Temporary disability pension recipients: Contextual stress factors and their effect on return-to-work-intention.

BACKGROUND AND PURPOSE: In the last decades, Germany has experienced a vast increase in the number of individuals applying for or receiving disability benefit. Only a small proportion of them intends to return to work. The present study aims to identify and describe the percentage of temporary disability pensioners, who have the intention to return to working life. METHODS: The final sample consisted of 496 insured individuals who were receiving temporary disability pension from the Regional German Pension Insurance (DRV) at that time. Participation was voluntary and anonymous. The following self-report instruments were administered: a. Evaluation of Contextual Factors; b. German Symptom Validation Test (BEVA); c. German Patient Health Questionnaire (PHQ-9); d. Readiness for Return-to-Work German Scale (RRTW). RESULTS: The results revealed that approximately 6% of participants were at the stage of "preparation", 31.9% at the stage of "contemplation", and more than half of the participants were at the stage of "pre-contemplation" according to the RRTW. Comparing the groups of "pre-contemplation" (Group 1) and "contemplation+preparation" (Group 2+3), no statistically significant differences were found, except for age. CONCLUSIONS: In conclusion, further research is required to identify possible factors which could predict the stage of RRTW. New interventions are needed that can raise the motivation for and success in the return to work of disability pensioners.

[Psychosomatic Rehabilitation for Post-COVID]. / Psychosomatische Rehabilitation bei Post-COVID.

Aim of the study Post-COVID is characterized by a large number of different symptoms. The indication for medical rehabilitation is based on the main symptom. Insured individuals who suffer from fatigue and have no relevant organic disorder are often rehabilitated in psychosomatic clinics. In the present study, the effectiveness of psychosomatic rehabilitation in patients with post-COVID will be investigated. Methods 91 patients with post-COVID are compared to 124 patients with mental disorders and 68 patients with cancer regarding the improvement of fatigue and depressiveness as well as satisfaction and socio-medical parameters. Results At admission, the level of fatigue did not differ in the three groups and was equally reduced. Patients with post-COVID and high depression scores at admission had clinically significant levels of fatigue at discharge. The proportion of patients with mental disorders who were discharged with a negative prognosis for employment was significantly increased. Discussion Although psychosomatic rehabilitation can reduce fatigue, the proportion of patients suffering from fatigue with post-COVID at discharge is still high. Conclusion The treatment concept for the rehabilitation of patients with post-COVID must take into account the often individual course of the disease. Psychosomatic rehabilitation can make an important contribution here.

Outpatient follow-up of tumour diseases through video-based value-oriented behavioural activation (ViVA): study protocol for a randomised controlled trial.

BACKGROUND: In Germany, approximately half a million people are diagnosed with cancer annually; this can be traumatic and lead to depression, anxiety, and adjustment disorders necessitating psycho-oncological intervention. Value-oriented behavioural activation, adopted from depression psychotherapy, aims to provide structured support to help patients adjust their personal values, goals, and activities within the context of their changed life situation. This trial aims to evaluate the effectiveness of video-based value-oriented behavioural activation against German S3-Guideline-compliant aftercare for cancer patients dealing with psychological distress. METHODS: This trial will use covariate-adaptive randomisation according to gender and type of tumour disease to assign participants to one of two study arms (value-oriented behavioural activation consisting of 12 manualised follow-up sessions delivered via video consultation vs. S3-Guideline-compliant aftercare comprising three supportive talks). Psychological strain, psychosocial distress, quality of life, work-related outcomes, fear of cancer recurrence, goal adjustment, satisfaction with the consultant-participant relationship, and rumination will be measured at baseline, twice during treatment, posttreatment, and at the 6-month follow-up. The target sample of 146 tumour patients experiencing high psychosocial distress will be recruited at the Rehazentrum Oberharz, Germany. DISCUSSION: This trial aims to test the effectiveness of value-oriented behavioural activation in aftercare for tumour patients, focusing on its capacity to reduce distress and the potential for long-term effects evaluated through a 6-month follow-up. The study's possible challenges include enrolling a sufficient sample and ensuring adherence to treatment, mitigated through in-person recruitment and rigorous training of staff. If successful, the results will be of high public health relevance, especially for psychotherapeutic care in rural areas and among patients with limited mobility considering the video-based approach of the trial. TRIAL REGISTRATION: This study was registered at the German Clinical Trials Register: DRKS00031900 on Sep 19, 2023.

