circumstances, e.g., the COVID-19 pandemic. As such, the present study aimed to investigate the role of mentalization; given that the construct comprises reflection abilities that might be particularly relevant to the pandemic's interpersonal challenges., Methods: A survey representative of the German population was conducted from May to June 2020 (N = 2503). We examined mentalization, operationalized as reflective functioning (RF) and measured using the Mentalization Questionnaire (MZQ), both as a protective factor against loneliness on its own and as a moderator of the association of social isolation with loneliness., Results: Of the overall sample, 822 (32.8 %) individuals reported social isolation. Worse RF was moderately associated with higher levels of loneliness (r = 0.433, p < .001). A linear regression model (controlling for sociodemographic characteristics and general personality pathology) confirmed this positive association, but also indicated an interaction effect of RF and social isolation in the statistical prediction of loneliness. Stratified models showed that RF was a comparatively weaker statistical predictor of loneliness among the socially isolated., Discussion: This representative population study expanded our knowledge about the factors shaping loneliness in the population. RF emerged as a potentially modifiable protective influence. Further research needs to clarify the mechanisms through which it mitigates loneliness., Limitations: The cross-sectional design does not give insight into the temporal association of RF and loneliness., Competing Interests: Declaration of competing interest The authors report no conflict of interest., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)
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- 2024
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18. Peripheral hypertrophic subepithelial corneal opacification - Role of tear secretion, medication and systemic diseases.
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Riedl JC, Misirkhanova A, Wasielica-Poslednik J, Schuster AK, Schmidtmann I, Beutel ME, Pfeiffer N, and Gericke A
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- Humans, Female, Male, Middle Aged, Retrospective Studies, Aged, Adult, Aged, 80 and over, Case-Control Studies, Young Adult, Epithelium, Corneal metabolism, Epithelium, Corneal pathology, Epithelium, Corneal drug effects, Hypertrophy, Lubricant Eye Drops administration & dosage, Tears metabolism, Corneal Opacity diagnosis, Corneal Opacity physiopathology, Corneal Opacity metabolism
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Background: Peripheral hypertrophic subepithelial corneal opacification (PHSCO) is a corneal disease that may severely affect vision. The major goal of this study was to test the hypothesis that tear secretion, medication and systemic diseases are associated with PHSCO., Methods: This is a retrospective, case-control study conducted at the Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz. We analysed medical records of patients diagnosed with PHSCO. Sex, age, Schirmer's test II, general medication and medical history were assessed and compared to an age- and sex-matched control group from the Gutenberg Health Study (GHS)., Results: One hundred ninety-five eyes of 112 patients with PHSCO were included. Eighty-eight patients were female with a mean age of 55.3 ± 14.7 years (23-89 years) and 24 patients were male with a mean age of 59.3 ± 12.6 years (38-84 years). In 83 patients (74.1%) both eyes were involved. The Schirmer's test II was significantly reduced in patients with PHSCO compared to the GHS control group (p < 0.001). Patients with PHSCO were more frequently administered artificial tears and steroid eye drops (p < 0.001) and were more hyperopic than healthy controls (p = 0.01). Systemic diseases or medication did not differ markedly between PHSCO and healthy controls., Conclusion: Reduced tear secretion and more frequent use of artificial tears in patients with PHSCO suggest a link between PHSCO and dry eye disease. The results of the study do not support our hypothesis that PHSCO is associated with systemic diseases. Interestingly, patients with PHSCO were less frequently on β-blockers than control subjects., (© 2024 The Authors. Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation.)
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- 2024
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19. Psychometric evaluation of the Brief Resilient Coping Scale (BRCS) over the course of the pandemic in a large German general population sample.
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Petersen J, Brähler E, Hettich-Damm N, Schepers M, König J, Lackner K, Pfeiffer N, and Beutel ME
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- Humans, Male, Female, Middle Aged, Adult, Germany epidemiology, Longitudinal Studies, Aged, Reproducibility of Results, Surveys and Questionnaires, Social Support, Anxiety epidemiology, Anxiety psychology, Young Adult, Stress, Psychological epidemiology, Stress, Psychological psychology, Depression epidemiology, Depression psychology, Adolescent, Psychometrics methods, Resilience, Psychological, COVID-19 psychology, COVID-19 epidemiology, Adaptation, Psychological, Pandemics
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Background: The Brief Resilience Coping Scale (BRCS) is a brief instrument suitable for epidemiological studies. The aims of this paper were to analyze changes in BRCS depending on time, sex, age group, relationship status, as well as risk of poverty, to test the psychometric properties including test-retest reliability and measurement invariance, and to determine associations with psychosocial stress, depressiveness, anxiety, social support, as well as subjective mental and physical health. As the data from this study was collected during the pandemic, an additional sensitivity analysis was performed with pre-pandemic data., Methods: A longitudinal study of resilience and distress in a large-sized community sample was performed at one pre-pandemic (T0) and three pandemic time points (T1-3). Resilient coping was assessed by the 4-Item short form of the BRCS, distress by the PHQ-9 and GAD-2., Results: BRCS decreased between the first and the second and increased at the third pandemic time point. The scale had a good internal consistency. Test-retest correlation coefficients ranged from 0.527 to 0.589. Higher resilient coping was found in younger participants, participants not at-risk-of-poverty and in males. Stability was higher in those with a partner, and at-risk-of-poverty. Significant negative associations with psychosocial stress, loneliness, depressiveness, anxiety, social support, as well as subjective and physical health and SES underscored the construct validity., Conclusion: Overall, findings underscore that resilient coping is a dynamic construct with considerable stability. The scale showed good psychometric properties including test-retest reliability over four months to two years. We found that it is not only important to describe the level of resilient coping, but also its stability., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Petersen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
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- 2024
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20. Change of self-rated physical health predicts mortality in aging individuals: results of a population-based cohort study.
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Reinwarth AC, Wicke FS, Rückert KK, Schattenberg JM, Tüscher O, Wild PS, Münzel T, König J, Lackner KJ, Pfeiffer N, and Beutel ME
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Background: Self-rated physical health (SRPH) is known as an important predictor of mortality. Previous studies mostly used baseline values of self-rated health to predict long-term mortality. The effect of change in self-rated physical health on mortality during the course of aging has rarely been researched. The present study aimed to determine SRPH over time in women and men of an aging population, assess whether and how change in SRPH affects mortality while adjusting for known determinants of mortality, and test effect modification by sex on the relation between course of SRPH and mortality., Methods: Data of N = 12,423 respondents of the 5-year follow-up of the Gutenberg Health Study (GHS) with participation at the baseline assessment were analysed. All-cause mortality from 5-year follow-up onwards was defined as the primary outcome. SRPH was assessed by a single item. Cox proportional hazards models with adjustment for age, sex, socio-economic status and physical diseases were fitted to assess the predictive power of baseline score and course of SRPH. Additionally, effect modification by sex was assessed., Results: During a median follow-up period of 7.3 years (quartiles 6.0-8.5 years), 618 (5%) participants died. Overall, 70.9% of the participants indicated good or very good SRPH at baseline (T1) and follow-up (T2), 6.9% rated their SRPH as not so good at T1 and T2, and 0.6% reported bad SRPH at T1 and T2. An improvement of SRPH was indicated by 9.6% and 12.0% indicated deterioration of their SRPH. Change in SRPH added substantial predictive information to the Cox proportional hazards models, when adjusting for relevant covariates. In men, deterioration and constantly bad SRPH were associated with the strongest increase in risk of mortality by 87%, resp. 228%. While improvements increased mortality risk in men (67%), women with an improved SRPH had a lower risk (57%)., Conclusion: A sizeable subgroup of aging participants reported deterioration of SRPH over five years. The association between change of SRPH and mortality is modified by sex. Deterioration of SRPH predicts mortality over baseline-assessment even when adjusted for relevant covariates. SRPH should be assessed regularly as part of an older individual's health evaluation. Deterioration, constantly bad and improved SRPH should be taken seriously as unfavorable prognostic indicators, the latter only in men., (© 2024. The Author(s).)
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- 2024
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21. Cardiovascular and genetic determinants of platelet high responsiveness: results from the Gutenberg Health Study.
