[Implementation and evaluation of a telephone hotline for professional mental health first aid during the COVID-19 pandemic in Germany]. / Implementierung und Evaluation einer Telefonhotline zur professionellen Ersthilfe bei psychischen Belastungen durch die COVID-19-Pandemie in Baden-Württemberg.

BACKGROUND: The COVID-19 pandemic represents a significant psychological burden for many people; however, especially during the first wave of the pandemic in Germany, little acute professional help was available for people in need. OBJECTIVE: In southern Germany, a telephone hotline for psychological first aid for COVID-19-related burdens was set up under the lead of the Baden-Wuerttemberg Ministry of Social Affairs and Integration, opened to the entire population and evaluated in April 2020. MATERIAL AND METHODS: In the period from 22 April to 24 July 2020, 753 volunteer psychotherapeutically trained counselors from different professional groups answered a total of 8096 calls. RESULTS: Depression symptoms (36%), anxiety symptoms (18%) and psychotic symptoms (19%) were most frequently reported. Every second call was related to a previous mental illness. During the counseling sessions, which lasted 25 min on average, a variety of psychological acute interventions were conducted. In the presence of unclear symptoms, psychotic symptoms or severe personality disorder symptoms, the counselors were able to help significantly less compared to the remaining calls in which other clearly defined symptoms were present. CONCLUSION: The results point to both the benefits and limitations of hotline services. The major benefits relate to the fast availability and effective professional help for people with clearly characterized symptoms. In the case of unclear or complex symptoms, immediate help by telephone seems to be possible only to a limited extent, but it could initiate access to further help offers. Overall, the results of this study provide a first indication that hotline services for psychological first aid are feasible under pandemic conditions.

Explaining gender differences in non-fatal suicidal behaviour among adolescents: a population-based study.

BACKGROUND: While suicide is the second leading cause of death among young people in most industrial countries, non-fatal suicidal behaviour is also a very important public health concern among adolescents. The aim of this study was to investigate gender differences in prevalence and emotional and behavioural correlates of suicidal behaviour in a representative school-based sample of adolescents. METHODS: A cross-sectional design was used to assess suicidal behaviour and various areas of emotional and behavioural problems by using a self-report booklet including the Youth Self-Report. One hundred sixteen schools in a region of Southern Germany agreed to participate. A representative sample of 5,512 ninth-grade students was studied. Mean age was 14.8 years (SD 0.73); 49.8% were female. RESULTS: Serious suicidal thoughts were reported by 19.8% of the female students and 10.8% of the females had ever attempted suicide. In the male group, 9.3% had a history of suicidal thoughts and 4.9% had previously attempted suicide. Internalizing emotional and behavioural problems were shown to be higher in the female group (difference of the group means 4.41) while externalizing emotional and behavioural problems slightly predominated in male students (difference of the group means -0.65). However, the total rate of emotional and behavioural problems was significantly higher in the adolescent female group (difference of the group means 4.98). Using logistic regression models with suicidal thoughts or attempted suicide as dependent variables, the pseudo-R2 of gender alone was only 2.7% or 2.3%, while it was 30% or 23.2% for emotional and behavioural problems measured by the YSR syndrome scales. By adding gender to the emotional and behavioural problems only an additional 0.3% of information could be explained. CONCLUSIONS: The findings suggest that gender differences in non-fatal suicidal behaviour among adolescents can to a large extent be explained by the gender differences in emotional and behavioural problems during this age.

Determinants of blood pressure in preschool children: the role of parental smoking.

