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Affective disorders profoundly affect individuals' emotional well-being and quality of life. This study investigates the epidemiology of affective disorders in Germany from 2011 to 2021, focusing on incidence rates, age- and sex-standardized rates, and developmental trends. Using nationwide data of ICD-10 diagnosis codes from 2011 to 2021, this cross-sectional study analyzed inpatient cases of affective disorders in individuals aged 20 years or older. Age- and sex-standardized incidence rates were calculated based on the population size of each birth cohort in the 16 German federal states. Incidence rate ratios (IRRs) for 2011 to 2021 and 2019 to 2021 were compared with a two-sample z-test. Between 2011 and 2021, F30 (manic episode) showed a decline of 42.8 % to an incidence of 4.9 per 100,000 inhabitants, even though not statistically significant (p = 0.322). F31 (bipolar affective disorder) remained relatively stable with a reduction of 15.3 % to an incidence of 13.6 per 100,000 inhabitants in 2021 (p = 0.653). F32 (depressive episode) decreased statistically significant by 25.7 % to an incidence of 64.1 per 100,000 inhabitants (p = 0.072). F33 (recurrent depressive disorder) slightly increased by 18.3 % to an incidence of 94.6 per 100,000 inhabitants (p = 0.267). No statistically significant differences were found when comparing the COVID-19 pandemic year 2021 to 2019 incidences (p ≥ 0.529). The study provides valuable insights into the changing landscape of affective disorders in Germany over the past decade. The observed decline in incidence rates underscores the importance of continued efforts to promote mental health awareness and access to care. • This studies utilized nationwide inpatient data from all clinics in Germany from 2011 to 2021 • 267,067 patients were hospitalized for affective disorders, (1.73% of the general population) in 2021 • Bipolar affective disorder remained relatively stable with an incidence of 13.6/100,000 inhabitants • Depressive episodes decreased by 25.7% to an incidence of 64.1/ 100,000 inhabitants • There were no statistically significant differences when comparing the COVID-19 pandemic year 2021 to 2019 incidences [ABSTRACT FROM AUTHOR]

Purpose: Psychiatric disorders and cancer are both common, and comorbidity has detrimental impacts on cancer outcomes. Previous studies focus on affective disorders which arise after cancer diagnosis, not on the impact of psychiatric disorders on cancer risk. We investigate the association between psychiatric disorders and subsequent gastrointestinal cancer in a large cohort in Germany. Methods: This case–control study used secondary data (electronic medical records) from the national IQVIA Disease Analyzer database. We evaluated the association between previous psychiatric diagnosis in 44,582 matched patients with and without gastrointestinal (GI) cancer. Regression analyses were stratified by psychiatric diagnosis and adjusted by chronic comorbidities and previous psychiatric treatments. Results: No association between any previous psychiatric disease and GI cancers was found (OR = 0.98 (0.95–1.02 95%CL, p = 0.39). Previous psychosomatic disorder and GI cancer showed a significant negative association (OR: 0.86, 0.81–0.90 95%CL, p < 0.0001). No association was found between previous diagnosis with depression or PTSD and GI cancer. These results remained consistent when including previous psychiatric treatments in the regression analyses. Conclusion: Psychiatric disease was not associated with GI cancer risk. Further investigation into the pathways linking psychiatric disease and cancer needs to be conducted, taking into consideration psychiatric treatments administered, to enhance our understanding of the relationship between these two common and devastating diseases. [ABSTRACT FROM AUTHOR]

The aim of this cross-sectional study was the evaluation of the oral health-related quality of life (OHRQoL) in patients with depression or attention-deficit/hyperactivity disorder (ADHD) in comparison with a group of mentally healthy individuals. Patients from the Department of Psychiatry and Psychotherapy, University of Leipzig, Germany, were recruited. A healthy comparison group (HC) was recruited from the Department of Cariology, Endodontology and Periodontology. The OHRQoL was assessed using the Oral Health Impact Profile G14 (OHIP G14). Furthermore, a questionnaire regarding oral hygiene behaviour was applied. A total of 141 patients with depression or ADHD (depression n = 94, ADHD n = 47) and 145 HC individuals with a balanced age and gender distribution were surveyed. OHIP G14 median scores were significantly higher in the overall psychiatric patient group compared to HC (5.00 vs. 0.00, p < 0.001). This was also found for the four dimensions of OHIP G14 (p < 0.001). The OHIP G14 sum score of patients with depression and ADHD was comparable (5.00 vs. 6.50, p = 0.302). A significant association among psychiatric patients between smoking, gum bleeding, professional tooth cleaning, oral health education, interdental cleaning, and elevated OHIP scores was found (p < 0.001). In conclusion, patients with depression and adults with ADHD show a reduced OHRQoL. A contradictory association between oral hygiene/oral health behaviour and OHRQoL supports the hypothesis of a changed perception of oral conditions in patients with mental diseases. Interdisciplinary collaboration between psychiatric specialists and dentists should be fostered. [ABSTRACT FROM AUTHOR]

It is widely assumed that autobiographical memory relies on an integration of episodic memory with the self-model. We hypothesise that self-memory integration depends critically on self-congruence. More specifically, self-incongruent experiences such as those that elicit shame or guilt may be more difficult to integrate. Self-incongruence may affect both the semantic reports of memories and their phenomenological characteristics, in particular their visual perspective (1PP or 3PP, i.e., field or observer perspective), their affective valence, and their perceived centrality. Diary based memories were assigned to 4 categories (shame, guilt, negative, neutral) and were rated for the different phenomenological dimensions. We used a deep neural network, univariate and multilevel models to assess differences and relationships between different variables. We found that memories that elicited shame (but not guilt) showed more pronounced 3PP as compared to other experiences. Shameful episodes also elicited the most pronounced negative affect. A multilevel analysis revealed that the amount of shame that an episode elicited, and its semantic similarity with shame episodes, predicted higher 3PP, while affective valence did not. Our results show that self-incongruence affects memories both at the level of their semantic reports and their phenomenology, and thus contributes to a mechanistic understanding of self-memory integration. [ABSTRACT FROM AUTHOR]

Potential contributing factors (PCFs) for irritability of an unknown origin (IUO) in children with neurological conditions are identifiable through structured diagnostics. Uncertainty exists regarding the actual relevance of identified PCFs to IUO. Assessments from parents as well as nursing, psycho-social, and medical professionals were used to determine the contribution of different PCFs in the development and maintenance of IUO. For this, individual PCFs of N = 22 inpatient children with IUO were presented to four raters. Descriptive statistics, Kruskal–Wallis tests, and Krippendorff's alpha were used to determine which PCFs were most relevant to explain IUO and rater agreement. Psycho-social aspects (44.7%), hyperarousal (47.2%), pain (24.6%), and dystonia (18.1%) were identified as the most relevant PCFs for IUO. Descriptively, physicians' relevance rating regarding psycho-social aspects, hyperarousal, and dystonia deviated the most from the overall group rating. All professional raters considered psycho-social aspects to be more relevant than did parents. Parents rated pain as more relevant than the other raters. Kruskal–Wallis tests showed no significant differences between relevance ratings (H = 7.42, p = 0.059) or the four parties' deviations (H = 3.32, p = 0.344). A direct comparison of the six two-party constellations showed that across all factors, agreement was weak to moderate. The highest agreement was between physicians and nurses (α = 0.70), and the lowest was between nurses and psycho-social experts (α = 0.61). Understanding which psycho-social and various biological PCFs are significant for IUO can facilitate more targeted and individualized pediatric palliative care for affected patients. [ABSTRACT FROM AUTHOR]