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Baidildinova G, Ten Cate V, Panova-Noeva M, Dahlen B, Gieswinkel A, von Ungern-Sternberg S, Rapp S, Strauch K, Beutel ME, Pfeiffer N, Lackner KJ, Münzel T, Ten Cate H, Wild PS, and Jurk K
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- Humans, Male, Female, Middle Aged, Platelet Aggregation Inhibitors therapeutic use, Platelet Aggregation Inhibitors pharmacology, Polymorphism, Single Nucleotide, Blood Platelets metabolism, Cardiovascular Diseases genetics, Cardiovascular Diseases etiology
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- 2024
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22. A powerful safety net: Social support moderates the association of quality of life deficits with suicidal ideation in long-term childhood cancer survivors.
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Schwinn T, Hirschmiller J, Brähler E, Merzenich H, Faber J, Wild PS, Beutel ME, and Ernst M
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Objectives: Cancer survivors are at risk for suicidality. We aimed to expand the knowledge about protective factors and their interplay with risk factors by testing social support as a modifier of the association of Quality of Life (QoL) deficits with suicidal ideation., Research Approach: We surveyed N = 633 childhood cancer survivors (CCS) using validated questionnaires (EORTC Core Quality of Life questionnaire QLQ-C30, Patient Health Questionnaire PHQ-9). The interaction of QoL and social support was investigated using multiple linear regression analysis., Findings: CCS reporting suicide attempts and current suicidal ideation (SI) had lower QoL. CCS with SI reported less social support. QoL and social support were independently associated with SI and interacted: among CCS with less social support, low QoL was more strongly associated with SI., Conclusion: The results highlight the need for interdisciplinary survivorship care, and to focus on risk and protective factors to strengthen suicide prevention.
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- 2024
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23. Inpatients with a history of suicide attempts in routine clinical care exhibit specific characteristics regarding sociodemographics, life events, personality, and symptom burden.
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Gemke TJ, Zwerenz R, Beutel ME, Michal M, Wiltink J, and Ernst M
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- Humans, Female, Male, Adult, Middle Aged, Risk Factors, Germany epidemiology, Aged, Life Change Events, Socioeconomic Factors, Symptom Burden, Suicide, Attempted psychology, Suicide, Attempted statistics & numerical data, Personality, Inpatients psychology
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Research indicates that patients with a lifetime history of suicide attempts are particularly burdened. However, investigations of their characteristics and comparisons with other patients are scarce. This study aimed to fill this research gap, using routine clinical data and guided by theoretical models. Data of N = 706 patients (54.4% women) was collected at the psychosomatic inpatient/day-clinic unit of a German university clinic. It comprised sociodemographic data and information about previous experiences (e.g., childhood abuse and neglect), symptom measures (e.g., the PHQ-9) and individual differences (e.g., the level of personality functioning assessed with the OPD-SQS). Groups were compared using independent t-tests or χ
2 -tests. Of the total sample, 118 patients (16.7%) reported suicide attempts. Those with a history of suicide attempts were more likely to have a migration background and a lower level of education, smoke (heavily) and use illegal substances. They reported lower levels of personality functioning, more current symptoms and traumatic previous experiences of abuse and neglect. Screening for previous suicidal behavior as well as associated factors can yield valuable information for clinical practice. Many group differences map onto previously observed specific risk factors for suicidal behavior, supporting the conceptual models and underscoring their relevance among clinical populations as well., (© 2024. The Author(s).)- Published
- 2024
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24. Convenience behavior in German university students is associated with sociodemographic, study- and health-related factors.
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Schwab L, Reichel JL, Werner AM, Schäfer M, Heller S, Edelmann D, Beutel ME, Letzel S, Dietz P, Simon P, and Kalo K
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- Humans, Male, Female, Germany, Universities, Surveys and Questionnaires, Young Adult, Adult, Sedentary Behavior, Health Behavior, Body Mass Index, Sociodemographic Factors, Adolescent, Exercise, Socioeconomic Factors, Students statistics & numerical data
- Abstract
Background: The transition from school to university is often accompanied by a change in students' lifestyles. So far little is known whether convenience behavior is an essential factor affecting students' health and social interaction. In a heterogeneous population regard to sociodemographic and anthropometric characteristics the Convenience Behavior Questionnaire (CBQ) showed a better relationship between convenience-related behavior with overweight and obesity than established questionnaires. Here we assessed convenience behavior in a large well characterized cohort of university students and its association with health-related (mainly sedentary behavior and physical activity), study-related and sociodemographic factors with the Convenience Behavior Questionnaire (CBQ)., Methods: A total of 4,351 students participated in an online survey, of which 3,983 (23.6 ± 5.3 years old, 71.3% females) answered the questions concerning convenience behavior. A low value in the CBQ indicates more convenience behavior [Convenience Behavior Index (CBI) range: 3-15]. Differences with regard to sociodemographic (age, gender, body mass index), study-related (semester, degree, field of study) and health-related (physical activity, sedentary behavior) variables were examined with Mann-Whitney-U test or Kruskal-Wallis test and post-hoc tests (Bonferroni)., Results: The CBI of men and women differed significantly ( z = -6.847, p < 0.001, r = 0.11). First-year students and students beyond their first year showed significant differences ( z = -2.355, p ≤ 0.05, r = 0.04). Differences were also found in the field of study (Chi2 (6) = 147.830, p < 0.001) and the targeted degree (Chi2 (7) = 79.985, p < 0.001). Furthermore, differences were found in the body mass index (Chi2 (5) = 70.678, p < 0.001), physical activity (Chi2 (2) = 279.040, p < 0.001) and sedentary behavior ( z = -4.660, p < 0.001, r = 0.07)., Conclusion: The results showed risk groups of convenience behavior among students [men, first-year, students enrolled in "Science, Technology, Engineering and Mathematics (STEM)," bachelor]. Our results confirm for the first time in a very homogeneous population a gender difference and an association between CBI and health-related factors. Further studies are needed to analyze the health behavior of students in more detail, especially their convenience behavior., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Schwab, Reichel, Werner, Schäfer, Heller, Edelmann, Beutel, Letzel, Dietz, Simon and Kalo.)
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- 2024
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25. Development and validation of a brief three-item form of the perceived social support questionnaire (F-SozU K-3).
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Petersen J, Reinwarth AC, Beutel ME, Brähler E, and Decker O
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Objective: The purpose of the present study was to develop and validate a brief screening instrument (F-SozU K-3) for the measurement of perceived social support in large scale surveys by shortening a well-established German questionnaire (F-SozU K-6)., Method: First, a brief three-item version of the F-SozU was developed based on a representative sample of N = 2482 respondents using exploratory and confirmatory factor analysis. Second, the newly developed brief three-item questionnaire was evaluated and standardized in an independent second representative population sample ( N = 2501)., Results: A suitable three-item solution with a good internal consistency (α = 0.89, ω = 0.89) was identified. Full invariance across sex and partnership was established. Construct validity of the brief three-item form was established. Younger age, female sex, partnership status, and current employment were positively associated with higher social support scores. Norm values for the general sample and separately for sex and partnership status were reported., Conclusions: The newly developed F-SozU K-3 is a reliable and valid screening instrument. It can be used as an economical alternative to previous longer instruments, especially in large scale surveys., Competing Interests: The authors declare that they have no competing interests., (© 2024 The Author(s).)
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- 2024
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26. Bi-Gaussian analysis reveals distinct education-related alterations in spherical equivalent and axial length-results from the Gutenberg Health Study.