[Factorial and Convergent Validity of the Short Form of the "Questionnaire of Thoughts and Feelings" (QTF-14) for Borderline Personality Disorder]. / Faktorielle und konvergente Validität der Kurzversion des "Fragebogens zu Gedanken und Gefühlen" (FGG-14) bei Borderline-Persönlichkeitsstörung.

The "Questionnaire of Thoughts and Feelings" (QTF) is being used as screening instrument as well as tool for treatment planning and treatment evaluation for patients with borderline personality disorder (BPD). The primary goal of this study was the validation of the dimensional structure of the short version with 14 items, QTF-14. Additionally, item characteristics, reliability and evidence of convergent validity were examined. A diagnostically homogenous sample of patients with BPD (N=3035) of a psychosomatic clinic was presented with several self-assessment inventories, including the QTF-14. The expected single-factor model of the structure of the FGG showed unacceptable model fit indices (CFI=0.751; TLI=0.706; RMSEA=0.115; SRMR=0.073). Exploratory factor analysis showed evidence of two or three specific factors. In a subsequent confirmatory factor analysis, a bifactor model with two specific factors proved to be preferable (CFI=0.956; TLI=0.936; RMSEA=0.054; SRMR=0.034). The internal consistency of the total scale as well as the suggested subscales "Relationship Difficulties and Emotional Dysregulation" and "Autoaggression" was acceptable to good (ω=.81-.84; α=.79-.85). Associations with similar scales were as expected. Good psychometric properties of the QTF-14 can be confirmed in this study. Using the suggested subscales could support treatment planning.

Sick leave before, during, and after short-term outpatient psychotherapy: a cohort study on sick leave days and health care costs between behavioral and psychodynamic psychotherapies on anonymized claims data.

BACKGROUND: Sick leave due to mental disorders poses a relevant societal and economic burden. Research on sick leave over a patient journey of individuals who received one of two treatment approaches - either behavioral (BT) or psychodynamic (PDT) psychotherapy - is scarce. METHODS: We conducted a cohort study on anonymized German claims data for propensity-score matched patients who received short-term outpatient BT or PDT. We analyzed sick leave days and direct health care costs one year before, during, and one year after psychotherapy. RESULTS: We analyzed data of patients who received BT and PDT, with N = 14 530 patients per group after matching. Patients showed sick leave days per person year of 33.66 and 35.05 days before, 35.99 and 39.74 days during, and 20.03 and 20.95 days after BT and PDT, respectively. Sick leave rates were overall higher in patients who received PDT. Both patient groups showed reductions of roughly 14 sick leave days per year, or 40%, from before to after therapy without a difference between BT and PDT (difference-in-difference [DiD] = -0.48, 95%-confidence interval [CI] -1.61 to 0.68). Same applies to direct health care costs which reduced in both groups by roughly 1800 EUR (DiD = 0, 95%-CI -158 to 157). CONCLUSIONS: Results suggest similar reductions in sick leave days and direct health care costs from before to after BT and PDT. As sick leave is discussed to serve as an indicator of overall health and functioning in mental disorders, both treatments may have a similar positive impact on mental health.

Validation of the German version of the Comparative Psychotherapy Process Scale.