BACKGROUND: Hypertension is the leading risk factor for cardiovascular disease. Although accumulating evidence suggests tracking of blood pressure from childhood into adult life, there is little information regarding the relative contributions of genetic, prenatal, biological, behavioral, environmental, and social determinants to childhood blood pressure. METHODS AND RESULTS: Blood pressure and an array of potential anthropometric, prenatal, environmental, and familial risk factors for high blood pressure, including parental smoking habits, were determined as part of a screening project in 4236 preschool children (age 5.7 ± 0.4 years). Smoking was reported by 28.5% of fathers and 20.7% of mothers, and by both parents 11.9%. In addition to classic risk factors such as body mass index, prematurity, low birth weight, and parental hypertension, both systolic (+1.0 [95% confidence interval, +0.5 to +1.5] mm Hg; P=0.0001) and diastolic blood pressure (+0.5 [+0.03 to +0.9] mm Hg; P=0.03) were higher in children of smoking parents. Parental smoking independently affected systolic blood pressure (P=0.001) even after correction for other risk factors, such as body mass index, parental hypertension, or birth weight, increasing the likelihood of having a systolic blood pressure in the top 15% of the population by 21% (2% to 44%; P=0.02). CONCLUSIONS: In healthy preschool children, parental smoking is an independent risk factor for higher blood pressure, adding to other familial and environmental risk factors. Implementing smoke-free environments at home and in public places may provide a long-term cardiovascular benefit even to young children.

Prevalence and psychological correlates of occasional and repetitive deliberate self-harm in adolescents.

OBJECTIVE: To determine the prevalence and the associated psychological and social factors of occasional and repetitive deliberate self-harming behavior in adolescents. DESIGN: Cross-sectional self-report survey. SETTING: One hundred twenty-one schools in Germany. PARTICIPANTS: A representative sample of 5759 ninth-grade students was studied between 2004 and 2005. OUTCOME MEASURES: Deliberate self-harm (DSH) and suicidal behaviors, emotional and behavioral problems (Youth Self-Report), living standard, family composition, parental conflict and illness, school type and performance, relationship to peers, bullying, body satisfaction and dieting, media consumption, smoking, and alcohol and drug use. RESULTS: Occasional forms of DSH within the previous year were reported by 10.9% of the ninth-grade students. Four percent of the students reported repetitive forms of DSH. Suicidal behavior was strongly associated with repetitive DSH, an association that held for both subtypes of DSH. The findings also indicated that social background factors were important concomitants of occasional DSH but were not related to an increased likelihood of repetitive DSH. Symptoms of depression/anxiety and delinquent/aggressive behavior were associated with self-harming behavior in both adolescent girls and boys. CONCLUSIONS: The data suggest that there is a link between social factors and occasional DSH and, especially in repetitive DSH, that there is a strong association between DSH and suicidal behavior as well as DSH and emotional and behavioral problems. These findings indicate a different pathway in the development of DSH in adolescents. The results support a need to investigate the possible neurobiological underpinnings of DSH within a longitudinal model to enhance the knowledge of this poorly understood behavior.

Neuropsychological effects of chronic low-dose exposure to polychlorinated biphenyls (PCBs): a cross-sectional study.

BACKGROUND: Exposure to indoor air of private or public buildings contaminated with polychlorinated biphenyls (PCBs) has raised health concerns in long-term users. This exploratory neuropsychological group study investigated the potential adverse effects of chronic low-dose exposure to specific air-borne low chlorinated PCBs on well-being and behavioral measures in adult humans. METHODS: Thirty employees exposed to indoor air contaminated with PCBs from elastic sealants in a school building were compared to 30 non-exposed controls matched for education and age, controlling for gender (age range 37-61 years). PCB exposure was verified by external exposure data and biological monitoring (PCB 28, 101, 138, 153, 180). Subjective complaints, learning and memory, executive function, and visual-spatial function was assessed by standardized neuropsychological testing. Since exposure status depended on the use of contaminated rooms, an objectively exposed subgroup (N = 16; PCB 28 = 0.20 microg/l; weighted exposure duration 17.9 +/- 7 years) was identified and compared with 16 paired controls. RESULTS: Blood analyses indicated a moderate exposure effect size (d) relative to expected background exposure for total PCB (4.45 +/- 2.44 microg/l; d = 0.4). A significant exposure effect was found for the low chlorinated PCBs 28 (0.28 +/- 0.25 microg/l; d = 1.5) and 101 (0.07 +/- 0.09 microg/l; d = 0.7). Although no neuropsychological effects exceeded the adjusted significance level, estimation statistics showed elevated effect sizes for several variables. The objectively exposed subgroup showed a trend towards increased subjective attentional and emotional complaints (tiredness and slowing of practical activities, emotional state) as well as attenuated attentional performance (response shifting and alertness in a cued reaction task). CONCLUSION: Chronic inhalation of low chlorinated PCBs that involved elevated blood levels was associated with a subtle attenuation of emotional well-being and attentional function. Extended research is needed to replicate the potential long-term low PCB effects in a larger sample.