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Hartmann A, Grabitz SD, Wagner FM, Wild PS, Müller-Nurasyid M, Lackner KJ, Beutel ME, Münzel T, Tüscher O, Schattenberg JM, Pfeiffer N, and Schuster AK
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- Humans, Female, Male, Middle Aged, Germany epidemiology, Normal Distribution, Biometry methods, Refraction, Ocular physiology, Follow-Up Studies, Refractive Errors physiopathology, Refractive Errors diagnosis, Refractive Errors genetics, Aged, Adult, Educational Status, Axial Length, Eye pathology
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Purpose: The aim of this study is to investigate the distribution of spherical equivalent and axial length in the general population and to analyze the influence of education on spherical equivalent with a focus on ocular biometric parameters., Methods: The Gutenberg Health Study is a population-based cohort study in Mainz, Germany. Participants underwent comprehensive ophthalmologic examinations as part of the 5-year follow-up examination in 2012-2017 including genotyping. The spherical equivalent and axial length distributions were modeled with gaussian mixture models. Regression analysis (on person-individual level) was performed to analyze associations between biometric parameters and educational factors. Mendelian randomization analysis explored the causal effect between spherical equivalent, axial length, and education. Additionally, effect mediation analysis examined the link between spherical equivalent and education., Results: A total of 8532 study participants were included (median age: 57 years, 49% female). The distribution of spherical equivalent and axial length follows a bi-Gaussian function, partially explained by the length of education (i.e., < 11 years education vs. 11-20 years). Mendelian randomization indicated an effect of education on refractive error using a genetic risk score of education as an instrument variable (- 0.35 diopters per SD increase in the instrument, 95% CI, - 0.64-0.05, p = 0.02) and an effect of education on axial length (0.63 mm per SD increase in the instrument, 95% CI, 0.22-1.04, p = 0.003). Spherical equivalent, axial length and anterior chamber depth were associated with length of education in regression analyses. Mediation analysis revealed that the association between spherical equivalent and education is mainly driven (70%) by alteration in axial length., Conclusions: The distribution of axial length and spherical equivalent is represented by subgroups of the population (bi-Gaussian). This distribution can be partially explained by length of education. The impact of education on spherical equivalent is mainly driven by alteration in axial length., (© 2024. The Author(s).)
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- 2024
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27. Predicting treatment response using machine learning: A registered report.
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Jankowsky K, Krakau L, Schroeders U, Zwerenz R, and Beutel ME
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- Humans, Male, Female, Adult, Middle Aged, Psychotherapy methods, Treatment Outcome, Outcome Assessment, Health Care statistics & numerical data, Aged, Inpatients psychology, Severity of Illness Index, Young Adult, Pre-Registration Publication, Machine Learning
- Abstract
Objective: Previous research on psychotherapy treatment response has mainly focused on outpatients or clinical trial data which may have low ecological validity regarding naturalistic inpatient samples. To reduce treatment failures by proactively screening for patients at risk of low treatment response, gain more knowledge about risk factors and to evaluate treatments, accurate insights about predictors of treatment response in naturalistic inpatient samples are needed., Methods: We compared the performance of different machine learning algorithms in predicting treatment response, operationalized as a substantial reduction in symptom severity as expressed in the Patient Health Questionnaire Anxiety and Depression Scale. To achieve this goal, we used different sets of variables-(a) demographics, (b) physical indicators, (c) psychological indicators and (d) treatment-related variables-in a naturalistic inpatient sample (N = 723) to specify their joint and unique contribution to treatment success., Results: There was a strong link between symptom severity at baseline and post-treatment (R
2 = .32). When using all available variables, both machine learning algorithms outperformed the linear regressions and led to an increment in predictive performance of R2 = .12. Treatment-related variables were the most predictive, followed psychological indicators. Physical indicators and demographics were negligible., Conclusions: Treatment response in naturalistic inpatient settings can be predicted to a considerable degree by using baseline indicators. Regularization via machine learning algorithms leads to higher predictive performances as opposed to including nonlinear and interaction effects. Heterogenous aspects of mental health have incremental predictive value and should be considered as prognostic markers when modelling treatment processes., (© 2023 The Authors. British Journal of Clinical Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society.)- Published
- 2024
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28. Age standardization and time-of-day performance for the Oldenburg Sentence Test (OLSA): results from the population-based Gutenberg Health Study.
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O'Brien K, Hackenberg B, Döge J, Bohnert A, Rader T, Lackner KJ, Beutel ME, Münzel T, Wild PS, Chalabi J, Schuster AK, Schmidtmann I, Matthias C, and Bahr-Hamm K
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- Female, Humans, Male, Prospective Studies, Speech Intelligibility, Speech Reception Threshold Test methods, Cochlear Implants, Deafness, Hearing Aids, Hearing Loss diagnosis, Speech Perception
- Abstract
Purpose: The Oldenburg Sentence Test (OLSA) is a German matrix test designed to determine speech recognition thresholds (SRT). It is widely used for hearing-aids and cochlear implant fitting, but an age-adjusted standard is still lacking. In addition, knowing that the ability to concentrate is an important factor in OLSA performance, we hypothesized that OLSA performance would depend on the time of day it was administered. The aim of this study was to propose an age standardization for the OLSA and to determine its diurnal performance., Methods: The Gutenberg Health Study is an ongoing population-based study and designed as a single-centre observational, prospective cohort study. Participants were interviewed about common otologic symptoms and tested with pure-tone audiometry and OLSA. Two groups-subjects with and without hearing loss-were established. The OLSA was performed in two runs. The SRT was evaluated for each participant. Results were characterized by age in 5-year cohorts, gender and speech recognition threshold (SRT). A time stamp with an hourly interval was also implemented., Results: The mean OLSA SRT was - 6.9 ± 1.0 dB (group 1 male) and - 7.1 ± 0.8 dB (group 1 female) showing an inverse relationship with age in the whole cohort, whereas a linear increase was observed in those without hearing loss. OLSA-SRT values increased more in males than in females with increasing age. No statistical significance was found for the diurnal performance., Conclusions: A study with 2900 evaluable Oldenburg Sentence Tests is a novelty and representative for the population of Mainz and its surroundings. We postulate an age- and gender-standardized scale for the evaluation of the OLSA. In fact, with an intergroup standard deviation (of about 1.5 dB) compared to the age dependence of 0.7 dB/10 years, this age normalization should be considered as clinically relevant., (© 2023. The Author(s).)
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- 2024
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29. How socio-political change is associated with the number of individually reported negative life events: a population-based study using the German reunification 1989/1990 as an example.
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Hahm S, Altweck L, Schmidt S, Fleischer T, Helmert C, Ulke C, Speerforck S, Schomerus G, Klinger-König J, Grabe HJ, Schmidt CO, Beutel ME, Brähler E, and Muehlan H
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- Humans, Female, Retrospective Studies, Life Change Events, Health Status, Employment
- Abstract
Background: Socio-political change often leads to disruptions in employment and social networks, which can exacerbate health issues and increase mortality rates. These consequences are likely observed as an increase in negative life events (NLEs), serving as indicators of the broader social and health impacts. Using the German reunification in 1989/1990 as an example, this study investigates changes in reported numbers of NLEs and differences regarding sociodemographic characteristics., Methods: We used data from the population-based Study of Health in Pomerania (SHIP-START-0, SHIP-Life-Events and Gene-Environment Interaction in Depression; N=1932). Numbers of NLEs in different categories (work/financial, social/interpersonal, illness (own) and illness/death (others)) were measured retrospectively in 5-year intervals (1980-2004) using a semistructured interview. Pre-reunification and post-reunification changes were modelled using piecewise mixed-effects Poisson regressions with the 1990-1994 interval (reunification) as change point. Interactions with age, sex and education were examined., Results: The number of most NLE categories, except social/interpersonal NLEs, increased at reunification. Whereas work/financial NLEs slightly decreased post-reunification, illness-related NLEs continued to increase. Higher numbers of social/interpersonal NLEs were found with younger age. More illness-related NLEs were reported with older age, lower education (illness (own)) and by women (illness/death (others)). However, the majority reported no NLEs at reunification (68.2%-80.7%, varying by category)., Conclusion: Our findings suggest that although some individuals experience a marked increase in NLEs due to socio-political changes, many remain unaffected, emphasising the need for a differentiated understanding of these effects. This increase in NLEs may partly account for ongoing health and well-being disparities among countries with differing transformation histories., Competing Interests: Competing interests: HJG has received travel grants and speakers’ honoraria from Fresenius Medical Care, Neuraxpharm, Servier and Janssen Cilag as well as research funding from Fresenius Medical Care., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2024
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30. Noise annoyance due to different sources is associated with tinnitus presence and distress in the general population.