The Comparative Psychotherapy Process Scale (CPPS) is a 20-item scale which aims to capture technical features distinguishing cognitive behavioral (CBT) from psychodynamic (PD) psychotherapy (and vice versa) in two corresponding subscales (CBT and PD Subscale). Our objective was to validate a German self-report version of the CPPS regarding a previous psychotherapy session in a psychotherapist- and in a patient-version. Fifty-three psychotherapists and their 53 patients answered to the according German CPPS Scale as well as to specific subscales of the Multitheoretical List of Therapeutic Interventions self-report-instrument (MULTI-30 subscales) assessing CBT- and PD-specific intervention characteristics. We analyzed (a) the correlation of the CPPS with the MULTI-30 subscales, (b) the ability of the CPPS to distinguish whether therapy sessions were either CBT or PD using logistic regression, and (c) the correlation between psychotherapists' and patients' self-report regarding the preceding session (correlation). Both the psychotherapist- and the patient-version showed acceptable to good values of internal consistencies (α = .78-.84). The CBT and PD Subscales of the MULTI-30 correlated with the CPPS subscales in both versions (CBT: rs = .85 [psychotherapist-version] and .80 [patient-version], PD: rs = .79 [both versions]). Subscales correctly discriminated whether the previous session was a CBT or a PD session (correct predictions in 88.7% in the psychotherapist-version, 73.6% in the patient-version; χ² ≥ 14.03, p < .001). The German version of the CPPS is a promising instrument to facilitate research on CBT- and PD-specific psychotherapy processes. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

[Insured Persons with High and Moderate Risk of Reduced Earning Capacity - Identification, Analysis of the Use of a Counselling Service and Illustration of their Health and Occupational Situation]. / Versicherte mit Erwerbsminderungsrisiko: Identifikation, Analyse der Inanspruchnahme eines Beratungsangebots und Darstellung der gesundheitlichen und beruflichen Situation ­ Eine Querschnittstudie.

PURPOSE: The aim of this study was to investigate the life situation, and analyse the need for rehabilitative interventions as well as the use of counselling service offered to persons insured by the German Pension Insurance Braunschweig - Hannover (DRV BS-H), using the moderate and high risk index for temporary disability penson (RI-EMR). METHOD: This is a cross-sectional study. The participants were generated from a random sample of the total insured persons of the DRV BS-H. 1778 persons were contacted offering telephone consultation and a request for participation in a questionnaire survey that recorded, among others, symptoms, burdens and impairments. Employed persons were asked about their stress at work, non-employed persons about their motivation to return to work. 391 (24.5%) participated in the questionnaire survey and 157 (9.8%) of those contacted responded to the offer of counselling service. The contents of the counselling sessions were evaluated descriptively. The questionnaire data were analysed comparatively (ANOVA, χ2-test). RESULTS: The offer of the telephone counselling was not used as expected in advance. Insured persons with a high RI-EMR showed more clearly complaints as well as burdens and impairments due to contextual factors than persons with a moderate RI-EMR. The majority of non-employed persons in both groups showed up in the motivational stage of forming intentions with regard to a possible return to employment. CONCLUSION: The question arises as to how insured persons with prognostically limited participation can be better reached with offers of assistance. The goal of early offer of support services is confronted with the problem that delays occur in the application of the routine data of the DRV and thus of the RI-EMR. Future studies should investigate how to improve insured persons' participation in counselling services and also their motivation to return to work.

[Domestic violence and its psychological consequences during the COVID-19 pandemic-key findings from German-speaking countries]. / Häusliche Gewalt und ihre psychischen Folgen während der COVID-19-Pandemie ­ Zentrale Befunde aus dem deutschsprachigen Raum.

The impact of traumatic experiences on mental health during the COVID-19 pandemic has been insufficiently discussed in the German-speaking countries. Against this background, a working group of scientifically and clinically active colleagues was formed on behalf of the German-Speaking Society for Psychotraumatology (DeGPT). The aim of the working group was to summarize central research findings on the incidence of domestic violence and associated psychological distress during the COVID-19 pandemic in German-speaking countries and to discuss their implications. In addition, associations between pre-existing childhood trauma and psychological distress during the pandemic should be illuminated. The present narrative review was prepared for this purpose.The results of the studies conducted indicate high prevalences of domestic violence during the COVID-19 pandemic, which, however, predominantly correspond to pre-pandemic prevalences. Adults with current or pre-existing interpersonal traumatic experiences during childhood or adolescence reported increased psychological distress during the pandemic compared with adults without such experiences. A number of risk factors (e.g., female gender, lower frequency of social contacts) increased the risk of psychological distress and posttraumatic stress disorder symptoms during the pandemic. According to these findings, people with current or past interpersonal trauma exposure represent a vulnerable group with special support needs during pandemic contexts.

Improvement of Work Ability After Weight Loss Surgery: Results of a Longitudinal Study of Patients Suffering from Extreme Obesity Before and 4 Years After Bariatric Surgery.

