Vortragssitzung
Mental health care
Vorträge
How depression and depressive symptoms changed in Germany during the COVID-19 pandemic: a systematic literature review
André Clement
Einleitung / Introduction
After the first case of COVID-19 was reported in Germany, it took until late February for the incidence to increase dramatically. The German government took temporary but comprehensive measures to slow down the spread of the virus and protect the health of its citizens. Facing the new unknown virus, the government focused on physical health and prolonged these temporary lockdowns repeatedly. Besides the pandemic itself, the resulting measures are also an important factor for mental health. Isolation, loneliness, uncertain future, and strongly reduced opportunities affect mental health and may lead to more depression and depressive symptoms (DDS) across the entire population. However, it remains unclear how much different subpopulations were affected in different phases of the COVID-19 pandemic.
Methode / Method
We searched the scholar database PubMed systematically applying the PRISMA guidelines. Included articles had to target DDS during the first year of the COVID-19 pandemic in Germany. Two reviewers assessed the eligibility of each article and discussed until both agreed on a final list. We distinguished between subpopulation and phase of the pandemic.
Ergebnisse / Results
A literature search revealed a total of 244 studies, plus three by hand search of these studies. After title and abstract screening, 79 full-text articles were assessed for eligibility. We excluded articles without sufficient data on DDS in Germany after February 2020, 41 remained. Thirteen targeted no specific subpopulation, seven university associates, six healthcare workers, five elderly and impaired patients, four people with mental issues two cancer patients, two chronic pain patients, and two families with under-aged children. The prevalence of DDS were higher in 11 of the 13 general population and several subpopulation studies. The everyday lives of people in the following groups were directly and significantly affected by the measures of or the pandemic itself: all healthcare workers but dentists, university students during the lecture period, parents of school kids during the lockdown, elderly without impairments, (not further treated) mental-, and cancer patients. Other populations such as university students before the lecture period, (mentally) impaired elderly, or treated mental health patients show normal values.
Zusammenfassung / Conclusion
The comprehensive measures during the COVID-19 pandemic affected mental health, especially DDS across different German subpopulations differently. The longer the measures were enforced and the higher their impact on everyday life, the worse were the outcomes. However, it remains unclear how a significantly increased prevalence of COVID-19 would have affected the mental health of the subpopulations if there had been fewer containment measures.
AutorInnen
André Clement, Universität Witten/Herdecke
Currency shock and mental health
Lukas Kauer, CSS Institut
Einleitung / Introduction
In January 2015, the Swiss National Bank decided to stop buying foreign currency and guaranteeing an exchange rate of CHF 1.20 per €, which led to an unexpected and significant appreciation of the Swiss currency within daytime. Suddenly, the Swiss population was faced with two changes in their economic circumstances. On the one hand, all residents had a significant increase in purchasing power compared to Eurozone states, a fact that people can exploit by spending their money across the border. On the other hand, the pressure on the Swiss labor market increased not only through the salary channel since Swiss salaries got even more attractive compared to wages in the Eurozone but also through the export channel making products and services produced in Switzerland more expensive for buyers from the Eurozone.
Methode / Method
We exploit this setting to analyze the causal relationship between the currency shock and mental health of the Swiss population, using individual level data. We use administrative data from the largest Swiss health insurer, enabling us to track approximately 1 million Swiss residents on a monthly basis and observing their health care costs and utilization two years before and after the currency shock. We use the travel time by car to the next supermarket across the border as a measure for the salience of the currency shock. Residents living closer to a foreign supermarket can exploit the strength of the Swiss Franc in terms of cross-border shopping with lower travel costs both in time and money. Furthermore, when foreign supermarkets are close, other goods and services may also be available across the border and consumed more frequently by Swiss residents. Hence, residents living close to foreign supermarkets not only benefit themselves from their strong currency but are also confronted with a fear from a possible reduction of their customers in the industry they work in, as spending the Swiss Franc abroad gets more attractive for everyone. This can lead to a fear of unemployment and an increase in perceived job insecurity.
Ergebnisse / Results
Preliminary results show that the positive income shock had no significant effect on total health expenditure or total physician visits. However, residents closer to the border have more visits to the psychiatrists and psychologists after the currency shock.
Zusammenfassung / Conclusion
If preliminary findings can be confirmed with additional analyses, the positive income effect through the currency shock, which should increase happiness and reduce health care consumption, would then be overshadowed by the growing anxiety of potential job loss, be it the own or the one of the peers. The benefits from the increase in purchasing power need then to be compared to the deteriorating mental health of part of the population.
AutorInnen
Lukas Kauer
Lukas Schmid, Universität Luzern
Valentina Sontheim, Universität Luzern
The Impact of Vertigo on Quality of Life: An Analysis of the Moderating Role of Personality Traits and Preferences with Data from the KORA-Fit Study
Lars Schwettmann, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH)
Einleitung / Introduction
Vertigo can lead to significant restrictions in mobility and autonomy. Therefore, the first aim of our study was to analyze the correlation between vertigo and health-related quality of life. Furthermore, we hypothesized that personality traits and economic preferences moderate this interrelation. Hence, our second aim was to investigate the moderating effects of corresponding concepts such as optimism, self-efficacy, and time and risk preferences.
Methode / Method
The study used data from the German population-based KORA-Fit study conducted in the Augsburg region in the years 2018 and 2019. The sample contained 3,058 adults aged 53 to 74 years. Answers on the EuroQoL 5-dimensional five-level (EQ-5D-5L) questionnaire for assessing the health-related quality of life (HRQoL) served as outcome variables. Furthermore, respondents stated their affection by vertigo during the last 7 days on a 5-point Likert scale. Regarding exposures, several validated instruments were deployed, such as the revised Life Orientation Test (LOT-R) to measure optimism or well-established items to assess risk attitudes or present orientation. By means of multivariate linear regression models, associated variables, which explain significant variance of each single HRQoL dimension as well as the calculated HRQoL score were identified. Moderating effects were estimated by separately adding interaction terms for each concept considered.
Ergebnisse / Results
Overall, 20.5% of the participants felt at least a little affected by vertigo in the last seven days before being interviewed. Regression analyses revealed a significant reverse relation between vertigo and HRQoL. Higher optimism, higher self-efficacy, being less anxious, having less comorbidities, being less depressive and lower disability were significantly associated with higher HRQoL (p < 0.001, R2 = 0.271). Regarding personal traits and preferences, present orientation interacted with vertigo in the main model (β = 40 1.73, p = 0.009), in the HRQoL score model and in the sub model for pain. The willingness to take health risks interacted with vertigo in the HRQoL score model as well as in the models for the dimensions mobility and pain. With respect to the dimensions pain and discomfort, the interaction between vertigo and self-efficacy was also significant.
Zusammenfassung / Conclusion
Based on findings from a large population-based sample, the present study provides new evidence on the moderating role of personality traits and particularly preference on the association between vertigo and lower HRQoL. Physicians involved in the therapy of vertigo may use this knowledge to develop more personalized programs to help their patients living well with their disease.