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Hahad O, Döge J, Bahr-Hamm K, Beutel ME, Kontohow-Beckers K, Schuster AK, Keller K, Hobohm L, Schmitt VH, Gianicolo E, Lackner KJ, Daiber A, Wild PS, Hackenberg B, and Münzel T
- Abstract
Background: The pathophysiology of tinnitus is not yet fully understood. Although there is a large amount of evidence associating traffic noise exposure with non-auditory health outcomes, there is no evidence regarding the impact of noise annoyance on auditory disorders such as tinnitus., Objective: Thus, we aimed to investigate the association between noise annoyance due to different sources and tinnitus presence and distress in the general population., Methods: Data of 6813 participants from a large German population-based cohort were used (Gutenberg Health Study). Participants were asked about the presence of tinnitus and how much they were bothered by it. In addition, information on annoyance from road traffic, aircraft, railways, industrial, and neighborhood noise during the day and sleep was collected through validated questionnaires., Results: The prevalence of tinnitus was 27.3%, and the predominant sources of noise annoyance in these subjects were aircraft, neighborhood, and road traffic noise. Overall, logistic regression results demonstrated consistent positive associations between annoyance due to different noise sources and prevalent risk of tinnitus with increases in odds ratios ranging from 4 to 11% after adjustment for sex, age, and socioeconomic status. Likewise, consistent increases in odds ratios were observed for tinnitus distress in subjects with prevalent tinnitus. For instance, neighborhood noise annoyance during the sleep was associated with a 26% increase in tinnitus distress (OR 1.26, 95% CI 1.13; 1.39)., Impact: This is the first study investigating the association between noise annoyance and tinnitus presence and distress in a large cohort of the general population. Our results indicate consistent and positive associations between various sources of noise annoyance and tinnitus. These unprecedented findings are highly relevant as noise annoyance and tinnitus are widespread. The precise etiology and locus of tinnitus remain unknown, but excessive noise exposure is thought to be among the major causes. This study suggests that transportation and neighborhood noise levels thought merely to contribute to annoyance and non-auditory health effects may be sufficient to cause or exacerbate tinnitus., (© 2024. The Author(s).)
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- 2024
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31. To what extent are psychological variables considered in the study of risk and protective factors for suicidal thoughts and behaviours in individuals with cancer? A systematic review of 70 years of research.
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Ernst M, Schwinn T, Hirschmiller J, Cleare S, Robb KA, Brähler E, Zwerenz R, Wiltink J, O'Connor RC, and Beutel ME
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- Humans, Risk Factors, Suicide, Attempted psychology, Suicide, Attempted statistics & numerical data, Suicide psychology, Suicide statistics & numerical data, Suicidal Ideation, Neoplasms psychology, Protective Factors
- Abstract
Psychological variables substantially shape the risk of suicidal thoughts and behaviours (STBs). However, it is unclear to what extent they are considered in individuals with cancer. We synthesized the quantitative research landscape concerning psychological risk/protective factors of STBs in the (psycho-) oncological context. This pre-registered review (PROSPERO-ID CRD42022331484) systematically searched the databases PubMed/Medline, CINAHL, PsycInfo, Cochrane Library, and Web of Science (as well as the grey literature and preprints). Risk of bias (RoB) was estimated using the ROBINS-I tool. Of 11,159 retrieved records, 319 studies were eligible for inclusion. Of those, 163 (51.1%) had investigated psychological factors (affective: n = 155; social: n = 65; cognitive: n = 63; personality/individual differences: n = 37; life events: n = 6), in a combined 3,561,741 participants. The most common STBs were suicidal ideation (n = 107) or death wishes (n = 20) rather than behaviour (suicide deaths: n = 26; attempts: n = 14). Most studies had a serious RoB. Thus, a large body of research investigated STBs in cancer patients/survivors, but it rarely aligned with the theoretical or clinical developments in suicide research. We propose a conceptual model of STBs in cancer delineating moderation and mediation effects to advance the integration of the fields, and to inform future research and practice., Competing Interests: Declaration of competing interest The authors have no conflicts of interest to declare., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)
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- 2024
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32. Early Childhood Care in the Former East Germany and Mental Stress in Adulthood.
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Braunheim L, Heller A, Helmert C, Kasinger C, Beutel ME, and Brähler E
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- Humans, Male, Female, Adult, Child, Preschool, Child, Germany, East epidemiology, Somatoform Disorders epidemiology, Somatoform Disorders psychology, Germany epidemiology, Prevalence, Infant, Middle Aged, Child Abuse statistics & numerical data, Child Abuse psychology, Young Adult, Child Care statistics & numerical data, Anxiety Disorders epidemiology, Stress, Psychological epidemiology
- Abstract
Background: It is still debated in Germany whether early childhood care outside the family might cause mental stress in adulthood. In the German Democratic Republic (GDR-the former East Germany before unification), children were often cared for outside the family from a very early age., Methods: To determine the relation between early childhood care outside the family and mental stress in adulthood, we carried out a survey among 1575 persons who were born and socialized in the GDR. They were classified into four care groups according to the age at which they were first cared for outside the family. Associations with depressiveness, somatization disorders, and anxiety disorders in adulthood were tested with logistic regression analysis. Care group-specific prevalences of experiences of abuse and neglect in childhood were estimated with analysis of variance., Results: Comparisons of persons cared for outside the family before the age of three, or from the age of three onward, with persons cared for within the family in their preschool years did not reveal any difference with respect to depressiveness (odds ratio [OR] = 0.95; 95% confidence interval [0.58; 1.55]; OR = 1.05 [0.63; 1.74]), somatization disorders (OR = 1.11 [0.74; 1.67]; OR = 1.09 [0.71; 1.66]), or anxiety disorders (OR = 0.87 [0.46; 1.64]; OR = 1.12 [0.59; 2.10]). Nor were there any intergroup differences with respect to experiences of abuse and neglect. Certain features of the very small group of children who had long-term care outside the family are discussed in the article., Conclusion: No relation was found between earlychildhood care in day-care centers in the GDR and mental stress in adulthood. The data were too sparse for any conclusions about specific aspects of care outside the home (e.g., quality or child-rearing norms).
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- 2024
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33. Recalled Maternal Rearing Behaviour of Individuals Born Preterm and Their Mothers: The Impact of Intimate Mother-Child Contact.
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Otten D, Ernst M, Schuster AK, Tesarz J, Gißler S, Mildenberger E, Pfeiffer N, Beutel ME, and Fieß A
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Background : Preterm birth is a risk factor for a variety of detrimental health outcomes. Previous studies have identified recalled (or remembered) parental rearing behaviour as a potential modifier of preterm individuals' mental health in adulthood. However, no investigations to date have contrasted the parents' and children's views, explored whether their congruence is associated with preterm individuals' mental health, or tested associations with maternal self-reported first skin-on-skin contact. Methods : This cohort study involved 199 participants of the Gutenberg Prematurity Eye Study (GPES), with prospective clinical examination and psychological assessment data available for individuals born preterm and term and their mothers' perspective on recalled parental rearing behaviour. Participants also completed the Patient Health Questionnaire-9 (PHQ-9). Results : There were substantial similarities between reported recalled maternal rearing behaviour of individuals born preterm and at term and their mothers, with individuals born preterm with lower gestational age (age of the pregnancy from the woman's last menstrual period) recalling mothers as comparatively more controlling and overprotective. Incongruence in recalled rejection/punishment was associated with more depressive symptoms. Late first skin-to-skin contact was related to more recalled maternal rejection/punishment, less emotional warmth, and more control/overprotection. Conclusions : this study expands the knowledge about the interrelations of preterm birth, maternal rearing behaviour, and mental health, underscoring the relevance of first relationship experiences, including close intimate contact., Competing Interests: N.P. receives financial support and grants from Novartis, Ivantis, Santen, Thea, Boehringer Ingelheim Deutschland GmbH & Co., Ltd., KG, Alcon, and Sanoculis. A.K.S. receives research support from Allergan, Bayer, Heidelberg Engineering, PlusOptix, and Novartis.
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- 2024
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34. Social support in older adults: Validation and norm values of a brief form of the Perceived Social Support Questionnaire (F-SozU K-6).
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Reinwarth AC, Petersen J, Beutel ME, Hautzinger M, and Brähler E
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- Humans, Female, Aged, Psychometrics methods, Reproducibility of Results, Surveys and Questionnaires, Social Support, Longevity
- Abstract
Background: Social relations are crucial for maintaining physical and mental health across the life span. As social roles, networks and needs change with age a valid assessment of social support in older adults and age-specific norms are necessary. The present work aims to [1) assess the level of social support in individuals > 60 years of the general German population, [2) evaluate the brief six-item form of the Perceived Social Support Questionnaire (F-SozU K-6) in this age group and to [3) provide age-specific norm values., Methods: We analyze data of N = 706 people representative for the German population collected in 2021. To assess social support, we used the F-SozU K-6. We tested for selectivity, item difficulty, internal consistency, construct and factor validity, as well as factorial invariance. Additionally, we assessed correlations and associations with depression, loneliness, and sociodemographic factors. Furthermore, we reported norm values for respondents > 60 years., Results: Participants > 60 years reported a mean level of 23.97 (SD = 4.82) of social support. Results of the CFA confirmed a very good model fit. Measurement invariance across sex and age was shown. Associations with ADS and LS-S supported construct validity. Multiple regression analysis showed that female sex, increasing age, having a partner, and a higher equivalized household income were associated with higher levels of social support., Conclusion: The F-SozU K-6 is a reliable and economical tool to assess perceived social support in older adults. Norm values for individual > 60 years are provided., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Reinwarth et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
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- 2024
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35. Current and past depression as risk factors for incident type 2 diabetes mellitus and pre-diabetes in men and women: evidence from a longitudinal community cohort.