Epidemiological evidence suggests that regular physical activity (PA) positively impacts individuals' mental health (MH). The PA-MH relationship may be critical among immigrants owing to psycho-social-cultural influences. This scoping review of 61 studies employed a holistic bio-psycho-socio-cultural framework to thoroughly investigate the complex relationship between PA (across life domains) and immigrants' MH in Western countries. A systematic search of five electronic databases (Medline, PubMed, Embase, PsycINFO and Anthropology Plus) was conducted to locate relevant articles. No limitations were applied to study design, age, gender, home country, MH condition or PA type. A bio-psycho-socio-cultural-informed conceptual model guided the analysis of the multi-domain PA-MH relationship. Immigrant PA-MH studies were conducted and reported most commonly in the USA (38%), Australia (18%), and Canada (11%). Overall, PA was positively related to MH. Each domain-specific PA appeared to be associated with unique MH-promoting pathways/mechanisms. Leisure-related PA may support MH by enhancing self-agency and minimizing risky behaviors, whilst travel- and domestic-related PA may promote self-accomplishment and physical engagement. Ethnic sports appeared to enhance resilience. Occupational-related PA was associated with either positive or negative MH, depending on the type of occupation. A bio-psycho-socio-cultural-informed model is required to gain an encompassing and integrated understanding of immigrants' health. The first iteration of such a model is presented here, along with an illustration of how the model may be used to deepen analysis and understanding of the multi-domain PA-MH relationship among immigrants and inform public health planners and practitioners. [ABSTRACT FROM AUTHOR]

Background: Multiple or persistent crying, sleeping, or feeding problems in early childhood (regulatory problems) are associated with increased internalizing symptoms in adulthood. Unknown is whether early regulatory problems are associated with emotional disorders in adulthood, and what psychosocial factors may provide protection. We tested whether early childhood multiple or persistent regulatory problems are associated with a higher risk of (a) any mood and anxiety disorder in adulthood; (b) perceiving no social support in adulthood; and (c) whether social support provides protection from mood and anxiety disorders among participants who had multiple/persistent regulatory problems and those who never had regulatory problems. Methods: Data from two prospective longitudinal studies in Germany (n = 297) and Finland (n = 342) was included (N = 639). Regulatory problems were assessed at 5, 20, and 56 months with the same standardized parental interviews and neurological examinations. In adulthood (24–30 years), emotional disorders were assessed with diagnostic interviews and social support with questionnaires. Results: Children with multiple/persistent regulatory problems (n = 132) had a higher risk of any mood disorder (odds ratio (OR) = 1.81 [95% confidence interval = 1.01–3.23]) and of not having any social support from peers and friends (OR = 1.67 [1.07–2.58]) in adulthood than children who never had regulatory problems. Social support from peers and friends provided protection from mood disorders, but only among adults who never had regulatory problems (OR = 4.03 [2.16–7.94]; p =.039 for regulatory problems x social support interaction). Conclusions: Children with multiple/persistent regulatory problems are at increased risk of mood disorders in young adulthood. Social support from peers and friends may, however, only provide protection from mood disorders in individuals who never had regulatory problems. [ABSTRACT FROM AUTHOR]

Background: The generic self-reported Recovering Quality of Life (ReQoL) measures were developed for measuring recovery-focused health-related quality of life (HrQoL) in persons with mental health conditions. The aim of this study was to assess the psychometric properties of the German version of the ReQoL measures in patients with affective disorders in Germany. Methods: Data from a patient sub-sample in a randomized controlled trial have been used (N = 393). The internal consistency and the test–retest reliability of the ReQoL measures were assessed using Cronbach's Alpha and the intra-class correlation coefficient (ICC). The concurrent validity and the known-group validity of the ReQoL measures were assessed using Pearson's Correlation coefficient and Cohen's d. The responsiveness was assessed using Glass' Δ and the standardized response mean (SRM). Results: The reliability among the items of the ReQoL-20 was overall excellent. The ICC of the ReQoL-20 was r = 0.70, indicating moderate test–retest reliability. The concurrent validity of the ReQoL-20 with the clinical measure PHQ-9 was strong with a correlation coefficient of r = − 0.76. The known-group validity of the ReQoL-20 using PHQ-9 cut-off points was large with an effect size of d = 1.63. The ReQoL measures were sensitive to treatment response and remission of symptoms measured by the PHQ-9 with large effect sizes/SRM. Discussion: The psychometric properties of the ReQoL measures for the assessment of patients with affective disorders were overall good. With the ReQoL, valid and reliable measures for the assessment of recovery-focused HrQoL for persons with affective disorders are available in German language. [ABSTRACT FROM AUTHOR]

Introduction: Flexible and integrated treatment options (FIT) have been established in German psychiatric hospitals to enhance continuous and patientcentered treatment for patients with mental disorders. We hypothesized that patients with experience in FIT treatment showed higher health-related quality of life (HRQoL) and comparable symptom severity compared with patients treated as usual (TAU). Further, we expected that some sub-dimensions of HRQoL determined HRQoL results clearer than others, while certain factors influenced HRQoL and symptom severity stronger in the FIT compared to the TAU group. In addition, we hypothesized that HRQoL is correlated with symptom severity. Methods: We undertook a controlled, prospective, multicenter cohort study (PsychCare) conducted in 18 psychiatric hospitals in Germany, using the questionnaires Quality of Well Being Self-Administered (QWB-SA) (HRQoL) and Symptom-Checklist-K-9 (SCL-K-9) (symptom severity) at recruitment (measurement I) and 15 months later (measurement II). We assessed overall HRQoL (measured in health utility weights (HUW) and symptom severity score for patients from FIT and TAU treatment. We investigated the QWB-SA dimensions and separated the results by diagnosis. We used beta regressions to estimate the effect of multiple co-variates on both outcomes. To investigate the correlation between HRQoL and symptom severity, we used Pearson correlation. Results: During measurement I, 1,150 patients were recruited; while 359 patients participated during measurement II. FIT patients reported higher HUWs at measurement I compared to TAU patients (0.530 vs. 0.481, p = 0.003) and comparable HUWs at measurement II (0.581 vs. 0.586, p = 0.584). Symptom severity was comparable between both groups (I: 21.4 vs. 21.1, p = 0.936; II: 18.8 vs. 19.8, p = 0.122). We found lowest HRQoL and highest symptom severity in participants with affective disorders. HRQoL increased and symptom severity decreased over time in both groups. The QWB-SA dimension acute and chronic symptoms was associated with highest detriments in HRQoL. We identified risk/protective factors that were associated with lower quality of life and higher symptom severity in both groups. We confirmed that HRQoL was negatively associated with symptom severity. Discussion: Health-related quality of life (during hospital treatment) was higher among patients treated in FIT hospitals compared to patients in routine care, while symptom severity was comparable between both groups. [ABSTRACT FROM AUTHOR]

The aim of this study is to assess adolescent refugees' psychological distress and examine how reliably caseworkers can assess distress through a proxy-report instrument. The distress of 102 unaccompanied refugees between 16 and 21 years of age housed in youth welfare accommodations in Germany was assessed by self-report using the Brief Symptom Checklist and by proxy-report through the Child Behavior Checklist. Independent of residence status, the self and proxy ratings reveal that more than half of the refugees suffer from increased levels of psychological distress, particularly from anxiety and somatisation. There was a moderate positive correlation between the total scales of the two instruments. The high number of clinically meaningful distress poses a great challenge to caseworkers in facilities for unaccompanied refugees. The Child Behavior Checklist can be a suitable measure to detect clinically meaningful problems, but its validity seems to depend on a good relationship between caseworker and refugee. [ABSTRACT FROM AUTHOR]

Design: A cross‐sectional study was conducted in December 2020/January 2021 in the five significant cities of Germany. Sample: 135 of 244 identified service institutions took part in the evaluation. Measurements: This evaluation included changes in institutions' operating hours as well as capacity for homeless people. Service institutions described changes in guests' characteristics, moods, and mental burden. Finally, equipment including face masks, coveralls, and gloves was investigated. In addition, the study examined how the cooperation with the health authorities works. Results: Institutions reduced their operating hours and capacity for guests (62.4%). Increased costs, which they had to cover themselves, were reported by 70.9% of institutions. Institutions reported, that guests showed more symptoms of aggression (15%), anxiety (25%), and desperation (32%) and fewer signs of being relaxed (75%). The institutions reported room for improvement in PPE supplies and collaboration with health authorities. Conclusions: Services are limited for a vulnerable population, which shows changes in moods and mental health. Health authorities are not sufficiently engaged to take over the role of institutions in caring for homeless people. In the future, in‐depth investigation to improve this is necessary. [ABSTRACT FROM AUTHOR]