PURPOSE: Body mass index (BMI) is directly associated with employment status. Our longitudinal prospective study is aimed at ascertaining whether work ability index (WAI) 4 years after surgery remains improved, such as 1 year after surgery, or changes and whether socio-demographic or psycho-social factors influence changes in work ability. MATERIALS AND METHODS: 197 bariatric surgery candidates were recruited. Data on demographic and psycho-social characteristics were collected prior to surgery (t1) and at 6 (t2), 12 (t3), and 48 months (t4). Change effects over time in the WAI and BMI were investigated using a repeated-measures analysis of variance (ANOVA). A hierarchical multiple regression analysis was calculated to predict socio-demographic and psychosocial characteristics at t1 on WAI at t4. RESULTS: Not only a significant increase in WAI was observed between t1 and t2 and between t3 and t4 but also a significant decrease between t2 and t4. BMI reduction was significant between t1 and t2 and t3 and t4, respectively. There was no significant interaction effect of BMI reduction 4 years after surgery on decreased work ability from t2 to t4. The hierarchical multiple regression analysis revealed an association of WAI scores at t1 on WAI scores at t4 only. CONCLUSIONS: Work ability 4 years after surgery remained significantly improved compared to the values at t1-t3 assessment. Since work ability was the only predictor at t1, findings might indicate the use of psycho-social measures post bariatric surgery to increase work ability. There was no association between work ability and other socio-demographic or psycho-social factors.

The Effect of the Covid-19 Pandemic on Domestic Violence in Germany: A Comparison of Three Representative Population Surveys.

The COVID-19 pandemic has had profound societal and economic effects. Concerns were raised that domestic violence might increase because of the enacted infection control measures. Previous findings on this issue have been contradictory. Since existing studies mainly rely on official reports, administrative data, helpline calls, or retrospective measures, their findings are likely to prove unreliable. Few population-based surveys include pre-pandemic data, limiting their ability to test for causality regarding increasing violence. Therefore, the aim of this study was to compare findings from population-representative surveys on the prevalence of intimate partner violence (IPV) and violence against children (VAC) before and during the COVID-19 pandemic. Based on the data of N = 3,639 individuals living with a romantic partner and N = 1,313 parents living with at least one of their children from three German representative population surveys, we estimated average marginal effects for the temporal trends (i.e., pre vs. post infection control measures) of domestic violence separately for males and females. To minimize bias across survey waves, inverse probability weighting was used. Results show no statistically significant increase in either physical or psychological forms of IPV or VAC as a result of the implementation of COVID measures. On the contrary, the 1-year prevalence was decreasing for certain forms of violence. Our findings suggest that the assessment of the consequences of infection control measures needs an empirical basis. Further research should be conducted using high-quality data sources. Therefore, the present study should be considered a stepping stone for ongoing research efforts to examine the consequences of pandemic-related infection control measures on the general population.

[Pension Due to Full Reduction in Earning Capacity: Do Psychiatric Reports Meet the Quality Criteria for Socio-Medical Assessment?] / Berentung wegen voller Erwerbsminderung: Erfüllen psychiatrische Gutachten die Qualitätskriterien für die sozialmedizinische Begutachtung?

OBJECTIVE: The quality of socio-medical expert opinions, which are prepared for the German Pension Insurance (GPI) in the context of applications for reduced earning capacity pension due to mental disorder, has hardly been investigated so far. The aim of the present study was to investigate to what extent expert medical reports on post-traumatic stress disorder (PTSD) comply with the guideline of the GPI on socio-medical reports for mental and behavioral disorders. METHODOLOGY: To examine the quality of expert opinions, 52 socio-medical expert opinions in which a diagnosis of post-traumatic stress disorder (PTSD) was assigned and a performance capacity of less than three hours was determined were analyzed. The quality of the expert opinions was assessed both quantitatively by calculating quality points and qualitatively by analyzing the content. Percent agreement and Cohen's kappa were calculated for two raters to examine rater agreement based on a subsample (n=11). RESULTS: The analyzed appraisals scored an average of 36.1 (SD=7.4) out of a possible 92 quality points (range 22/56). In most of the expert opinions, the descriptions of participation limitations, epicrisis, and sociomedical conclusion were unsatisfactory. CONCLUSION: The inadequate presentation of the functional and participation limitations in the expert opinions may not do justice to the actual facts of the case, so that the evidence of a health disorder with the corresponding participation limitations cannot be provided beyond doubt. Accordingly, measures to improve the quality of expert opinions such as training and regular quality reviews are necessary.