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Wicke FS, Otten D, Schulz A, Wild PS, Lackner KJ, Münzel T, König J, Ernst M, Wiltink J, Reiner I, Ghaemi Kerahrodi J, Pfeiffer N, and Beutel ME
- Abstract
Background: Depression is associated with an increased risk for type 2 diabetes mellitus. However, depression may take different courses, and it is not fully understood how these affect the development of diabetes. It is further to be determined whether sex modifies the association between depression and type 2 diabetes., Methods: We analyzed data from the Gutenberg Health Study, a longitudinal and population-based cohort study (N = 15,010) in Germany. Depressive symptoms (measured by PHQ-9), history of depression, diabetes mellitus, and relevant covariates were assessed at baseline, and the outcomes of prediabetes and type 2 diabetes mellitus were evaluated 5 years later. Logistic regression was used to estimate odds ratios of incident prediabetes and type 2 diabetes mellitus, adjusting for potential confounders as identified in a Directed Acyclic Graph., Results: In the confounder adjusted model, current depression (PHQ-9 ≥ 10 at baseline; OR = 1.79, 95% CI = 1.11 to 2.74, p = 0.011), and persistent depression had a statistically significant (OR = 2.44, 95% CI = 1.62 to 3.54, p = 0.005) effect on incident type 2 diabetes mellitus. A history of depression without current depression had no statistically significant effect on type 2 diabetes (OR = 1.00, 95% CI = 0.68 to 1.43, p = 0.999). The effect of depression on incident diabetes did not differ significantly between women (OR = 2.02; 95% CI = 1.32 to 3.09) and men (OR = 2.16; 95% CI = 1.41 to 3.31; p-value for interaction on the multiplicative scale p = 0.832 and on the additive scale p = 0.149). Depression did not have a significant effect on incident prediabetes., Conclusion: This study shows how the history and trajectory of depression shape the risk for diabetes. This raises interesting questions on the cumulative effects of depression trajectories on diabetes and body metabolism in general. Depression can negatively affect physical health, contributing to increased morbidity and mortality in people with mental disorders., (© 2024. The Author(s).)
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- 2024
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36. Gender differences in the prevalence of mental distress in East and West Germany over time: a hierarchical age-period-cohort analysis, 2006-2021.
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Otten D, Heller A, Schmidt P, Beutel ME, and Brähler E
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- Male, Humans, Female, Adolescent, Sex Factors, Cross-Sectional Studies, Germany epidemiology, Cohort Studies, Prevalence
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Purpose: Mental distress has become a major public health concern. Temporal trends in psychological distress are complex and depend on numerous factors. In this study, we examined age-period-cohort effects for mental distress including gender and German region over a 15 years' time span., Methods: Data on mental distress from ten cross-sectional surveys of the general German population, covering the years from 2006 to 2021, was used. Hierarchical age-period-cohort analyses including gender and German region as predictors were performed to disentangle age, period, and cohort effects. The Patient Health Questionnaire-4 was used as a brief screener for mental distress., Results: We found significant period and cohort effects, with peek values for mental distress in the years 2017 and 2020 and for the oldest birth cohort (born before 1946). Age did not affect mental distress when cohort- and period effects as well as gender and German region were considered. An interaction effect for gender and the German region was found. Women in West Germany reported significantly higher mental distress compared to women in East Germany. Compared to men, women reported the highest prevalence in both regions., Conclusion: Important political events as well as major crises can lead to an increase of mental distress in societies. Furthermore, an association between birth cohort and mental distress could be linked to socialization effects of that certain time, causing traumatic experiences or a specific coping style within this cohort group. Prevention and intervention strategies could benefit from acknowledging structural differences linked to period and cohort effects., (© 2023. The Author(s).)
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- 2024
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37. Development and evaluation of an internet- and mobile-based intervention for individualized return to work planning after inpatient rehabilitation - Study protocol for a randomized-controlled-trial.
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Kreis A, Gomes A, Tsiouris A, Beutel ME, Ruckes C, Dahn I, Schiller A, Loy G, Zajac H, Kosmuetzky G, Ziser P, Sträßner E, Schneider V, Wilde T, Leber M, Schäfer H, Kilian R, and Zwerenz R
- Abstract
Background: Following discharge, it is crucial for patients to transfer intentions and action plans from inpatient rehabilitation into everyday life. This ensures their reintegration into social and working life and prevents economic costs due to sick leave or reduced earning capacity pension. However, most established aftercare programs do not specifically address occupational problems or challenges during occupational measures such as graded return to work. The aim of this study is to evaluate the efficacy of the low-threshold online self-help intervention marena (Meine Arbeitsbezogene Reha-Nachsorge - My Work-related Rehabilitation Aftercare) to support return to work., Methods: A two-arm randomized-controlled-trial (RCT) will be conducted. A total of N = 400 rehabilitation inpatients across different indication areas (psychosomatic, orthopedic, or cardiologic) aged 18 to 65 years with a planned return to work after medical rehabilitation, have a heightened social-medical risk and private internet access and are insured with the German Pension insurance or statutory health insurance, will be recruited in four medical and psychosomatic clinics in Germany. Participants will be allocated to either the intervention (IG) or the control group (CG). In a stepped-care model, participants of the IG will receive access to the non-guided internet- and mobile-based intervention marena (IG subgroup 1) or marena in combination with GSA-Online plus (IG subgroup 2), a guided psychodynamic internet-based intervention that has proven effective in two trials regarding occupational and health objectives. Based on a priori defined indication criteria, clinic staff will recommend either IG subgroup 1 or IG subgroup 2. The CG will receive optimized treatment as usual with access to a survey feature within marena . The primary outcome will be work status after 6 months (T2) and 12 months (T4). The endpoint at 12 months (T4) after discharge from inpatient rehabilitation will be considered as secondary endpoint. Work status is defined as positive if the participant is working and has ≤ 6 weeks of sick leave at T2 and ≤ 12 weeks of sick leave at T4. Secondary outcomes include successful completion of graded return to work, successful application for benefits for participation in working life, current work ability, social-medical risk, subjective prognosis of future employment, quality of life, somatic symptoms, coping, social support, depression, anxiety, and psychosocial stress., Discussion: This study will contribute to the evidence concerning efficacy of online aftercare interventions. If proven efficacious, marena could provide an individualized and adaptable self-help approach to promote return to work following inpatient rehabilitation., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Adina Kreis reports financial support was provided by German Pension Insurance. Ruediger Zwerenz reports financial support was provided by German Pension Insurance. Manfred Beutel reports financial support was provided by German Pension Insurance. Anna Gomes reports financial support was provided by German Pension Insurance. The authors are the evaluators and developers of the software. The cooperating clinics are compensated for recruitment., (© 2024 The Authors.)
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- 2024
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38. The effects of effort-reward imbalance on the job, overcommitment, and income on life satisfaction in Germany from a longitudinal perspective.