Affective disorders are common, complex disorders representing one of the major challenges to global health in the 21st century. To mitigate the burden of disease, substantial public health efforts need to be undertaken since research on the causes and adequate treatment requires multidisciplinary approaches. These should integrate translational, and clinical research, aided by technological advancements in collecting and analysing comprehensive data. Here we present the rationale, concept, mission and vision of the recently founded National Centre of Affective Disorders (NCAD) in Germany. NCAD founding partners build on their previous successful cooperation within the German Research Network for Mental Disorders funded by the Federal Ministry of Education and Research (BMBF). They form an internationally pre-eminent network of integrative excellence, leading in science and contributing significantly to the improved care of affective disorder patients. The partners will provide complementary structures and innovative methods across the entire translational continuum from bench to clinical and real-world settings. The vision of the NCAD is to foster cross-disciplinary research from basic neuroscience to public mental health by close translational collaboration between academia, non-university research institutions, and international partners, including industry, to deliver cutting-edge research, innovative clinical services and evidence-based training to young clinicians and scientists. The mission is to accomplish research in a highly translational manner, especially with respect to clinical studies in a trans-sectoral way. This approach aims to ensure continuous improvement in the treatment and care provided to patients and an interdisciplinary environment for high-level research and education in affective disorders. [ABSTRACT FROM AUTHOR]

Over the last decades, the number of immigrants in Germany has been rising steadily. One result of this is that currently, around 40% of children in the country have immigrant parents. Existing studies report rather mixed results concerning their mental health outcomes. The present study provides some insight into factors that affect the mental health of this population. We compared emotional and behavioral problems (assessed via the SOEP-SDQ) in 5- to 10- year-old children of immigrants and their native German peers (N = 2441). We considered socioeconomic status as well as immigration-related characteristics of parents (age at immigration, country of origin, perceived discrimination, host country language skills, and immigrant generation). We examined the mental health status of the parents as a possible mediator between these characteristics and the children's mental health outcomes. We did not find a difference in emotional and behavioral problems between immigrant and native children living in Germany. Low socioeconomic status was associated with more emotional and behavioral problems in both immigrant and native German children. Younger age at immigration to Germany in fathers and poorer German language skills among mothers were found to be directly associated with poorer mental health in children of immigrants. Mothers' mental health status mediated the effects of perceived discrimination and mothers' German language skills. The results underline the urgent need for a more detailed examination of immigration-related characteristics in immigrants living in Germany in order to better understand and prevent possible mental health-related disadvantages among their children. Highlights: No differences were found in respect to emotional and behavioral problems between children of immigrants and their native German peers. Low socioeconomic status in both children of immigrants as well as native German peers was found to be associated with increased emotional and behavioral problems. Better German language skills among mothers and older age at immigration to Germany among fathers were associated with fewer emotional and behavioral problems in children. The associations between perceived discrimination and mothers' German language skills and children's emotional and behavioral problems were mediated by maternal mental health status. [ABSTRACT FROM AUTHOR]

Background and hypothesis No objective tests are currently available to help diagnosis of major psychiatric disorders. This study evaluates the potential of eye movement behavior patterns to predict schizophrenia subjects compared to those with major affective disorders and control groups. Study design Eye movements were recorded from a training set of UK subjects with schizophrenia (SCZ; n  = 120), bipolar affective disorder (BPAD; n  = 141), major depressive disorder (MDD; n  = 136), and healthy controls (CON; n  = 142), and from a hold-out set of 133 individuals with proportional group sizes. A German cohort of SCZ (n  = 60) and a Scottish cohort of CON subjects (n  = 184) acted as a second semi-independent test set. All patients met DSMIV and ICD10 criteria for SCZ, BPAD, and MDD. Data from 98 eye movement features were extracted. We employed a gradient boosted (GB) decision tree multiclass classifier to develop a predictive model. We calculated the area under the curve (AUC) as the primary performance metric. Study results Estimates of AUC in one-versus-all comparisons were: SCZ (0.85), BPAD (0.78), MDD (0.76), and CON (0.85). Estimates on part-external validation were SCZ (0.89) and CON (0.65). In all cases, there was good specificity but only moderate sensitivity. The best individual discriminators included free viewing, fixation duration, and smooth pursuit tasks. The findings appear robust to potential confounders such as age, sex, medication, or mental state at the time of testing. Conclusions Eye movement patterns can discriminate schizophrenia from major mood disorders and control subjects with around 80% predictive accuracy. [ABSTRACT FROM AUTHOR]

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Digital maturity describes the self-determined use of digital technologies to support psychological growth and social adjustment and has been associated with reduced negative mobile device use. However, the relationships between digital maturity and a goal-directed use of technology (i.e., instrumental use) and well-being remain poorly understood. We conducted two studies (N total = 641, age 12–18) with parent-adolescent dyads in Austria and Germany and investigated the associations of digital maturity with instrumental device use, indicators of well-being (life satisfaction, positive affect, psychological richness), and ill-being (negative affect, psychological distress), as well as the mediating role of psychological need satisfaction and frustration using structural equation modeling. The results confirmed that digital maturity is linked to instrumental device use. In addition, we found that digital maturity is positively associated with well-being and negatively with ill-being, partially mediated through psychological need satisfaction and frustration. The results indicate that a self-determined use of digital technologies (i.e., digital maturity) may support well-being while shielding against threats and dangers to well-being, and that psychological need satisfaction and frustration are important mechanisms of these relationships. • Digital maturity defined as self-determined use of digital technology. • Examined how digital maturity correlates with instrumental device use and well-being in two studies (N = 641). • Digital maturity was found to be positively related to well-being and inversely related to ill-being in adolescents. • Psychological need satisfaction and frustration mediated these relationships. • The findings highlight the role of digital maturity in promoting well-being and reducing potential digital threats. [ABSTRACT FROM AUTHOR]

BACKGROUND: Previous research studies have demonstrated that neuro-enhancement, the use of legal or illegal drugs by healthy individuals to improve their job performance, is practiced among employees. Researchers discussed possible reasons for employees to consider the use of substances for neuro-enhancement. OBJECTIVE: The aim of this study was to identify the prevalence of usage and motives for practicing neuro-enhancement among a sample of German junior physicians. The secondary objective was to determine associations between neuro-enhancement, mental health outcomes and quality of life. METHODS: This cross-sectional study included an online survey to analyze junior physicians' neuro-enhancement stimulant use and their motives for usage (n = 873). Second, mental health outcomes and quality of life were assessed. Descriptive and analytic (Kruskal Wallis test, logistic regression) statistics were obtained. RESULTS: Of the 873 junior physicians, 18% reported having used stimulants for neuro- enhancement. 8% of the physicians have taken prescription stimulants (e.g. modafinil) or illicit drugs (e.g. cannabis) at least once in their lifetime. The most common reasons for taking stimulants were to enhance concentration, to relax and to increase alertness. Neuro-enhancement was associated with emotional exhaustion (p < 0.01), lower quality of life (p < 0.05) and work-related stress (p < 0.01). CONCLUSIONS: Our study results give an overview on the actual situation regarding frequency and motives for taking performance-enhancing substances. The prevalence rate was low in comparison to current public debates. Decreasing the prevalence of neuro-enhancement among physicians requires the implementation of strategies targeting stress reduction and workload management. [ABSTRACT FROM AUTHOR]