[Parent- and teacher-reported behavior problems of first graders]. / Verhaltensauffälligkeiten bei Erstklässlern aus Sicht der Eltern und der Lehrerinnen.

Parents information about behavior, problems and life situation of children before and after first year of school were analysed and compared with data from teacher reports. At the end of first grade 131 parents were asked about behavior problems of their children using the child behavior checklist (CBCL) and additional items about living condition of the familiy and child. Findings were compared with those of a large epidemiological study conducted one year before in the same area using the same instruments. Additional teacher-reported data about behavior problems and school achievement were included. Comparing data before and after first year of school, no significant change in average CBCL total score could be observed. From parents view oppositional behavior was the most prevalent problem. There was a decrease of social problems. Children became more independent having more contact with peers. More children have their own television and computer at the end of first grade. Prevalence of headache and perfectionism as well as symptoms of tension and irritation increased. The most important problems from teachers' view are lack of attention and concentration affecting 32% of the first graders. Compared to the parents, teachers report only few oppositional and aggressive behavior. Achievement at school and behavior problems are highly correlated. Especially attention problems go along with low achievement at school. Parents' and teachers' ratings show an average correlation of r = .28 with the highest accord for attention problems and school achievement. The results of the study contribute to the question how children deal and cope with the new situation coming to school. The findings of a high rate of attention problems at school and the close relationship between behavior problems and achievement lead to the conclusion that an early prevention of behavior problems is essential to promote school performance.

[Behavioral symptoms in preschool children at the time of school entrance from the perspective of parents--data regarding prevalence and risk factors in an epidemiological study]. / Verhaltensauffälligkeiten im Einschulungsalter aus elterlicher Perspektive--Ergebnisse zu Prävalenz und Risikofaktoren in einer epidemiologischen Studie.

Behavioral and emotional problems based on parents information from the Child Behavior Checklist (CBCL) were investigated in a large epidemiological sample of 4363 six year old pre-school children from the area of Heidelberg and Rhein-Neckar county. An overview about symptom frequencies of boys and girls is given, taking age specific evaluations into account. Considering symptoms and syndromes, externalizing and attention problems show high prevalence, especially for boys. Family problems are the most important predictors of child global symptomatology, explaining about 10% of variance of the CBCL total score. Other factors like gender, chronical illness, adverse living conditions, family constellation or amount of TV consumption prove as additional independent predictors. An overall model explains about 20% of variance of child symptomatology. Results are discussed from the view of normal child development, developmental psychopathology, changing norms and altered socio-cultural conditions.

Quantification of iodine supply: representative data on intake and urinary excretion of iodine from the German population in 1996.

BACKGROUND/METHODS: In Germany, iodine deficiency is common. In a representative group of 2,500 Germans (age >13 years), using a specially designed food questionnaire, the iodine intake was calculated. In addition, iodine and creatinine concentrations in spot urine samples were determined in three groups with a possibly increased risk of iodine deficiency (769 conscripts, 886 pairs of mothers and newborns) or future hyperthyroidism (574 adults, age range 50-70 years) from 26 representative regions. In four groups of controls (young and older male and female adults; n = 91), 24-hour urine iodine and creatinine were measured in six diurnal fractions to calculate group- and period-specific factors for the estimation of the 24-hour iodine excretion from data of iodine/creatinine ratio and time of micturition in spot urine samples. RESULTS: The mean calculated iodine intake (excretion) was 119 microg/day for the group of Germans above 13 years; it was 119 microg/day (125 microg/day) for adults aged 50-70 years, 137 microg/day (125 microg/day) for conscripts, and 162 microg/day for breast-feeding mothers. The median iodine concentration (iodine/creatinine ratio) was 9.4 microg/dl (83 microg/g) in 566 adults aged 50-70 years, 8.3 microg/dl (57 microg/g) in 772 conscripts. and 5.6 microg/dl (156 microg/g) in 739 breast-fed newborns. CONCLUSIONS: Compared to older data, the iodine intake in Germany has increased. In 1996, the meticulously quantified average deficit was about 30% of the recommended iodine intake.