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Braunheim L, Dragano N, Khachatryan K, Beutel ME, and Brähler E
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- Humans, Germany, Reward, Job Satisfaction, Surveys and Questionnaires, Stress, Psychological epidemiology, Occupational Stress epidemiology, European People
- Abstract
Background: The effort-reward imbalance at work model offers a theoretical and analytical framework to estimate the subjective perception of work-related stress. High demands and low rewards in return can harm mental and physical health, well-being, and life satisfaction. According to the theory, overcommitment partially explains why employees endure such straining jobs. In Germany, cultural and economic aspects of labor differ between East and West. Incomes are lower in the East, while work centrality there is higher. In this article, the effects of effort-reward imbalance, overcommitment, and income on life satisfaction as well as their interactions with region were analyzed to gain a clearer picture of regional disparities regarding life satisfaction and the generality of this work stress model in Germany., Methods: Data from 3848 participants from 2006 to 2011 of the German Socio-Economic Panel were analyzed. Within-between models were estimated, including fixed and random effects of the continuous form of effort-reward imbalance to predict subjective life satisfaction. Time-variant covariates - e.g., overcommitment or income - as well as time-constant variables - e.g., region, sex, education - were integrated. Differences in regional labor markets between East and West Germany were considered., Results: Easterners exhibited higher imbalances and overcommitment than Westerners, indicating worse working conditions. Higher imbalances and overcommitment were associated with lower life satisfaction within and between participants, whereas for income only random effects were supported. While region did not moderate the effect of work stress, East Germans' life satisfaction benefitted more from a higher income., Conclusion: The importance of internal work structures in terms of recognition, adequate pay, advancement opportunities, or time pressure were underlined. As compared to the West, Easterners' life satisfaction benefitted more from higher income but not more from a lower imbalance or lower overcommitment. The interplay between materialistic and nonmaterialistic rewards at work should be focused on in the future., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)
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- 2024
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39. Predictors for COVID-19 Vaccine Hesitancy in a Population-Based Cohort Study.
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Baumkötter R, Yilmaz S, Zahn D, Schulz A, Prochaska JH, Hettich-Damm N, Schmidtmann I, Schuster AK, Lackner KJ, Münzel T, Beutel ME, and Wild PS
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- Humans, Cohort Studies, Vaccination, COVID-19 Vaccines therapeutic use, COVID-19 prevention & control
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- 2023
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40. Cigarette Smoking, Risky Alcohol Consumption, and Marijuana Smoking among University Students in Germany: Identification of Potential Sociodemographic and Study-Related Risk Groups and Predictors of Consumption.
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Hoff TA, Heller S, Reichel JL, Werner AM, Schäfer M, Tibubos AN, Simon P, Beutel ME, Letzel S, Rigotti T, and Dietz P
- Abstract
(1) Background: Cigarette smoking, risky alcohol consumption, and marijuana smoking are the most common behaviors related to legal and illicit drug use worldwide, including among university students. To plan effective evidence-based programs to prevent the risky consumption of these substances among university students, the present study aimed to identify potential sociodemographic and study-related risk groups and predictors of consumption. (2) Methods: A cross-sectional online health survey with approximately 270 health-related items was conducted among students at the University of Mainz, Germany. Cigarette smoking, risky alcohol consumption (AUDIT-C score: female ≥ 4, male ≥ 5), and marijuana smoking were chosen as dependent variables. Of the 270 health-related items, 56 were chosen as independent variables and collated into five groups (sociodemographic, psychological, study-related psychosocial, general psychosocial and health behavior). The prevalence of cigarette smoking, risky alcohol consumption, and marijuana smoking was assessed using established and validated instruments. Pearson's chi-square test was used to analyze the differences in prevalence between the sociodemographic and study-related groups, and binary logistic regression was used for analyses with stepwise inclusion of the five variable groups. (3) Results: Of the 3991 university students who entered the analyses, 14.9% reported smoking cigarettes, 38.6% reported risky alcohol consumption, and 10.9% reported smoking marijuana. The prevalence of these differed between genders, fields of study, and aspired degree level, among other factors. Binary logistic regression analyses revealed nine significant predictors ( p ≤ 0.05) of cigarette smoking (Nagelkerke R
2 = 0.314), 18 significant predictors of risky alcohol consumption (Nagelkerke R2 = 0.270), and 16 significant predictors of marijuana smoking (Nagelkerke R2 = 0.239). (4) Conclusions: This study showed cigarette smoking, risky alcohol consumption, and marijuana smoking among university students in Germany to be associated with multiple factors, especially health behaviors. Furthermore, each of the substances was highly associated with each of the two other substances we examined. Other variable groups, such as psychological or psychosocial variables, seemed to play a rather minor role. Therefore, our recommendation for future prevention programs is that substance use among university students should be addressed as a whole, not just in terms of specific substances.- Published
- 2023
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41. Recruitment of Patients With Cancer for a Clinical Trial Evaluating a Web-Based Psycho-Oncological Intervention: Secondary Analysis of a Diversified Recruitment Strategy in a Randomized Controlled Trial.
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Tsiouris A, Mayer A, Wiltink J, Ruckes C, Beutel ME, and Zwerenz R
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Background: Participant recruitment poses challenges in psycho-oncological intervention research, such as psycho-oncological web-based intervention studies. Strict consecutive recruitment in clinical settings provides important methodological benefits but is often associated with low response rates and reduced practicability and ecological validity. In addition to preexisting recruitment barriers, the protective measures owing to the COVID-19 pandemic restricted recruitment activities in the clinical setting since March 2020., Objective: This study aims to outline the recruitment strategy for a randomized controlled trial evaluating the unguided emotion-based psycho-oncological online self-help (epos), which combined traditional and web-based recruitment., Methods: We developed a combined recruitment strategy including traditional (eg, recruitment in clinics, medical practices, cancer counseling centers, and newspapers) and web-based recruitment (Instagram, Facebook, and web pages). Recruitment was conducted between May 2020 and September 2021. Eligible participants for this study were adult patients with any type of cancer who were currently receiving treatment or in posttreatment care. They were also required to have a good command of the German language and access to a device suitable for web-based interventions, such as a laptop or computer., Results: We analyzed data from 304 participants who were enrolled in a 17-month recruitment period using various recruitment strategies. Web-based and traditional recruitment strategies led to comparable numbers of participants (151/304, 49.7% vs 153/304, 50.3%). However, web-based recruitment required much less effort. Regardless of the recruitment strategy, the total sample did not accurately represent patients with cancer currently undergoing treatment for major types of cancer in terms of various sociodemographic characteristics, including but not limited to sex and age. However, among the web-recruited study participants, the proportion of female participants was even higher (P<.001), the mean age was lower (P=.005), private internet use was higher (on weekdays: P=.007; on weekends: P=.02), and the number of those who were currently under treatment was higher (P=.048). Other demographic and medical characteristics revealed no significant differences between the groups. The majority of participants registered as self-referred (236/296, 79.7%) instead of having followed the recommendation of or study invitation from a health care professional., Conclusions: The combined recruitment strategy helped overcome general and COVID-19-specific recruitment barriers and provided the targeted participant number. Social media recruitment was the most efficient individual recruitment strategy for participant enrollment. Differences in some demographic and medical characteristics emerged, which should be considered in future analyses. Implications and recommendations for social media recruitment based on personal experiences are presented., Trial Registration: German Clinical Trials Register DRKS00021144; https://drks.de/search/en/trial/DRKS00021144., International Registered Report Identifier (irrid): RR2-10.1016/j.invent.2021.100410., (©Angeliki Tsiouris, Anna Mayer, Jörg Wiltink, Christian Ruckes, Manfred E Beutel, Rüdiger Zwerenz. Originally published in JMIR Cancer (https://cancer.jmir.org), 27.11.2023.)
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- 2023
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42. Self-rated physical health predicts mortality in aging persons beyond objective health risks.
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Reinwarth AC, Wicke FS, Hettich N, Ernst M, Otten D, Brähler E, Wild PS, Münzel T, König J, Lackner KJ, Pfeiffer N, and Beutel ME
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- Humans, Male, Female, Adult, Middle Aged, Mental Health, Risk Factors, Health Status, Aging
- Abstract
Previous studies on self-rated health and mortality have usually not differentiated between physical and mental health, respectively have not considered physical diseases. This study aims to determine self-rated physical and mental health from middle to old age, examine associations with mortality adjusted for objective risk factors and assess effect modification by gender. In a large population-based sample (N = 14,993 at baseline), self-rated physical and mental health were rated separately by a single-item. Associations to mortality were modelled by Cox regressions, adjusting for potential confounding variables. Most participants rated their physical (79.4%), resp. mental health (82.3%) as good. Poor self-rated physical health was lowest in the youngest group (19.6%, age 35-44), and highest in midlife (29.1%, age 55-64). Poor self-rated mental health was lowest among the oldest (18.5%), and highest from 45 to 54 years (29.3%). Poor self-rated physical, but not mental health was predictive of mortality when adjusting for objective risk factors. Male gender and poor self-rated physical health interacted (RERI 0.43 95%-CI 0.02-0.85). Self-rated physical health was best in the youngest and worst in the midlife group, this pattern was reversed regarding self-rated mental health. Poor self-rated physical, but not mental health was predictive of mortality, adjusting for objective risk factors. It was more strongly predictive of mortality in men than in women. Poor subjective physical health ratings, should be taken seriously as an unfavorable prognostic sign, particularly in men., (© 2023. The Author(s).)