Objectives: Work-family conflict (WFC) has severe negative effects on workers' health and well-being. This study examined whether parents' WFC also affects the well-being of their children. It was analyzed whether, and to what extent, maternal WFC is associated with child emotional and behavioral problems, and whether this association is mediated by mothers' use of harsh parenting practices. Methods: Using data from two waves of the German Family Panel (pairfam) a total of 1781 children and their employed mothers were analyzed using mediation modeling with pooled OLS regressions. Results: The analyses show that children whose mothers experience higher levels of WFC report higher levels of emotional problems, conduct problems, and hyperactivity. The results also indicate that this association is mediated by mothers' parenting behavior. Conclusions: The findings suggest that mothers' parenting behavior underpins the association between maternal WFC and child behavioral problems: Mothers who experience higher levels of WFC use harsher parenting practices, which negatively affects their children's well-being. [ABSTRACT FROM AUTHOR]

Background: Health literacy (HL) is considered a key concept to positively address relevant decisions concerning physical and mental health. According to an integrated model of a European Consortium, the process to access, understand, appraise and apply health information is at the centre of practising HL. Aim: In this study, we examine HL in a population with an early onset of a mental disorder (MD). Methods: Results are based on a cross-sectional survey among people with MD (n = 310) who sought help at an early detection centre for MD in Cologne, Dresden or Munich. Help-seekers filled out the European Health Literacy Survey questionnaire (HLS-EU-Q) on perception-based HL, socio-demographic data and general health status. Psychopathology was assessed separately by trained specialists. Data are compared with a representative sample of the German population. Results: Overall, HL was lower in a sample with MD compared with the general population. Disease-specific limitations were present in accessing, appraising and applying health information, whereas understanding was perceived fairly easy. Statistical analysis of limited HL revealed correlations with the diagnosis of affective disorders and anxiety disorders, an increase of depressive symptoms as well as the presence of more than one MD. In line with these findings, low levels of HL were associated with a worse general health status. Conclusion: In a population with MD, accessing, appraising and applying health information seemed to be particularly challenging. Therefore, educational programmes that mainly focus on increasing knowledge might not be sufficient for improving the HL in people with MD. Further research should concentrate on context-specific HL to foster behavioural change and improve overall health. [ABSTRACT FROM AUTHOR]

Background: Self-compassion may be shaped by early attachment experiences, and has been linked to mental health and well-being. This study examined the role of two distinct features of self-compassion, self-warmth and self-coldness, in the relationship between attachment insecurity and depression as well as quality of life in a general population sample in Germany.Methods: Participants (N = 2,253; 53.4% female, Mage 50 years) completed the Self-Compassion Scale (SCS), Adult Attachment Scale (AAS), Beck Depression Inventory-Fast Screen (BDI-FS), and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). Mediation analysis was used to examine whether insecure attachment predicted increased symptoms of depression and decreased quality of life through decreased self-warmth and increased self-coldness.Results: Attachment-related anxiety and avoidance had a significant direct effect on depressive symptoms and significant indirect effect via self-warmth and self-coldness. The indirect effect via self-warmth appears to be of negligible magnitude. Attachment-related anxiety and avoidance had a significant direct effect on quality of life, and significant indirect effect via self-coldness. The indirect effect via self-warmth was not statistically significant, speaking against self-warmth as a relevant mediator.Limitations: Causal conclusions cannot be drawn based on cross-sectional research design. All measures were based on participant self-report.Conclusions: This study contributes to a more differentiated understanding of how attachment insecurity and self-compassion may contribute to affective disorders. Findings suggest that self-coldness may be particularly relevant in affective disorders and when addressing relational struggles, with both theoretical and clinical implications for psychotherapy and future research. [ABSTRACT FROM AUTHOR]

Background. General population data on associations between mental disorders and total mortality are rare. The aim was to analyze whether the number of mental disorders, single substance use, mood, anxiety, somatoform or eating disorders during the lifetime and whether treatment utilization may predict time to death 20 years later in the general adult population. Methods. We used data from the Composite International Diagnostic Interview, which includes DSM-IV diagnoses for substance use, mood, anxiety, somatoform, and eating disorders, for a sample of 4,075 residents in Germany who were 18-64 years old in 1996. Twenty years later, mortality was ascertained using the public mortality database for 4,028 study participants. Cox proportional hazards models were applied for disorders that existed at any time in life before the interview. Results. The data revealed increased hazard ratios (HRs) for number of mental disorders (three ormore; HR1.4; 95%confidence interval [CI] 1.1-1.9) and for single disorders (alcohol dependence, dysthymia, panic disorder with agoraphobia, and hypochondriasis), with the reference group being study participants who had not suffered from any of the mental disorders analyzed and with adjustments made for age, sex, and education. Among individuals with any mental disorder during their lifetimes, having been an inpatient in treatment for amental disorder was related to a higherHR (2.2; CI 1.6-3.0) thanwas not having been in any treatment for amental disorder. Conclusions. In this sample of adults in the general population, three or more mental disorders, alcohol dependence, dysthymia, panic disorder with agoraphobia, and hypochondriasis were related to premature death. [ABSTRACT FROM AUTHOR]

Background: Background: Smoking has been linked to depression and anxiety problems for a long time, and it is a known health risk. The precise nature of the varied and intricate association between smoking and mental health illnesses is still unknown, though. Three studies have been carried out to look at this intriguing subject. Material and methods: Materials and Method: The first study primarily focused on nicotine dependence in patients already diagnosed with depression or anxiety. It looked into how these people's experiences of sadness and anxiety developed in relation to their smoking and nicotine dependence. The third study looked at the relationship between adolescent depression and smoking initiation, while the second study focused on smoking and depression in particular in teenagers. Results: Results: Patients with anxiety or depression who had previously been treated were monitored over time in the first research. The most severe symptoms and the slowest recovery were seen in smokers who were also nicotine dependent. If nicotine dependency remained, people's symptoms did not always get better even after they stopped smoking. This implies that the intensity and progression of anxiety and depressive disorders may be made worse by nicotine dependency. Teenagers were observed for a full year in the second trial. The results showed that whereas depressed teens were not necessarily more likely to start smoking heavily, smoking adolescents were more likely to experience depression. Additionally, the best indicator of becoming a heavy smoker was trying cigarettes before going through depression. This suggests that depression may not always be the main cause of a teen's decision to start smoking. The idea that smoking may cause depression in teenagers was further supported by the third study, which evaluated previous data. Conclusions: Conclusion: When considered collectively, these studies point to a complicated reciprocal relationship between smoking and anxiety or depression. Depression and anxiety disorders can worsen in intensity and course, even though smoking--especially when it leads to nicotine dependence--may not always precede the onset of depression, especially in teenagers. For those who are battling these disorders, understanding this complex interplay is essential to creating interventions and treatment plans that work. To clarify the underlying mechanisms and guide comprehensive preventative and intervention efforts, more study is necessary. Healthcare professionals can provide their patients with more comprehensive care if they simultaneously address mental health and smoking-related disorders. For those who are battling melancholy or anxiety in addition to smoking, this strategy might provide greater results and enhance general wellbeing. [ABSTRACT FROM AUTHOR]

Adolescents with gender dysphoria (GD) often face various associated social, emotional, and behavioral difficulties. In such a marginalized group, it is crucial to identify factors that may impact psychological functioning to better accommodate their needs. Therefore, the present study investigated the impact of two specific risk factors, poor peer relations and general family functioning, on the development of psychological problems in adolescents with GD, and their possible interaction effect. The Youth Self-Report, a Peer Relations Scale, and a General Family Functioning scale were assessed in a sample of n = 180 clinically referred adolescents (mean age 15.5; 146 transgender boys with a female birth-assigned sex, and 34 transgender girls with a male birth-assigned sex) with a complete GD diagnosis (fulfillment of the DSM 5 criteria A and B) at their initial admission to the Hamburg Gender Identity Service. Multiple linear regression analysis was conducted to examine the relationship between peer relations, family functioning, and psychological functioning outcomes. Adolescents with GD presented significantly higher Internalizing and Total Problem scores compared to the German reference norm. Externalizing problems were above the norm for transgender boys, but within the normal range for transgender girls. Multiple regression analysis revealed that, overall, adolescents with an advanced age, a female birth-assigned sex, poorer peer relations, and poorer family functioning showed more behavioral and emotional problems. Consequently, incorporating both the family and social environment in transgender care is of high importance to adequately tend to the needs of adolescents with GD. [ABSTRACT FROM AUTHOR]

