Changes in the ability to correctly identify schizophrenia and depression: results from general population surveys in Germany over 30 years.

PURPOSE: This study aims to examine time trends in the ability to correctly identify schizophrenia and major depression within the German general population from 1990 to 2020, as an indicator of changing mental health literacy (MHL). Additionally, we investigated shifts in the use of stigmatizing language. METHODS: Our analysis is based on four waves of representative population surveys in Germany in 1990/1993 (West Germany: N = 2044, East Germany: N = 1563), 2001 (N = 5025), 2011 (N = 2455), and 2020 (N = 3042) using identical methodology. Respondents were presented with an unlabelled case vignette describing a person who exhibited symptoms of either schizophrenia or major depression. Participants were then asked to name the problem described in the vignette using an open-ended question. RESULTS: From 1990/1993 to 2020, correct identification of schizophrenia increased from 18% to 34% and from 27% to 46% for major depression. However, derogatory labels remained constant throughout all survey waves, particularly for schizophrenia (19% in 1990/1993 and 18% in 2020). For depression, more trivializing and potentially devaluing statements were recorded. CONCLUSION: Despite the increasing use of psychiatric terminology among the general population, the persistence of derogatory labels suggests that improved MHL, reflected in higher recognition rates, may not automatically translate into a reduction in stigmatizing language. With depression, a normalization and trivialization of a severe illness could pose new challenges to people with major depression. Dedicated efforts to combat the stigma of severe mental illness are still needed.

[Social acceptance of public breastfeeding over time: experiences and attitudes of the population and of breastfeeding mothers in 2016 and 2020]. / Die gesellschaftliche Akzeptanz von öffentlichem Stillen im zeitlichen Vergleich: Erfahrungen und Einstellungen der Bevölkerung und stillender Mütter 2016 und 2020.

BACKGROUND AND OBJECTIVE: Germany is only moderately breastfeeding-friendly, according to a systematic inventory from 2019. Based on a reference study, a survey on the acceptance of breastfeeding in public was conducted. The aim of the work is to capture perceptions and attitudes towards public breastfeeding in a periodic comparison. In addition, differences between the general population and mothers of young children as well as between mothers with different levels of education are considered. MATERIALS AND METHODS: In 2020, 1007 people aged 16 and older and 307 mothers with children up to 24 months were surveyed online about public breastfeeding. The results were compared with a previous survey from 2016. RESULTS: In 2020, a larger percentage of mothers breastfeed in public than in 2016; it is avoided less often. Mothers with lower levels of education are less likely to breastfeed, also in public, and more likely to report mixed reactions. Among the general population, acceptance of public breastfeeding has declined, for example, in gastronomy. About one in six (17%) explicitly rejects breastfeeding in public. Knowledge about the health effects of breastfeeding is lower among the general public than among mothers. As in 2016, knowledge about the positive effects of breastfeeding is associated with greater acceptance of public breastfeeding. CONCLUSIONS: The results underline the importance of measures, for example, to communicate knowledge to the population, show breastfeeding more frequently in mass media and through positive role models, and make the settings in which families live more breastfeeding-friendly. Measures should pay special attention to women with lower levels of education.