[Participation Restriction and its Prediction in Victims of Acts of Violence During the Proceedings Under the Victims Compensation Act: A File-Based Exploratory Cohort Study]. / Teilhabebeeinträchtigung und deren Prädiktion bei Opfern von Gewalttaten im Verfahren nach dem Opferentschädigungsgesetz: Eine aktenbasierte explorative Kohortenstudie.

After an act of violence, affected individuals not only suffer psychological and physical damage, but also impairment in their professional, social and societal participation. So far, however, no studies have been conducted examining the severity of participation restrictions and prognostically relevant characteristics. Using a category system, sociodemographic information as well as trauma-, crime- and health-specific characteristics of adult victims of acts of violence, whose entitlement to benefits were recognized under the German Victims Compensation Act (OEG), were recorded from files. Based on psychiatric assessments of damage, participation restrictions were also assessed post-hoc based on the International Classification of Functioning, Disability and Health (ICF). The data are extracted from 99 files; 72 of those affected were female. The average age of the victims at the time of the offence was 25 years. 53 were victims of sexual violence, 24 were victims of forms of bodily injury and 45 were victims of other acts of violence. 29 victims experienced more than one type of violence. All had at least one mental disorder with pathological significance. An average of four years passed between the first and second psychiatric assessment. While 85 of those affected stated that they had been employed before the offence, the number of employees dropped to 53 after the offence. The most pronounced participation restriction was found in professional participation. A multiple regression analysis revealed that a higher degree of participation restriction was associated with lack of employment and a stronger negative impact after the crime as well as the victim's familiarity with the perpetrator; but not associated with a mental disorder or a lack of a victim's trustworthy relationships. In future, participation restrictions should regularly be assessed based on the ICF during the psychiatric assessment. The results suggest that particularly benefits for professional participation are to be granted within the framework of the OEG.

Self-Efficacy Beliefs of Employees with Mental Disorders or Musculoskeletal Diseases after Sickness-Related Absence: Validation of the German Version of the Return-to-Work Self-Efficacy Scale.

Return-to-work self-efficacy (RTW-SE) is an important predictor of the duration until employees return to work after a sickness-related absence. The aim of the present validation study was to investigate the psychometric properties of the German RTW-SE scale. Data were obtained from three independent samples of employees who were in outpatient care due to mental disorders or musculoskeletal diseases (n1 = 301, n2 = 103, n3 = 104). Confirmatory factor analyses showed an inadequate fit for a one-factor solution and an acceptable fit for a two-factor model that distinguished by item-wording direction. To test whether the two factors represent substantively different dimensions of the construct or rather a statistical item-wording effect, two subscales were formed based on item-wording direction. As the subscales were not differentially associated with external measures, the one-factor solution may be considered appropriate. The scale showed good to excellent internal consistency values over time and across samples, had low retest reliability indices, and indicated construct validity based on moderate to high associations with cognitive and disease-related variables. The results further demonstrated the scale's sensitivity to change. The RTW-SE baseline score predicted physical performance and pain-related psychological impairment after orthopedic rehabilitation. In multiple regression analysis, RTW-SE remained a significant predictor of pain-related psychological impairment but not physical performance, partially demonstrating the predictive validity of the scale. The German version of the RTW-SE scale demonstrated satisfactory results regarding its validity and reliability.

Cognitive-Emotional Aspects of Post-Traumatic Stress Disorder in the Context of Female Genital Mutilation.