Personality, psychopathology, and motives of 44 surviving offenders committing mass murder in Germany over 25 years (1984–2009) were analyzed using court files and psychiatric expertises. Initially, 123 mass murders in Germany were detected in the time period 1980–2010 (inclusive deceased offenders). Using a data entry form based on ViCLAS (Violent Crime Linkage Analysis System), we categorized the 44 surviving mass murderers into three prototypes using the 'TwoStep Cluster'-method (separation of the offenders in different groups depending on their similarity of specific items): 1. Narcissistic or aggressive men suffering from addiction or affective disorder, committing mass murder out of rage/hate when being intoxicated by alcohol, 2. Psychotic offenders with schizophrenia and comorbid substance abuse. 3. Aggressive, narcissistic or anxious adolescents, half of them suffering from affective disorder or ADHD, committing mass murder out of rage/hate. Not included are such events where the offenders died and therefore no court files or psychiatric expertises were available. Classification and subtyping of the offenders' personalities and psychopathological conditions might help to improve the chances for an early detection of persons at risk. [ABSTRACT FROM AUTHOR]

Background Decreasing gender differences in mental health are found largely in countries in which the roles of men and women have improved in terms of opportunities for employment, education, child care and other indicators of increasing gender equality. In this study, we examine how European welfare regimes influence this association between mental health and the social roles that men and women occupy. Methods The EU-World Mental Health data are used, which covers the general population in 10 European countries (n = 37 289); Countries were grouped into four welfare regions: Liberal regime (Northern Ireland), Bismarckian regime (Belgium, Germany, the Netherlands and France), Southern regime (Spain, Italy, Portugal) and Central-Eastern regime (Romania and Bulgaria). The lifetime prevalence of mood, anxiety and alcohol disorders was determined by using the Composite International Diagnostic Interview 3.0. Overall prevalence rates along with odds ratios by means of bivariate logistic regression models are calculated to compare the presence of common mental disorders in women versus men per welfare regime. Results Overall prevalence of common mental disorders is highest in the Liberal regime and lowest in the Central/Eastern regime. The gender gap in mental disorders is largest in the Southern regime and smallest in the Liberal regime. Marital status and certain employment positions help to explain variation in mental disorders across and within welfare regimes. Conclusion Most prominent pathways linking gender to mental ill-health being are related to marital status and certain employment positions. However, these pathways also show substantial variation across welfare regimes. [ABSTRACT FROM AUTHOR]

Highlights • Psychiatric inpatients show increased values of Facebook Addiction Disorder (FAD). • They suffer from withdrawal symptoms and interpersonal conflicts due to FAD. • FAD level is higher in persons with week depression than with moderate depression. • FAD is significantly positively linked to duration of Facebook use and narcissism. Abstract The present study explored the Facebook Addiction Disorder (FAD) in an inpatient sample in Germany. Of the 112 Facebook users (71.4% women; age(years): M (SD) = 49.43 (9.17)), who were patients of a psychosomatic rehabilitation clinic with affective disorders and anxiety disorders as most common diagnoses, 28.6% reached the critical polythetic cutoff score of FAD, 0.9% researched the critical monothetic cutoff score, and 86.6% had enhanced values of withdrawal symptoms due to Facebook use. The mean level of FAD was significantly higher in inpatients with week depression than in inpatients with moderate depression. In the whole sample, FAD was significantly positively linked to duration of Facebook use and the personality trait narcissism. Present results provide first evidence of FAD in a non-student inpatient sample. They contribute to the understanding of the development of FAD and demonstrate that addictive Facebook use may impact persons who suffer from mental disorders, especially when they have enhanced levels of the personality trait narcissism. Practical applications for research and clinical treatment, as well as limitations of present results are discussed. [ABSTRACT FROM AUTHOR]

Despite potentially severe medical consequences of pica and rumination disorder (RD), little is known about their prevalence and association with other psychopathology in childhood. As a part of a larger population-based study, 804 children aged 7-14 years and their parents were asked about their experience of pica and RD behaviors, and associated eating, feeding and general psychopathology. A total of 12.31 and 11.49% of the participants reported having engaged in pica or RD behaviors, respectively, at least once. Recurring pica or RD behaviors had been experienced by 4.98 and 1.49% of the participants, respectively. The behaviors showed a significant but small correlation with one another (r = 0.28, p < 0.01). Correlations with symptoms of avoidant/restrictive food intake disorder (ARFID) were significant but small (pica: r = 0.18, RD: r = 0.27, both p < 0.01). Prevalence rates of recurring pica behavior were significantly increased if recurring RD was present (58.33%), and also vice versa (17.50%). The prevalence rates of recurrent pica and RD behaviors were also increased in the presence of an ARFID diagnosis (both behaviors 12.0%). However, correlations with restraint and eating, weight, and shape concern were non-significant (all p > 0.05). Additionally, RD behavior was positively correlated with emotional and conduct problems (r = 0.15 and 0.22, both p < 0.01), and both behaviors were negatively correlated with prosocial behavior (r = −  0.10 and − 0.09, both p < 0.05). Our findings underscore the clinical significance of pica and RD behaviors. More research is warranted on both disorders and their association and relation with ARFID to deepen the understanding of their presentation and to ascertain diagnostic validity. [ABSTRACT FROM AUTHOR]

Objective: Somatic symptoms are one of the most prevalent complaints in both psychiatric and general population, and validated scales are required to assess these problems. The present study was conducted to determine psychometric properties of the Persian version of Screening for Somatic Symptom Disorders-7(SOMS-7) in an Iranian population. Method: This was a multi centric comprehensive study conducted in Psychosomatic Research Center of Isfahan University of Medical Sciences in collaboration with Department of Clinical Psychology of Philipp University of Marburg, Germany. This part of the study includes 100 patients with anxiety/mood disorders and 291 healthy individuals. All participants completed the Patient Health Questionnaire (PHQ-15) and Screening for Somatic symptom disorders 7(SOMS-7). Data were analyzed by Pearson and Spearman correlation coefficient, factor analysis, independent t test, and discriminant analysis using SPSS-20 software. Results: Reliability coefficient based on Cronbach's alpha was 0.92 and 0.94 (clinical vs. healthy sample). Validity index of the SOMS according to correlation between factor 1 and 2 with PHQ somatic subscale was. 51 and. 59, respectively. Score of 15.5 as cut-off point was accompanied with sensitivity of 77% and specificity of 66%. Factor analysis extracted 2 factors in patients and 4 factors in healthy population. Conclusion: Findings of this study indicated that the Persian version of SOMS-7 has appropriate reliability and validity for the assessment of somatic symptoms disorder and evaluation of treatment effects in these patients. [ABSTRACT FROM AUTHOR]

Background Very preterm (<32 weeks' gestational age; VP) or very low-birth weight (<1,500 g; VLBW) birth has been associated with increased risk for anxiety and mood disorders and less partnering in adulthood. The aim was to test whether (a) VP/VLBW are at increased risk of any anxiety or mood disorders from 6 to 26 years compared with term-born individuals; (b) social support from romantic partners is associated with protection from anxiety and mood disorders; and (c) VP/VLBW adults' lower social support mediates their risk for any anxiety and mood disorders. Methods Data are from a prospective geographically defined longitudinal whole-population study in South Bavaria (Germany). Two hundred VP/VLBW and 197 term individuals were studied from birth to adulthood. Anxiety and mood disorders were assessed at 6, 8, and 26 years with standardized diagnostic interviews and social support via self-report at age 26. Results At age 6, VP/VLBW children were not at increased risk of any anxiety or mood disorder. At age 8, VP/VLBW more often had any anxiety disorder than term comparisons (11.8% vs. 6.6%, OR = 2.10, 95% CI [1.08-4.10]). VP/VLBW adults had an increased risk for any mood (27.5% vs. 18.8%, OR = 1.65 [1.02-2.67]) but not for any anxiety disorder (33.0% vs. 28.4%, OR = 1.27 [0.82-1.96]). None of the significant differences survived correction for multiple testing. Social support was associated with a lower risk of anxiety or mood disorders in both groups (OR = 0.81 [0.68-0.96]) and mediated the association of VP/VLBW birth with any anxiety or any mood disorders at age 26. Conclusions This study does not show a persistently increased risk for any anxiety or mood disorder after VP/VLBW birth. Low social support from a romantic partner mediates the risk for anxiety or mood disorders after VP/VLBW birth. [ABSTRACT FROM AUTHOR]