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- 2023
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43. Much higher prevalence of keratoconus than announced results of the Gutenberg Health Study (GHS).
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Marx-Gross S, Fieß A, Münzel T, Wild PS, Beutel ME, Schmidtmann I, Lackner KJ, Pfeiffer N, and Schuster AK
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Keratoconus appears to be a rare corneal disease with a prevalence previously estimated at 1:2000. The aim of our study was to investigate the prevalence of keratoconus in a large German cohort and to evaluate possible associated factors., Method: In the population-based, prospective, monocentric cohort study, Gutenberg Health Study, 12,423 subjects aged 40-80 years were examined at the 5-year follow-up. Subjects underwent a detailed medical history and a general and ophthalmologic examination including Scheimpflug imaging. Keratoconus diagnosis was performed in two steps: all subjects with conspicuous TKC analysis of corneal tomography were included in further grading. Prevalence and 95% confidence intervals were calculated. Logistic regression analysis was carried out to investigate association with age, sex, BMI, thyroid hormone, smoking, diabetes, arterial hypertension, atopy, allergy, steroid use, sleep apnea, asthma, and depression., Results: Of 10,419 subjects, 75 eyes of 51 subjects were classified as having keratoconus. The prevalence for keratoconus in the German cohort was 0.49% (1:204; 95% CI: 0.36-0.64%) and was approximately equally distributed across the age decades. No gender predisposition could be demonstrated. Logistic regression showed no association between keratoconus and age, sex, BMI, thyroid hormone, smoking, diabetes, arterial hypertension, atopy, allergy, steroid use, sleep apnea, asthma, and depression in our sample., Conclusion: The prevalence of keratoconus disease in a mainly Caucasian population is approximately tenfold higher than previously reported in the literature using latest technologies (Scheimpflug imaging). Contrary to previous assumptions, we did not find associations with sex, existing atopy, thyroid dysfunction, diabetes, smoking, and depression., (© 2023. The Author(s).)
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- 2023
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44. Assessment of health-related quality of life in individuals with depressive symptoms: validity and responsiveness of the EQ-5D-3L and the SF-6D.
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Stolz M, Albus C, Beutel ME, Deter HC, Fritzsche K, Herrmann-Lingen C, Michal M, Petrowski K, Ronel J, Schultz JH, Söllner W, Weber C, de Zwaan M, and Krauth C
- Subjects
- Humans, Depression, Surveys and Questionnaires, Psychometrics, Reproducibility of Results, Quality of Life, Mental Disorders
- Abstract
Background: The EQ-5D and the SF-6D are examples of commonly used generic preference-based instruments for assessing health-related quality of life (HRQoL). However, their suitability for mental disorders has been repeatedly questioned., Objective: To assess the responsiveness and convergent validity of the EQ-5D-3L and SF-6D in patients with depressive symptoms., Methods: The data analyzed were from cardiac patients with depressive symptoms and were collected as part of the SPIRR-CAD (Stepwise Psychotherapy Intervention for Reducing Risk in Coronary Artery Disease) trial. The EQ-5D-3L and SF-6D were compared with the HADS (Hospital Anxiety and Depression Scale) and PHQ-9 (Patient Health Questionnaire) as disease-specific instruments. Convergent validity was assessed using Spearman's rank correlation. Effect sizes were calculated and ROC analysis was performed to determine responsiveness., Results: Data from 566 patients were analysed. The SF-6D correlated considerably better with the disease-specific instruments (|r
s |= 0.63-0.68) than the EQ-5D-3L (|rs |= 0.51-0.56). The internal responsiveness of the SF-6D was in the upper range of a small effect (ES: - 0.44 and - 0.47), while no effect could be determined for the EQ-5D-3L. Neither the SF-6D nor the EQ-5D-3L showed acceptable external responsiveness for classifying patients' depressive symptoms as improved or not improved. The ability to detect patients whose condition has deteriorated was only acceptable for the EQ-5D-3L., Conclusion: Overall, both the convergent validity and responsiveness of the SF-6D are better than those of the EQ-5D-3L in patients with depressive symptoms. The SF-6D appears, therefore, more recommendable for use in studies to evaluate interventions for this population., (© 2022. The Author(s).)- Published
- 2023
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45. Vertigo and its burden of disease-Results from a population-based cohort study.
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Hackenberg B, O'Brien K, Döge J, Lackner KJ, Beutel ME, Münzel T, Wild PS, Pfeiffer N, Chalabi J, Matthias C, and Bahr-Hamm K
- Abstract
Objectives: Vertigo describes symptoms of abnormal movement of the environment or the patient's own body. As such, it affects patients' quality of life, prevents them from following their daily activities, and increases healthcare utilization. The Global Burden of Disease Project aims to quantify morbidity and mortality worldwide. In 2013, a separate disability weight for vertigo was introduced. The aim of this study is to estimate the symptom burden of disease caused by vertigo., Methods: This study analyzes data from the Gutenberg Health Study (GHS). The GHS is a population-based cohort study representative of the city of Mainz and its district. Participants were asked whether they suffered from vertigo and, if so, how bothered they felt by it, rating their distress on a six-level scale from 1 = little stressful to 6 = extremely stressful., Results: Eight thousand five hundred and nineteen participants could be included in the study. The overall prevalence of vertigo was 21.6% (95%-confidence interval [CI] [20.7%; 22.5%]). Vertigo prevalence peaked in the age group of 55-64 years. Vertigo annoyance averaged 2.42 ( ± 1.28). When an annoyance of 3-6 was considered bothersome, the prevalence of bothersome vertigo was 8.1 % (95%-CI [7.5%; 8.7%]). Age-standardized to the European Standard Population 2013, vertigo caused a burden of 2102 years lived with disability per 100,000 population., Conclusion: In this study, it was found that one in five people suffer at least occasionally from vertigo. This result suggests a significant burden of disease. This burden is reported at the symptom level. Future studies are needed to attribute the burden to specific causes., Level of Evidence: 2., Competing Interests: The authors have no conflicts of interest to declare., (© 2023 The Authors. Laryngoscope Investigative Otolaryngology published by Wiley Periodicals LLC on behalf of The Triological Society.)
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- 2023
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46. Circulating microRNAs predict recurrence and death following venous thromboembolism.