Around 200 million women and girls worldwide are affected by female genital mutilation/cutting (FGM/C). FGM/C is a procedure that harms or alters the external female genitals for non-medical reasons, and is usually performed on children. Often, this procedure leads to severe consequences for the women's physical and mental health. In a cross-sectional sample of 112 women seeking medical counseling, physical and mental health characteristics associated with FGM/C were examined and possible predictors for the development of post-traumatic stress disorder (PTSD) in women affected by FGM/C were identified. A total of 55.4% (n = 66) of the women reported symptom levels of probable PTSD. Predictors for higher PTSD symptomology were an older age at the time of the FGM/C procedure, feelings of guilt and the centrality of the event in the woman's life. Thus, cognitive-emotional processing was found to play an important role in the emergence of PTSD in women suffering from FGM/C. However, interventions taking into consideration these characteristics are mostly lacking and need to be investigated further in the context of FGM/C.

Changes in Work Ability after Weight-Loss Surgery: Results of a Longitudinal Study of Persons with Morbid Obesity before and after Bariatric Surgery.

INTRODUCTION: Bariatric surgery is a life-changing treatment, but knowledge of its influence on changes in work ability is still limited. We hypothesized that self-reported work ability improves in response to surgery-induced weight loss and sociodemographical variables (e.g., age, sex, and marital status), and that psychosocial characteristics (e.g., depressive symptoms and dysfunctional eating) may have predictive value as to patients' work ability. METHODS: A total of 200 participants scheduled for bariatric surgery were recruited between September 2015 and June 2018. They completed several self-report measures at the preoperative examination (t1) and at 6- (t2) and 12 months (t3) after bariatric surgery. A repeated-measures analysis of variance was calculated to detect any changes in the work ability and body mass index (BMI) among the 3 time points. Further, a hierarchical multiple regression analysis was used to determine whether any demographical and psychosocial characteristics at (t1) would predict work ability at (t3). RESULTS: Participants (82% of whom were women) were middle-aged and showed a BMI of nearly 46 at the preoperative medical examination. Excess weight loss at (t2) and at (t3) was 49 and 66%, respectively. Work ability increased toward a moderate level after weight-loss surgery. Work ability and dysfunctional eating at (t1) showed significant predictive value with respect to work ability at (t3). DISCUSSION: The results suggest that weight-loss surgery has a positive impact on work ability, and indicate a predictive value for the extent of weight loss and dysfunctional eating behavior. Against our hypothesis and in contrast to former research, a predictive value for depressive symptoms and age was not revealed. Further research must show how interventions can support and maintain improvements in work ability after bariatric surgery, in order to reduce sick leave and unemployment in patients with preoperative morbid obesity.

Gender-related differences in health-care and economic costs for eating disorders: A comparative cost-development analysis for anorexia and bulimia nervosa based on anonymized claims data.

OBJECTIVE: Anorexia nervosa (AN) and bulimia nervosa (BN) impose a significant financial burden and immense sufferings on affected individuals. Yet little is known about the differences between how each disorder affects males and females, respectively. METHOD: We performed a retrospective cost-development analysis of anonymized claims data from the German statutory health-insurance system. Insured persons who suffered from an onset of AN (F50.0; N = 1,242 females and 71 males) or BN (F50.2; N = 1,104 females and 64 males) were analyzed for cost-of-illness over a 5-year period, beginning 2 years before the index diagnosis. RESULTS: In total, all groups incurred similar distributions of total costs over the 5-year observation period, with roughly 14,000-20,000 EUR median costs. About two-thirds of the total costs for females and males with AN are associated with mental illness, whereas for females and males with BN, this applies to approximately half the total costs. Analyses revealed differences between disorders and genders for single outcomes. AN is associated with a stronger increase in costs within a short period following onset and higher inpatient treatment costs, whereas BN entails more instances of incapacity to work before and after onset. Compared to females, males incurred lower costs in outpatient treatments. DISCUSSION: Our study adds evidence as to the disparities in health-care utilizations and costs over the course of illness, in outcome ratios, and between genders, for both AN and BN.

Sexual Contact Patterns in High-Income Countries-A Comparative Analysis Using Data From Germany, the United Kingdom, and the United States.