Purpose: To prospectively examine whether higher daily hassles predict a variety of incident mental disorders and respective associations vary by gender, age, perceived coping efficacy and number of negative life events.Methods: Data comes from the Early Developmental Stages of Psychopathology Study (EDSP), a prospective-longitudinal study among adolescents and young adults from the community (n = 2797, aged 14-24 at baseline) followed up in up to 3 assessment waves over 10 years. Mental disorders were assessed at each wave using the DSM-IV/M-CIDI. Daily hassles, perceived coping efficacy, and negative life events were assessed at baseline using the Daily Hassles Scale, Scale for Self-Control and Coping Skills, and Munich Life Event List.Results: In logistic regressions adjusted for gender, age, other mental disorders, perceived coping efficacy and number of negative life events at baseline, higher daily hassles at baseline predicted the incidence of any anxiety disorder, specific phobia, obsessive-compulsive disorder, any affective disorder, and major depressive episodes at follow-up (OR 1.2-1.9 per standard deviation). Daily hassles interacted with perceived coping efficacy at baseline in predicting incident panic attacks (OR 1.3) and panic disorder (OR 1.3) at follow-up, i.e., higher daily hassles only predicted incident panic pathology among individuals with low perceived coping efficacy (OR 1.6-2.0) but not high perceived coping efficacy. Moreover, the associations between daily hassles and incident mental disorders partially varied by gender and age but not by negative life events at baseline.Conclusions: Targeted stress management interventions among individuals with increased daily hassles might be useful to prevent the onset of anxiety and affective disorders. [ABSTRACT FROM AUTHOR]

Objective: People with mental illness struggle with symptoms and with public stigma. Some accept common prejudices and lose self-esteem, resulting in shame and self-stigma, which may affect their interactions with mental health professionals. This study explored whether self-stigma and shame are associated with consumers' preferences for participation in medical decision making and their behavior in psychiatric consultations.Methods: In a cross-sectional study conducted in Germany, 329 individuals with a diagnosis of a schizophrenia spectrum disorder or an affective disorder and their psychiatrists provided sociodemographic and illness-related information. Self-stigma, shame, locus of control, and views about clinical decision making were assessed by self-report. Psychiatrists rated their impression of the decision-making behavior of consumers. Regression analyses and structural equation modeling were used to determine the association of self-stigma and shame with clinical decision making.Results: Self-stigma was not related to consumers' participation preferences, but it was associated with some aspects of communicative behavior. Active and critical behavior (for example, expressing views, daring to challenge the doctor's opinion, and openly speaking out about disagreements with the doctor) was associated with less shame, less self-stigma, more self-responsibility, less attribution of external control to powerful others, and more years of education.Conclusions: Self-stigma and shame were associated with less participative and critical behavior, which probably leads to clinical encounters that involve less shared decision making and more paternalistic decision making. Paternalistic decision making may reinforce self-stigma and lead to poorer health outcomes. Therefore, interventions that reduce self-stigma and increase consumers' critical and participative communication may improve health outcomes. [ABSTRACT FROM AUTHOR]

Migration, acculturation, and psychiatric disorders may cause stress and adaptation processes differently in men and women, but empirical research is scarce. In a retrospective study n = 62 Turkish migrants and n = 62 native German inpatients with depressive or anxiety disorders, matched for age, gender, and diagnoses, were compared using a 10-item instrument for the assessment of migration- and acculturation related stressors (MIGSTR10). Gender differences in the prevalence of stressors and in the total sum of stressors were calculated and compared between migrants and indigenous patients. Results showed a higher global stress level in migrants and in women than in men with migration background. Regarding single stressors, the perceived loss of status was significantly more prevalent and more pronounced in men than in women ( P < 0.05) whereas guilt feelings were more severe in women with Turkish migration background compared to men ( P < 0.05). Gender differences of perceived stress should be taken into account in migration and acculturation research. [ABSTRACT FROM AUTHOR]

Background: The polymorphism at codon 129 of the prion protein gene (PRNP) and the PrPSc types 1 and 2 belong to a molecular classification of sporadic Creutzfeldt-Jakob disease (sCJD) that correlates well with the clinical and neuropathological phenotype of sCJD.Objective: The aim of the study was to perform the first detailed evaluation of neuropsychological deficits in a large group of definite sCJD patients with known molecular subtype.Methods: We analyzed neuropsychological symptoms in a cohort of 248 sCJD patients with known M129 V polymorphism of PRNP and prion protein type.Results: Neuropsychological symptoms were very frequent in our patients (96%) and occurred as early as in the first third of the disease course. Besides amnesia and impaired attention (89% each), frontal lobe syndrome (75%), aphasia (63%), and apraxia (57%) were the most common neuropsychological deficits. There was no statistically significant difference with regard to frequency of neuropsychological symptoms between the subtypes. In MV2 and VV2 patients, the onset of neuropsychological symptoms was significantly later than in all other subtypes.Conclusion: We provide the first detailed analysis of neuropsychological symptoms in a large group of sCJD patients with known M129 V genotype and prion protein type. We suggest that the rate of progression of neuropsychological symptoms is subtype-specific. These data may improve the diagnosis in atypical sCJD subtypes. [ABSTRACT FROM AUTHOR]

Background: Previous studies have shown that individual differences in affect dynamics during depressed patients' everyday lives allow the prediction of treatment outcome and of symptom reoccurrence in remitted patients. In this study, we analyze whether understanding patients' affective states and their fluctuation patterns helps predict early treatment response (until session 5).Methods: Ecological Momentary Assessment (EMA) strategies allow in-depth analyses of real-time affective states and of their dynamics. Repeated assessments were made four times a day during a two-week period to capture real-life affective states (positive affect, PA and negative affect, NA) and dynamics (fluctuations in NA and PA) before the start of outpatient treatment of 39 patients. Due to the nested structure of the data, hierarchical linear models were conducted.Results: PA/NA ratios, as well as fluctuations in NA predicted early treatment response, even when adjusting for initial impairment. In contrast, mean levels of NA or PA, as well as fluctuations in PA did not predict treatment response.Limitations: The time between the EMA assessment and treatment onset varied between patients. However, this variation was not associated with early change.Conclusions: The results suggest that pre-treatment affect dynamics could provide valuable information for predicting treatment response independent of initial impairment levels. Better predictions of early treatment response help to improve treatment choices early in the treatment progress. [ABSTRACT FROM AUTHOR]

The quality of depression in borderline personality disorder (BPD) was reported to differ from that in patients with major depressive disorder (MDD) only. However, little is known about affect dynamics in 'borderline-depression.' The authors assessed affective instability and reactivity in 20 MDD patients with BPD and in 21 MDD patients without BPD by Ambulatory Assessment. Participants reported on current affect, daily events, and attribution of affective states to events five times per day over a 7-day period. The results do not indicate higher affective instability in MDD patients with BPD comorbidity. Depressed patients with BPD reported less subjectively perceived affective reactivity, while observed associations between events and affect were not different between groups, except for one finding: In depressed patients with BPD, overall mood was lower after being alone. These findings suggest impaired attribution of mood changes and less tolerance of being alone as specific for depression in BPD. [ABSTRACT FROM AUTHOR]

