Mental health of Covid-19 risk groups during the first Covid-19 lockdown in Germany: a cross-sectional study.

BACKGROUND: The ongoing Covid-19 pandemic not only threatens physical health, but also affects the mental health of people. Yet, health consequences of the pandemic do not affect all members of society equally. We therefore assessed the mental health burden of individuals who are at increased risk of severe illness from Covid-19 compared to individuals who are at low risk of severe illness during the first lockdown (March, 2020) in Germany. Furthermore, we investigated variables mediating the effect of being an individual at increased risk of serve illness on depression. METHODS: Adult German residents (n = 2.369) provided responses to a cross-sectional online survey about risk factors for of severe illness from Covid-19 and various aspects of mental health during the first lockdown in Germany. For data collection, standardized and validated self-report measures were used and for data analysis Mann-Whitney U-tests as well as regression and mediation analyses were performed. RESULTS: The results clearly show that the mental health burden is higher among individuals at increased risk of severe illness from Covid-19 compared to individuals at low risk of severe illness from Covid-19. Moreover, our findings indicate that the association between Covid-19 risk status and depressive symptoms is mediated by concerns about mental health, anxiety and loneliness in a causal effect chain. CONCLUSIONS: Individuals at increased risk of severe illness from Covid-19 have an increased need for psychosocial support during times of lockdown. Future public health policies should pay special attention to these individuals and support them by targeted offers. More research, however, is needed on possible long-term consequences of social distancing on mental health.

Chemsex and Mental Health of Men Who Have Sex With Men in Germany.

Background: Chemsex is defined as using certain substances immediately before or during sexual activities to facilitate, prolong and/or intensify sexual experience, mainly by some communities of men who have sex with men (MSM). Four substances are typically associated with chemsex: methamphetamine, mephedrone, GHB/GBL, and ketamine. While there is a lot of evidence for increased prevalence of HIV, sexually transmitted infections and other sexual health measures among MSM, who engage in chemsex, there has been little research on mental health aspects. This study aims to describe aspects of mental health among a sample of German men who have sex with men (MSM) who engage in chemsex and to describe potentially adverse consequences of chemsex behavior. Method: This paper refers to a subset of participants from the German Chemsex Survey, an MSM-community recruited, self-completed online survey with a self-selected convenience sample. The survey comprised 420 different items considering recreational substance use, substance use in sexual settings, mental health, sexual transmitted infections, adverse consequences of chemsex behavior, and experiences of non-consensual sex acts. A group of participants who used methamphetamine, mephedrone, GHB/GBL, and/or ketamine in a sexual setting in the last 12 months (n = 280, chemsex group) was analyzed regarding symptoms of depression (PHQ-9), general anxiety disorder (GAD-7), somatization (PHQ-15), and PTSD (Primary Care PTSD Screen). Group comparisons were conducted between the chemsex group and men who did not use substances in a sexual context (n = 177, non-chemsex group). Mean scores of mental health measures were compared, as well as scores above a cut-off that indicates clinically relevant symptoms. Logistical regression was utilized to determine whether mental health measures can predict adverse consequences of engagement in chemsex behaviors. Results: A total of 1,583 men started the survey; 1,050 participants provided information on substance use. Twenty-seven percent of participants (n = 280) reported that they used methamphetamine, mephedrone, GHB/GBL and/or ketamine in a sexual setting in the last 12 months. The chemsex group showed significantly higher mean scores for depression, anxiety, and somatization than the non-chemsex group, but effect sizes were low. Even though mean scores were heightened, they were still far below the cut-off for clinically relevant symptoms. The chemsex group reported significantly higher incidences of non-consensual sex acts compared with the non-chemsex group. Some men in the chemsex-group experienced potentially adverse consequences, such as loss of control regarding time and money spent for chemsex activities or amount of substances used at one occasion (49.6%), negative impacts on social functioning (33.6%), psychotic symptoms (13.2%), and physically aggressive behavior toward others (2.9%). Clinically relevant symptoms did not predict a higher likelihood for adverse consequences. Discussion: Mean scores for depression, anxiety, and somatization were significantly higher in the chemsex-group, but effect sizes were low. Both groups reported poorer mental health compared to men in the German general population. Mental health measures did not contribute to predict potentially adverse consequences of chemsex behavior.