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Ten Cate V, Rapp S, Schulz A, Pallares Robles A, Jurk K, Koeck T, Espinola-Klein C, Halank M, Seyfarth HJ, Beutel ME, Schuster AK, Marini F, Hobohm L, Lankeit M, Lackner KJ, Ruf W, Münzel T, Andrade-Navarro MA, Prochaska JH, Konstantinides SV, and Wild PS
- Subjects
- Humans, Cohort Studies, Proteomics, Circulating MicroRNA genetics, Venous Thromboembolism diagnosis, Venous Thromboembolism genetics, MicroRNAs genetics
- Abstract
Background: Recurrent events frequently occur after venous thromboembolism (VTE) and remain difficult to predict based on established genetic, clinical, and proteomic contributors. The role of circulating microRNAs (miRNAs) has yet to be explored in detail., Objectives: To identify circulating miRNAs predictive of recurrent VTE or death, and to interpret their mechanistic involvement., Methods: Data from 181 participants of a cohort study of acute VTE and 302 individuals with a history of VTE from a population-based cohort were investigated. Next-generation sequencing was performed on EDTA plasma samples to detect circulating miRNAs. The endpoint of interest was recurrent VTE or death. Penalized regression was applied to identify an outcome-relevant miRNA signature, and results were validated in the population-based cohort. The involvement of miRNAs in coregulatory networks was assessed using principal component analysis, and the associated clinical and molecular phenotypes were investigated. Mechanistic insights were obtained from target gene and pathway enrichment analyses., Results: A total of 1950 miRNAs were detected across cohorts after postprocessing. In the discovery cohort, 50 miRNAs were associated with recurrent VTE or death (cross-validated C-index, 0.65). A weighted miRNA score predicted outcome over an 8-year follow-up period (HR
SD , 2.39; 95% CI, 1.98-2.88; P < .0001). The independent validation cohort validated 20 miRNAs (ORSD for score, 3.47; 95% CI, 2.37-5.07; P < .0001; cross-validated-area under the curve, 0.61). Principal component analysis revealed 5 miRNA networks with distinct relationships to clinical phenotype and outcome. Mapping of target genes indicated regulation via transcription factors and kinases involved in signaling pathways associated with fibrinolysis., Conclusion: Circulating miRNAs predicted the risk of recurrence or death after VTE over several years, both in the acute and chronic phases., Competing Interests: Declaration of competing interests None of the authors report any conflicts of interest with respect to the content of this article. P.S.W. reports grants from Bayer AG within the submitted work. Outside the submitted work, he reports nonfinancial grants from Philips Medical Systems, grants and consulting fees from Boehringer Ingelheim, Novartis Pharma, Sanofi-Aventis, Daiichi Sankyo Europe, grants, consulting, and lecturing fees from Bayer Health Care, lecturing fees from Pfizer Pharma and Bristol-Myers Squibb, consulting fees from Astra Zeneca, consulting fees and nonfinancial support from Diasorin, and nonfinancial support from I.E.M. P.S.W. was funded by the Ministry of Education and Research (BMBF 01EO1003 and 01EO1503). J.H.P. has received honoraria for lectures from Bayer AG, Boehringer Ingelheim, Daiichi Sankyo GmbH, and Sanofi-Aventis GmbH, and research grants from the Federal Ministry of Education and Research (BMBF 01EO1503) and the German Center for Cardiovascular Research (DZHK) outside the topic of the present study. S.K. reports grants and consulting fees from Bayer AG, Daiichi-Sankyo, Boston Scientific, and Inari Medical, and lecture fees from Pfizer – Bristol-Myers Squibb and MSD. The remaining authors report no conflict of interest. P.S.W. and T.M. are the principal investigators of the German Center for Cardiovascular Research (DZHK), and P.S.W. is the principal investigator of the DIASyM research core (BMBF DIASyM research core [BMBF 161L0217A])., (Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.)- Published
- 2023
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47. [The relationship of functional and symptomatic changes after multimodal psychodynamic treatment].
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Rückert KK, Ernst M, Zwerenz R, Michal M, Beutel ME, and Krakau L
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- Humans, Personality, Personality Disorders diagnosis, Personality Disorders therapy, Psychotherapy, Psychodynamic
- Abstract
Objectives: Personality organization or functioning describes biographically acquired characteristics for the regulation of psychological processes. Limitations correlate with symptom load. This study examines whether significant improvement in personality functioning can be achieved in the framework of a multimodal psychodynamic treatment and its influence on the psychological symptoms. Methods: In this naturalistic study design (N = 318) personality organization was measured with the OPD-SQS and the symptoms were obtained using PHQ-9, GAD-7, SCL-9 and mini- Spin. Changes in the functioning levels were calculated using a t-test. The associations between the functional and symptom improvements were calculated using hierarchical regressionmodels. ANOVAs for dependent samples were used to calculate the association of the personality organization changes on symptom reduction Results: Treatment resulted in significant improvement in personality structure.The greater the changes, the lower the symptom burden at the end of treatment. Patients with lower personality structure benefited equally well from treatment. Conclusions: Personality functioning improves with multimodal psychodynamic therapy and is accompanied by reduction of psychological symptoms. Structural changes proceed equally in high and low structured patients.
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- 2023
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48. Association of autoantibody levels with different stages of age-related macular degeneration (AMD): Results from the population-based Gutenberg Health Study (GHS).
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Korb CA, Lackner KJ, Wolters D, Schuster AK, Nickels S, Beutgen VM, Münzel T, Wild PS, Beutel ME, Schmidtmann I, Pfeiffer N, and Grus FH
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- Humans, Adult, Middle Aged, Aged, Retina, Fundus Oculi, Autoantibodies, Macular Degeneration diagnosis, Retinal Drusen
- Abstract
Purpose: Anti-retinal autoantibodies are assumed to be associated with age-related macular degeneration (AMD). To our knowledge, this is the first evaluation of autoantibodies in human sera of participants with different stages of AMD in a large population-based, observational cohort study in Germany., Methods: The Gutenberg Health Study (GHS) is a population-based, observational cohort study in Germany, including 15,010 participants aged between 35 and 74. Amongst others, non-mydriatic fundus photography (Visucam PRO NM™, Carl Zeiss Meditec AG, Jena, Germany) was performed. Fundus images of the first 5000 participants were graded based on the Rotterdam Eye Study classification. Sera of participants with AMD (n=541) and sera of age-matched participants without AMD (n=490) were analyzed by antigen-microarrays. Besides descriptive statistics, autoantibody-levels were compared by Mann-Whitney-U test and the associations of level of autoantibodies with AMD were calculated by logistic regression analysis. Likewise, possible associations of the autoantibodies and both clinical and laboratory parameters on AMD subjects were analyzed., Results: Autoantibodies against transferrin (p<0.001) were significantly downregulated in participants with early AMD and soft, distinct drusen (≥63 μm) or pigmentary abnormalities only compared to Controls. Mitogen-activated protein kinase 3 (p=0.041), glutathione peroxidase 4 (p=0.048), clusterin (p=0.045), lysozyme (p=0.19), protein kinase C substrate 80K-H (p=0.02), heat shock 70 kDa protein 1A (p=0.04) and insulin (p=0.018) show a trend between Control and participants with early AMD and soft, distinct drusen (≥63 μm) or pigmentary abnormalities only., Conclusions: This study contributes to a growing knowledge of autoantibodies in association with different AMD stages compared to controls in the context of a large population-based study in Germany. Especially autoantibodies against inflammatory proteins were downregulated in participants with early AMD and soft, distinct drusen (≥63 μm) or pigmentary abnormalities only., (© 2023. The Author(s).)
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- 2023
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49. [Life events related to the German reunification and their associations with psychosocial health in a sample of northeast Germany].
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Hahm S, Altweck L, Franz H, Schmidt S, Fleischer T, Helmert C, Ulke C, Speerforck S, Schomerus G, Klinger-König J, Grabe HJ, Beutel ME, Brähler E, and Muehlan H
- Subjects
- Humans, Germany epidemiology, Mental Health, Social Support
- Abstract
Objectives: The aim of the present study was to investigate (1) the type and frequency of reported life events of the East German population related to the German reunification and (2) their associations with psychosocial health. Methods: Data of 2247 participants of the Study of Health in Pomerania was used.These qualitative responses were analysed using quantitative content analysis. Their associations with subjective physical and mental health, optimism, social support, depressive symptoms, and chronic stress were examined. Results: Eight life event categories were identified (education, employment-related changes, material changes, new opportunities, personal life events, politics, separations, reunifications). Especially, experiencing new opportunities was associated with a higher level of optimism as well as a lower level of depressive symptoms and chronic stress. Conclusions: In this study, events frequently described in the literature (e.g., employment-related and social changes) were confirmed and systematized.The observed associations of these events with psychosocial factors should be examined further in future studies.
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- 2023
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50. Mental resources, mental health and sociodemography: a cluster analysis based on a representative population survey in a large German city.
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Khachatryan K, Otten D, Beutel ME, Speerforck S, Riedel-Heller SG, Ulke C, and Brähler E
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- Child, Humans, Male, Cluster Analysis, Data Collection, Germany epidemiology, Mental Health, Employment
- Abstract
Background: Mental resources such as optimism and social support are important to face different stressors. The aim of this study is to identify groups in the population that are similar in terms of their mental resources., Methods: For this purpose, a randomly selected general population community sample was used, representative for the city of Leipzig, Germany. In a two-stage process, three clusters were identified using hierarchical cluster analysis and the K-means method and then tested with a multinomial logistic regression analysis for differences in sociodemographic characteristics., Results: Three clusters were identified which vary in their extent of social support and optimism. In distinguishing between those with higher and lower (medium or poor) mental resources, male gender, unemployment, being born abroad and low household income are risk factors for having fewer mental resources. Internal migrants from West Germany and persons with children at home have a higher chance of being in the type with good mental resources. The groups with medium and lower mental resources differ significantly only by variables living with a partner and employment., Conclusion: Our results indicate that good mental resources are associated with good mental health. Special mental health care programs, focusing in particular on the needs of vulnerable groups with poor mental resources within a society, should be implemented., (© 2023. BioMed Central Ltd., part of Springer Nature.)
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- 2023
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