The Sixth Kraepelin Symposium was held at the Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich in October 2018, covering reports from 12 working groups (Keith H. Nuechterlein, Ph.D. University of California, Los Angeles; Kim T. Mueser, Ph.D. Center for Psychiatric Rehabilitation, Boston University, U.S.A.; Dominic Dwyer, Ph.D, Hospital LMU, Munich; David Fowler, Ph.D. University of Sussex, Brighton, U.K.; Martin Hautzinger, Ph.D. University of Tübingen; Nikolaos Koutsouleris, M.D. Hospital LMU, Munich; Stephan Leucht, M.D. Technical University Munich, Munich; David Miklowitz, Ph.D. UCLA School of Medicine, Los Angeles. U.S.A.; Cornelius Schüle, M.D. Hospital LMU, Munich; Florian Seemüller. M.D. kbo-Lech-Mangfall Clinics for Psychiatry and Psychotherapy, Garmisch Partenkirchen; Carla Torrent, Ph.D. Institute of Neuroscience, University of Barcelona, Barcelona, Spain.) from the United States and Europe on understanding and treating cognitive impairment and depression in schizophrenia and affective disorders. Current psychological interventions to improve outcome in schizophrenia and affective disorder such as cognitive remediation, illness management, psychoeducational and cognitive therapy were focused on, as were evidence-based psychological and pharmacological treatment options, guidelines for treating cognitive deficits and depression in schizophrenia, Cochrane-meta-analysis of acute therapies, relapse prevention as well as supported withdrawal from medication. Prevention of cognitive dysfunction and symptom exacerbation was approached in terms of machine learning methods to revisit Kraepelin's illness distinctions, application of new strategies in order to increase the rate of social recovery in patients with first-episode psychosis as well as in terms of state of the art psychosocial interventions for bipolar disorder in adolescents. Finally, the dissemination of information to consumers and the contribution to the reduction of stereotypes in psychiatry was also part of the symposiums aims. [ABSTRACT FROM AUTHOR]

The present study analysed whether bullying/victimisation and related social support vary by emotional and behavioural disturbances (EBD) as well as school type. We examined 540 German adolescents with and without emotional disturbances (ED)/behavioural disturbances (BD) attending regular and special schools for students with EBD. Adolescents with BD and co-morbid co-occurring emotional and behavioural disturbances (ED + BD) reported elevated levels of bullying, while students with ED and co-morbid ED + BD reported elevated levels of victimisation. Enhanced levels of overt victimisation were also found in adolescents from special schools. Students from special schools perceived less peer support but more teacher support. Furthermore, adolescents with co-morbid ED + BD were least likely to tell teachers about being victimised. It is concluded that bullying interventions for adolescents with EBD and students from special schools need to be implemented and evaluated. [ABSTRACT FROM AUTHOR]

Background: Worldwide, approximately one in eight children or adolescents suffer from a mental disorder. The present study was designed to determine the cross-national prevalence of mental health problems in children aged 6-11 across seven European countries including Italy, Germany, the Netherlands, Lithuania, Bulgaria, Romania, and Turkey.Methods: Data were collected on 7682 children for whom either parent- or teacher SDQ were completed.Results: The present study provides country-specific normative banding for both parent- and teacher SDQ scores. Overall, 12.8 % of children have any probable disorder, with rates ranging from 15.5 % in Lithuania to 7.8 % in Italy, 3.8 % of children have a probable emotional disorder, 8.4 % probable conduct disorder, and 2.0 % probable hyperactivity/inattention. However, when adjusting for key sociodemographic variables and parental psychological distress, country of residence did not predict the odds of having any disorder. For specific disorders, however, country of residence does have an effect on the odds of presenting with mental health problems.Conclusions: As normative data are key in the comparison of mental health status on an international level, the present data considerably advance the possibilities of future research. Furthermore, the findings underline the importance of controlling for a number of sociodemographic and parental variables when conducting international comparisons of child mental health. In addition, the findings suggest that efforts are needed locally to assist in the detection and prevention of parental psychological distress. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Previous research demonstrated that the exposure to media portrayals of the thin body ideal negatively affects body satisfaction and mood of healthy women and thus represents a sociocultural risk factor for the development of eating disorders. However, at present, it is not known whether negative effects of the thin ideal are pronounced in eating-disordered patients. Method Female inpatients with a current diagnosis of anorexia nervosa ( N = 36), bulimia nervosa ( N = 32), or mood or anxiety disorder ( N = 31), and women with no current psychiatric diagnosis were randomly assigned to exposure to magazine pictures depicting the thin female body ideal or landscape scenes in two experimental phases (leafing through a magazine followed by instructed imagination of a picture from the magazine). The groups were compared on measures of body satisfaction and mood that were collected before and after the two phases. Results Leafing through a fashion magazine was not associated with negative effects on body satisfaction or mood in all groups. Imagining the thin ideal resulted in a decrease in body satisfaction and a decrease in positive mood. We found no diagnosis-specific effects indicating no stronger negative impact of the thin ideal on eating-disorder patients. Discussion Given the lacking differences between eating-disordered patients and controls, these findings underline the importance of future research to enhance our understanding of what happens when patients are exposed to external or internal stimuli of media images of the thin ideal. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:708-715) [ABSTRACT FROM AUTHOR]

Studies have shown impairments in cognitive function among adult patients with anorexia nervosa (AN) and affective disorders (AD). The association between cognitive dysfunctions, AN and AD as well as the specificity for these psychiatric diagnoses remains unclear. Therefore, we examined cognitive flexibility and processing speed in 47 female adolescent patients with AN, 21 female adolescent patients with unipolar affective disorders and 48 female healthy adolescents. All participants completed a neuropsychological test battery. There were no significant group differences regarding cognitive function, except for psychomotor processing speed with poorer performance in patients with AN. A further analysis revealed that all groups performed with the normal range, although patients with AN were over represented in the poorest performing quartile. We found no severe cognitive impairments in either patient group. Nevertheless, belonging to the AN group contributed significantly to poor performances in neuropsychological tasks. Therefore, we conclude that the risk for cognitive impairments is slightly higher for patients with AN. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association. [ABSTRACT FROM AUTHOR]

Difficulties in emotion regulation (ER) are present in psychotic disorders, but their precise nature is not yet fully understood and it is unclear which difficulties are unique to psychosis compared with other disorders. This study investigated whether ER difficulties in psychosis are more prominent for the ability to modify emotions or for the ability to tolerate and accept them. Furthermore, it investigated whether ER difficulties occur for sadness, anxiety, anger and shame likewise. ER skills were assessed in participants with psychotic disorders (n = 37), participants with depression (n = 30) and healthy controls (n = 28) using the Emotion Regulation Skill Questionnaire that asks participants to rate the intensity of different emotions over the past week and the skills employed to handle each of them. Compared with healthy controls, participants with psychosis showed reduced skills related to awareness, understanding and acceptance of potentially distressing emotions, but not in the ability to modify them. These differences remained significant after controlling for depression. Participants with psychosis showed reduced ER skills in regard to all of the assessed emotions compared with the healthy controls, despite the fact that they only reported sadness as being significantly more intense. The participants with depression showed a similar pattern of ER skills to the psychosis sample, although with a tendency towards even more pronounced difficulties. It is concluded that psychosis is characterized by difficulties in using specific ER skills related to awareness, understanding and acceptance to regulate anger, shame, anxiety and sadness. These difficulties are not unique to psychosis but nevertheless present a promising treatment target. [ABSTRACT FROM AUTHOR]