Crystal Methamphetamine Use in Sexual Settings Among German Men Who Have Sex With Men.

Introduction: Men who have sex with men (MSM) are a vulnerable subgroup for problems with substance use, including crystal methamphetamine. Drug use in sexual settings, commonly referred to as "chemsex," has been an issue of growing concern in MSM communities. Recreational drugs commonly associated with chemsex include crystal methamphetamine, gamma-hydroxybutyrate/gamma-butyrolactone (GHB/GBL), mephedrone, and ketamine. Drug use in sexual settings is correlated with sexual practices associated with the acquisition and transmission of sexually transmitted infections, including HIV and hepatitis C. Adverse mental health outcomes are often reported at higher rates among MSM who use methamphetamine. Methods: This paper refers to a subset of participants from the German Chemsex Survey, an MSM-community recruited, self-completed online survey with a self-selected convenience sample. Participants who used crystal methamphetamine for sex (n = 130) were compared to participants who did not use drugs for sex (n = 177). The survey comprised 420 different items considering recreational substance use, substance use in sexual settings, harm reduction strategies, mental health, sexual transmitted infections, and mental health care service utilization. Results: A total of 1,583 men started the survey; 1,050 participants provided information on substance use. Twenty-seven percent of participants used crystal methamphetamine in the last 12 months, and of those, 89% used methamphetamine in a sexual setting and 50% reported injecting methamphetamine. Regarding mental health, participants who reported methamphetamine use in sexual settings were more likely to report symptoms of depression, somatization, anxiety, and posttraumatic stress disorder (PTSD) than the German male general population. Participants who reported methamphetamine use for sex were more likely to report symptoms of major depression, being HIV positive, and taking HIV pre-exposure prophylaxis (PrEP) than participants who did not report methamphetamine use. Most participants used harm reduction practices to reduce the risks associated with using methamphetamine in sexual settings. Conclusion: Crystal methamphetamine is used in the context of sexual activities by German MSM. Poorer mental health status than in the male general population was observed. MSM who used methamphetamine in this study seemed to be aware of potential health risks associated with their substance use and utilized harm reduction strategies and biomedical HIV prevention strategies like PrEP.

Somatic Comorbidity in Chronic Constipation: More Data from the GECCO Study.

Background. Comorbidity in chronic constipation has rarely been investigated, despite the fact that constipation can occur as one symptom in a number of neurological, systemic, and other nonintestinal and intestinal disorders. Methods. Of 1037 individuals with constipation identified during a telephone survey, 589 returned a postal questionnaire with valid data, asking for sociographic data, clinical symptoms, comorbid conditions, medication intake, and health care behavior related to constipation. Among them, 245 reported some somatic diagnoses and another 120 regular medication intake. They were compared to individuals without comorbid condition and presumed functional constipation (n = 215). Results. Individuals reporting a somatic comorbid condition and/or regular medication were significantly older than those with functional constipation (63.8 ± 15.8 and 43.7 ± 15.5 years, resp., p < 0.001) and had lower health and social status (both p < 0.001), but similar general life satisfaction (n.s.). Their quality-of-life was lower for the physical (p < 0.001) but not for the mental health domain (n.s.), while among those with functional constipation, the mental health domain distinguished IBS-C individuals from those with functional constipation but without pain (p < 0.001). Conclusion. In an unselected population sample with constipated individuals, those with a somatic comorbid condition outnumber those with functional constipation alone and are distinctly different with respect to age and health status.

Prevalence of constipation in the German population - a representative survey (GECCO).