Sexual contact patterns determine the spread of sexually transmitted infections and are a central input parameter for mathematical models in this field. We evaluated the importance of country-specific sexual contact pattern parametrization for high-income countries with similar cultural backgrounds by comparing data from two independent studies (HaBIDS and SBG) in Germany, a country without systematic sexual contact pattern data, with data from the National Survey of Sexual Attitudes and Lifestyles (Natsal) in the UK, and the National Survey of Family Growth (NSFG) in the US, the two longest running sexual contact studies in high-income countries. We investigated differences in the distribution of the reported number of opposite-sex partners, same-sex partners and both-sex partners using weighted negative binomial regression adjusted for age and sex (as well as stratified by age). In our analyses, UK and US participants reported a substantially higher number of lifetime opposite-sex sexual partners compared to both German studies. The difference in lifetime partners was caused by a higher proportion of individuals with many partners in the young age group (<24 years) in the UK and the US. Partner acquisition in older age groups was similar. The number of same-sex partners was similar across countries, while there was heterogeneity in the reported experience with partners from both sexes, consistent with the differences observed for opposite-sex sexual partners. These patterns can lead to substantially different dynamics of sexually transmitted infections across ages, and have strong impact on the results of modeling studies.

Early intervention, treatment and rehabilitation of employees with common mental disorders by using psychotherapeutic consultation at work: study protocol of a randomised controlled multicentre trial (friaa project).

BACKGROUND: Common mental disorders are one of the leading causes for sickness absence and early retirement due to reduced health. Furthermore, a treatment gap for common mental disorders has been described worldwide. Within this study, psychotherapeutic consultation at work defined as a tailored, module-based and work-related psychotherapeutic intervention will be applied to improve mental health care. METHODS: This study comprises a randomised controlled multicentre trial with 1:1 allocation to an intervention and control group. In total, 520 employees with common mental disorders shall be recruited from companies being located around five study centres in Germany. Besides care as usual, the intervention group will receive up to 17 sessions of psychotherapy. The first session will include basics diagnostics and medical indication of treatment and the second session will include work-related diagnostics. Then, participants of the intervention group may receive work-related psychotherapeutic consultation for up to ten sessions. Further psychotherapeutic consultation during return to work for up to five sessions will be offered where appropriate. The control group will receive care as usual and the first intervention session of basic diagnostics and medical indication of treatment. After enrolment to the study, participants will be followed up after nine (first follow-up) and fifteen (second follow-up) months. Self-reported days of sickness absence within the last 6 months at the second follow-up will be used as the primary outcome and self-efficacy at the second follow-up as the secondary outcome. Furthermore, a cost-benefit assessment related to costs of common mental disorders for social insurances and companies will be performed. DISCUSSION: Psychotherapeutic consultation at work represents a low threshold care model aiming to overcome treatment gaps for employees with common mental disorders. If successfully implemented and evaluated, it might serve as a role model to the care of employees with common mental disorders and might be adopted in standard care in cooperation with sickness and pension insurances in Germany. TRIAL REGISTRATION: The friaa project was registered at the German Clinical Trial Register (DRKS) at 01.03.2021 (DRKS00023049): https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00023049 .

Willingness to pay for a quality-adjusted life year for depressive disorders compared to heart disease based on population preferences.

PURPOSE: According to estimations of the World Health Organization, depressive disorders, and cardiovascular disease will be the leading causes for global burden of disease in 2030. The aim of the present study was to estimate the value a representative sample of the German population places on quality-adjusted life years (QALYs) for depressive disorders compared to heart disease. METHODS: A representative sample of N = 967 of the German general public was randomly presented with one of two hypothetical health-loss scenarios: One version of the questionnaire presented respondents with health loss due to depression, while the other version dealt with health loss due to experiencing a heart disease. Respondents were asked to indicate their willingness to pay (WTP) for four hypothetical health-gain scenarios with different treatment options. RESULTS: In the depression questionnaire median WTP values ranged from 1000 to 1500 EUR; in the heart disease questionnaire from 1000 to 2000 EUR. Results of the Mann-Whitney U-Test and Median Test indicate higher WTP values for heart disease compared to depressive disorders when QALY gains were minor and stretched over a long period of time, and when treatment with bypass operation (rather than treatment with ECT) was offered. Zero WTP was significantly higher in all scenarios of the depression questionnaire in comparison to the hearth disease questionnaire. CONCLUSION: Results indicate that respondents valued the necessity of paying for treatment higher when presented with heart disease compared to depression.