Background The increased risk of mental health problems in children and adolescents with intellectual disability ( ID) has been reported in several studies. However, almost no research has been conducted on parents' experiences with the general mental health system. We have investigated the prevalence of emotional and behavioural problems in children with ID as well as the availability and quality of mental health care from the parents' point of view. Methods Teachers of specialised schools for ID in Berlin were asked to complete the Teacher's Report Form ( TRF) of the Child Behavior Checklist. Information was collected for 1226 children and adolescents aged 6-18 years with mild to profound ID (response 70.5%). The availability and quality of mental health care was assessed by a questionnaire given to parents who had already been seeking help for their children. A total of 330 parents completed the questionnaires (response 62.0%). In addition to univariate analysis, we conducted multiple logistic regressions regarding the psychopathology reported by teachers ( TRF-syndrome scales) and difficulties concerning mental health care reported by parents for a paired sample of 308 children. Results Overall, 52.4% of the children and adolescents with ID had a total problem score on the TRF in the deviant range (47.1% when eliminating four items reflecting cognitive deficits). Compared with the general population normative sample of children, this is a three-time higher prevalence. The most striking problems were thought problems (schizoid and obsessive-compulsive), aggressive behaviour, attention problems and social problems. Parents whose children had more severe behavioural or emotional dysfunction reported more difficulties with the mental health system. From the parents' point of view, mental health professionals frequently did not feel responsible or were not sufficiently skilled for the treatment of children with ID. As a consequence, 96% of all parents were longing for specialised in- and outpatient services. Conclusions This study confirms the findings from other studies regarding the high rate of co-occurrence of ID and mental health problems in youths. Results indicate that both are strongly requested by parents: specialised in- and outpatient services, as well as more professional general services and equitable treatment for all children, with and without ID. [ABSTRACT FROM AUTHOR]

Background. Evidence suggests that in affective, non-psychotic disorders: (i) environmental exposures increase risk of subthreshold psychotic experiences (PEs) and strengthen connectivity between domains of affective and subthreshold psychotic psychopathology; and (ii) PEs are a marker of illness severity. Method. In 3021 adolescents from the Early Developmental Stages of Psychopathology cohort, we tested whether the association between PEs and presence of DSM-IV mood disorder (MD)/obsessive-compulsive disorder (OCD) would be moderated by risk factors for psychosis (cannabis use, childhood trauma and urbanicity), using the interaction contrast ratio (ICR) method. Furthermore, we analysed whether the interaction between environment and PEs was mediated by non-psychotic psychopathology. Results. The association between PEs and MD/OCD was moderated by urbanicity (ICR = 2.46, p = 0.005), cannabis use (ICR = 3.76, p = 0.010) and, suggestively, trauma (ICR = 1.91, p = 0.063). Exposure to more than one environmental risk factor increased the likelihood of co-expression of PEs in a dose-response fashion. Moderating effects of environmental exposures were largely mediated by the severity of general non-psychotic psychopathology (percentage explained 56-68%, all p < 0.001). Within individuals with MD/OCD, the association between PEs and help-seeking behaviour, as an index of severity, was moderated by trauma (ICR = 1.87, p = 0.009) and urbanicity (ICR = 1.48, p = 0.005), but not by cannabis use. Conclusions. In non-psychotic disorder, environmental factors increase the likelihood of psychosis admixture and helpseeking behaviour through an increase in general psychopathology. The findings are compatible with a relational model of psychopathology in which more severe clinical states are the result of environment-induced disturbances spreading through a psychopathology network. [ABSTRACT FROM AUTHOR]

A substantial number of preschool children exhibit psychological symptoms that have an impact on their own and their families' lives. The aim of the current study was to investigate the prevalence, stability and increase/decrease in emotional and behavioral symptoms and the resultant impairment at two assessment points at preschool age. The sample consisted of 1,034 children drawn from the general population with a mean age of 51 months at t1 and 72 months at t2. Parents completed the Strengths and Difficulties Questionnaire extended version (Goodman, J Child Psychol Psychiatry 38(5):581-586, ; Goodman, J Child Psychol Psychiatry 40(5):791-799, ). At t1, 6.9 % of the preschoolers had a total difficulties and 6.8 % a total impact score within the abnormal range. At t2, these scores were 5.7 and 6.2 %, respectively. We found moderate stability of symptoms. From t1 to t2, emotional symptoms and prosocial behavior significantly increased, while hyperactivity, conduct problems, peer problems and total difficulties decreased. The mean total impact score did not change. Boys showed higher levels of symptoms (except emotional symptoms) and impact, and lower prosocial behavior, than girls. Moreover, there was a significant time × gender interaction, with girls showing a larger decrease in hyperactivity/inattention and in total difficulties than boys. The stepwise multiple regression analysis revealed that the total impact score at baseline, male gender, conduct problems, hyperactivity and peer problems significantly contributed to the explained variance of the total impact score at follow-up. This is one of very few studies to examine the stability and change of psychological symptoms in a large community sample of preschoolers, assessed twice during preschool age. [ABSTRACT FROM AUTHOR]

BackgroundResearch evidence suggests that cognitive and neural mechanisms involved in social information processing may underlie the key aspects associated with the emergence of aggression and psychopathy. Despite extensive research in this field, it is unclear whether this deficit relates to general attentional problems or affects early stages of information processing. Therefore, the aim was to explore the link between aggression, psychopathic traits, and the early processing deficits in young antisocial violent offenders (YAVOs) and healthy controls (CTLs).MethodParticipants were presented with rapidly changing Mondrian-like images in one eye, while a neutral or emotional (happy, angry, fearful, disgusted, surprised, sad) face was slowly introduced to the other eye. Participants indicated the location in which the face had appeared on the screen, reflecting the time when they became aware of the stimulus. The relative processing advantage was obtained by subtracting mean reaction times for emotional from neutral faces.ResultsThe results indicated that individuals with higher levels of unemotional traits tended to exhibit an extensive early processing disadvantage for fearful facial expressions; this relationship was only evident in the YAVO as opposed to the CTL sample.ConclusionsThese findings indicate that an emotion processing deficit in antisocial individuals is present even at the most basic levels of processing and closely related to certain psychopathic traits. Furthermore, this early processing deficit appears to be highly specific to fearful expressions, which is consistent with predictions made by influential models of psychopathy. The clinical significance and potential implications of the results are discussed. [ABSTRACT FROM PUBLISHER]

Conventional treatments for mood disorders primarily focus on reducing negative affect, but little on enhancing positive affect. Loving-kindness meditation (LKM) is a traditional meditation practice directly oriented toward enhancing unconditional and positive emotional states of kindness towards oneself and others. We report here two independent and uncontrolled studies carried out at different centers, one in Boston, USA (n = 10), and one in Frankfurt, Germany (n = 8), to examine the potential therapeutic utility of a brief LKM group intervention for symptoms of dysthymia and depression. Results at both centers suggest that LKM was associated with large-sized effects on self-reported symptoms of depression (d = 3.33 and 1.90), negative affect (d = 1.98 and 0.92), and positive affect (d = 1.63 and 0.94). Large effects were also found for clinician-reported changes in depression, rumination and specific positive emotions, and moderate effects for changes in adaptive emotion regulation strategies. The qualitative data analyses provide additional support for the potential clinical utility of the intervention. This proof-of-concept evaluation of LKM as a clinical strategy warrants further investigation. [ABSTRACT FROM AUTHOR]

Introduction: Diagnosis related costs analyses are the subject of science and research and are of great relevance and importance for decision makers in the hospital and for funding bodies, but also for international health policy. Up to now, standardized costs analyses with valid costs data have not been available for inpatient care of patients with affective and somatoform disorders. Background: This clinical picture presents a major challenge for the provision of outpatient and inpatient care. An interdisciplinary approach in an inpatient setting can be beneficial for already "chronified" patients with severe forms of progression. Because of its structural and procedural demands, this type of care is associated with a greater expenditure of resources. Methods: Costs data from the years 2008 to 2012 were analyzed for a total of 17,424 hospitalized patients in more than 200 different hospitals in Germany. The study compared the costs of treating patients with the main diagnosis affective and somatoform disorders using standardized interdisciplinary therapy, with the costs of conventional therapy. Results: Interdisciplinary patient care is characterized by a high proportion of the costs derived from the structural and procedural implementation and the medical and nursing care. For interdisciplinary therapy with a mean period of hospitalization of 15.2 days, over 60% of the total costs were incurred by the personnel and material costs of the medical and non-medical infrastructure. The outlay is considerably greater than would be incurred by a conventional therapeutic approach without interdisciplinary therapy. Discussion and conclusion: For the first time, detailed diagnosis-related costs data are published which were generated by consistent, standardized cost unit accounting. An interdisciplinary, holistic approach to the clinical picture results in a significant increase in costs for the hospitals. [ABSTRACT FROM AUTHOR]