BACKGROUND: Variable prevalence rates between 2.4 and 35% have been reported for chronic constipation across different countries worldwide, with a low 5% for Germany. OBJECTIVES AND METHODS: We conducted a computer-assisted telephone interview among 15,002 representative individuals in Germany, asking about health-related problems, including constipation. Those who acknowledged the presence of constipation symptoms during the preceding 12 months were questioned concerning constipation features and sociographic variables. RESULTS: Of 15,002 individuals interviewed, 2,239 (14.9%) acknowledged having experienced constipation during the last 12 months, 864 (5.8%) reported constipation during the last 4 weeks, and 380 (2.5%) had current constipation symptoms; 4.4% had taken medication because of their constipation, and 2.6% had consulted a doctor for constipation. In comparison to non-constipated volunteers, those constipated had a lower health quality of life and poorer health, and lower income and social status. CONCLUSION: Up to 15% of the general (German) population report symptoms of constipation depending on the definition. This matches pooled constipation rates across 18 countries (14%).

Functional Constipation and Constipation-Predominant Irritable Bowel Syndrome in the General Population: Data from the GECCO Study.

Background. The prevalence of constipation in the (German) population has been shown to be 14.9% in a telephone survey, but more detailed data are required to characterize the sociographics and clinical characteristics of persons with different types of functional constipation, either constipation-predominant irritable bowel syndrome (IBS-C) or functional constipation with or without meeting Rome criteria. Methods. Of 2239 constipated individuals identified during the telephone interview, 1037 (46.3%) were willing to provide a postal address for a questionnaire, of which 589 (56.8%) returned the questionnaire, inquiring about sociographic data, clinical symptoms, and health care behavior related to constipation, as well as health-related quality-of-life (SF12). Subgroups of functionally constipated individuals were compared. Results. More than 50% of the respondents reported a somatic comorbid condition and/or regular medication intake that may contribute to constipation. We split the remaining individuals (N = 214) into three groups, matching Rome-criteria for IBS (IBS-C, n = 64) and for functional constipation (FC-R, n = 36) and FC not matching Rome criteria (n = 114). Nearly all sociographic and clinical characteristics were equal among them, and all individuals with constipation had similar and lowered QOL on the SF-12 physical health domain, but in IBS-C the scores were also significantly lower in comparison to FC-R and FC, in both the physical health and the mental health domain. Conclusion. Only a fraction of individuals with chronic constipation match Rome criteria for IBS-C or FC, but subgroups do not differ with respect to most other measures except quality-of-life profiles.

Communication, social capital and workplace health management as determinants of the innovative climate in German banks.

OBJECTIVE: The present study aims to measure the determinants of the innovative climate in German banks with a focus on workplace health management (WHM). METHODS: We analyze the determinants of innovative climate with multiple regressions using a dataset based on standardized telephone interviews conducted with health promotion experts from 198 randomly selected German banks. RESULTS: The regression analysis provided a good explanation of the variance in the dependent variable (R² = 55%). Communication climate (ß = 0.55; p < 0.001), social capital (ß = 0.21; p < 0.01), the establishment of a WHM program (ß = 0.13; p < 0.05) as well as company size (ß = 0.15; p < 0.01) were found to have a significant impact on an organization's innovative climate. CONCLUSIONS: In order to foster an innovation-friendly climate, organizations should establish shared values. An active step in this direction involves strengthening the organizations' social capital and communication climate through trustworthy management decisions such as the implementation of a WHM program.

Burnout in nurses - the relationship between social capital in hospitals and emotional exhaustion.

AIMS: The aim of this study is to examine the relationship between a hospital's social capital, individual decision latitude, workload and emotional exhaustion in nurses, controlling for age, sex, years of professional experience and job tenure. BACKGROUND: In western countries between 15-45% of nurses working in hospitals suffer from burnout, characterised by emotional exhaustion, depersonalisation and decreased personal performance. The prevention of burnout constitutes a great challenge to those responsible for the health care system, not least because burnout may cause increasing turnover rates in nurses and lead to medical mistakes. DESIGN: Survey. METHOD: A questionnaire was mailed to 1325 nurses working at four hospitals in east and west Germany in 2002. Nine hundred and fifty nine nurses responded (response rate: 72.4%). RESULTS: Logistic regression identified three significant predictors of emotional exhaustion in nurses: workload (OR: 4.523, CI: 3.230-6.333) was positively associated with emotional exhaustion. Decision latitude (OR: 0.376, CI: 0.254-0.557) and social capital in the hospitals (OR: 0.549, CI: 0.403-0.746) were negatively associated with emotional exhaustion. Emotional exhaustion was not affected by age, sex, years of professional experience and job tenure. Nagelkerke's Pseudo R(2) was 0.225. CONCLUSIONS: The findings underline the importance of social capital and organisational development in hospital management. RELEVANCE TO CLINICAL PRACTICE: Efforts to create a good working atmosphere with readiness to provide mutual support and the pursuit of joint values in a hospital, the reduction of workload and increased decision latitude may prevent the development of emotional exhaustion in nurses.

The relationship between social capital in hospitals and physician job satisfaction.

BACKGROUND: Job satisfaction in the hospital is an important predictor for many significant management ratios. Acceptance in professional life or high workload are known as important predictors for job satisfaction. The influence of social capital in hospitals on job satisfaction within the health care system, however, remains to be determined. Thus, this article aimed at analysing the relationship between overall job satisfaction of physicians and social capital in hospitals. METHODS: The results of this study are based upon questionnaires sent by mail to 454 physicians working in the field of patient care in 4 different German hospitals in 2002. 277 clinicians responded to the poll, for a response rate of 61%. Analysis was performed using three linear regression models with physician overall job satisfaction as the dependent variable and age, gender, professional experience, workload, and social capital as independent variables. RESULTS: The first regression model explained nearly 9% of the variance of job satisfaction. Whereas job satisfaction increased slightly with age, gender and professional experience were not identified as significant factors to explain the variance. Setting up a second model with the addition of subjectively-perceived workload to the analysis, the explained variance increased to 18% and job satisfaction decreased significantly with increasing workload. The third model including social capital in hospital explained 36% of the variance with social capital, professional experience and workload as significant factors. CONCLUSION: This analysis demonstrated that the social capital of an organisation, in addition to professional experience and workload, represents a significant predictor of overall job satisfaction of physicians working in the field of patient care. Trust, mutual understanding, shared aims, and ethical values are qualities of social capital that unify members of social networks and communities and enable them to act cooperatively.

Spontaneous dissociation of long-range Feshbach molecules.

We study the spontaneous dissociation of diatomic molecules produced in cold atomic gases via magnetically tunable Feshbach resonances. We provide a universal formula for the lifetime of these molecules that relates their decay to the scattering length and the loss rate constant for inelastic spin relaxation. Our universal treatment as well as our exact coupled channels calculations for 85Rb dimers predict a suppression of the decay over several orders of magnitude when the scattering length is increased. Our predictions are in good agreement with recent measurements of the lifetime of 85Rb(2).

Molecular production in two component atomic fermi gases.

We provide a practical approach to the molecular production via linear downward sweeps of Feshbach resonances in degenerate Fermi gases containing incoherent mixtures of two atomic spin states. We show that the efficiency of the association of atoms is determined just by the Landau-Zener parameter in addition to the density of the gas. Our approach of pairwise summation of the microscopic binary transition probabilities leads to an intuitive explanation for the observed saturation of the molecular production and recovers all atomic loss curves of Regal et al. [Nature (London) 427, 47 (2003))]] as well as Strecker et al. [Phys. Rev. Lett. 91, 080406 (2003))]] without adjustable parameters.

Three-body problem in a dilute bose-Einstein condensate.

We derive the explicit three-body contact potential for a dilute condensed Bose gas from microscopic theory. The three-body coupling constant exhibits the general form predicted by Wu [Phys. Rev. 115, 1390 (1959)]] and is determined in terms of the amplitudes of two- and three-body collisions in vacuum. In the present form, the coupling constant becomes accessible to quantitative studies which should provide the crucial link between few-body collisions and the stability of condensates with attractive two-body forces.