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Loneliness is a highly relevant public mental health issue. This work presents the validation of a single-item measure of loneliness and its subjective experience: \"I am frequently alone/have few contacts\". It can be used in large-scale population surveys where an economical assessment is of key importance. Data was drawn from two representative German population surveys conducted in early and late 2020 (combined N = 4,984; 52.9% women; age: M = 48.39 years (SD = 17.88)). We determined the prevalence of loneliness in men and women across different age groups. In order to test concurrent validity, bivariate correlation analyses and Chi-square tests were performed. Convergent and discriminant validity were tested by investigating intercorrelations of the single-item measure of loneliness with another loneliness measure, other mental health outcomes, and associations with sociodemographic characteristics. Based on the single-item measure, 23.4% of participants reported some degree of loneliness, 3.4% among them severe loneliness. Comparisons with the LS-S showed similar prevalence rates of loneliness. A moderately positive relationship between the two loneliness measures was found by bivariate correlation analysis (ρ = .57, p < .001), but results indicated only weak convergent validity. Construct validity was supported by associations with depressive symptoms, anxiety symptoms, satisfaction with life, household size, and partnership. Loneliness is frequently reported in the general population. The single-item measure of loneliness is suitable as a brief screening measure in population-based assessments.

Addressing the lack of population-based data the purpose of this representative study was to assess procrastination and its associations with distress and life satisfaction across the life span. A representative German community sample (1,350 women; 1,177 men) between the ages of 14 and 95 years was examined by the short form of the General Procrastination Scale (GPS-K; 1) and standardized scales of perceived stress, depression, anxiety, fatigue and life satisfaction. As hypothesized, procrastination was highest in the youngest cohort (14-29 years). Only in the youngest and most procrastinating cohort (aged 14 to 29 years), men procrastinated more than women. As we had further hypothesized, procrastination was consistently associated with higher stress, more depression, anxiety, fatigue and reduced satisfaction across life domains, especially regarding work and income. Associations were also found with lack of a partnership and unemployment. Findings are discussed with regard to potential developmental and cohort effects. While procrastination appears to be a pervasive indicator for maladjustment, longitudinal analyses in high-risk samples (e.g. late adolescence, unemployment) are needed to identify means and mechanisms of procrastinating.

Background The objectives of the study were to generate normative data for the Oslo Social Support Scale (OSSS-3) for different age groups for men and women and to further investigate the factor structure in the general population. Methods Nationally representative face-to face household surveys were conducted in Germany in 2008 ( n  = 2524). Results Normative data for the Oslo Social Support Scale were generated for men and women (52.3% female) and different age levels (mean age (SD) of 48.9 (18.3) years). Men had mean scores comparable to women (10.1 [SD = 2.3] vs. 10.2 [SD = 2.2]). The EFA resulted in a clear one-factor solution for the OSSS-3. Conclusions The normative data provide a framework for the interpretation and comparisons of social support with other populations.

While noise annoyance has become recognized as an important environmental stressor, its association to mental health has hardly been studied. We therefore determined the association of noise annoyance to anxiety and depression and explored the contribution of diverse environmental sources to overall noise annoyance. We investigated cross-sectional data of n = 15.010 participants of the Gutenberg Health Study (GHS), a population-based, prospective, single-center cohort study in Mid-Germany (age 35 to 74 years). Noise annoyance was assessed separately for road traffic, aircraft, railways, industrial, neighborhood indoor and outdoor noise (\"during the day\"; \"in your sleep\") on 5-point scales (\"not at all\" to \"extremely\"); depression and anxiety were assessed by the PHQ-9, resp. GAD-2. Depression and anxiety increased with the degree of overall noise annoyance. Compared to no annoyance, prevalence ratios for depression, respectively anxiety increased from moderate (PR depression 1.20; 95%CI 1.00 to 1.45; PR anxiety 1.42; 95% CI 1.15 to 1.74) to extreme annoyance (PR depression 1.97; 95%CI 1.62 to 2.39; PR anxiety 2.14; 95% CI 1.71 to 2.67). Compared to other sources, aircraft noise annoyance was prominent affecting almost 60% of the population. Strong noise annoyance was associated with a two-fold higher prevalence of depression and anxiety in the general population. While we could not relate annoyance due to aircraft noise directly to depression and anxiety, we established that it was the major source of annoyance in the sample, exceeding the other sources in those strongly annoyed. Prospective follow-up data will address the issue of causal relationships between annoyance and mental health.

Background The Perceived Stress Scale Cohen (J Health Soc Behav 24:385-96, 1983) is a widely and well-established self-report scale measuring perceived stress. However, the German version of the PSS-10 has not yet been validated. Thus, the purposes of this representative study were to psychometrically evaluate the PSS-10, and to provide norm values for the German population. Methods The PSS-10 and standardized scales of depression, anxiety, fatigue, procrastination and life satisfaction were administered to a representative, randomly selected German community sample consisting of 1315 females and 1148 male participants in the age range from 14 to 90 years. Results The results demonstrated a good internal consistency and construct validity. Perceived stress was consistently associated with depression, anxiety, fatigue, procrastination and reduced life satisfaction. Confirmatory factor analysis revealed a bi-dimensional structure with two related latent factors. Regarding demographic variables, women reported a higher level of stress than men. Perceived stress decreased with higher education, income and employment status. Older and married participants felt less stressed than younger and unmarried participants. Conclusion The PSS-10 is a reliable, valid and economic instrument for assessing perceived stress. As psychological stress is associated with an increased risk of diseases, identifying subpopulations with higher levels of stress is essential. Due to the dependency of the perceived stress level on demographic variables, particularly age and sex, differentiated norm values are needed, which are provided in this paper.

During the pandemic, the extent of subsequent mental health strains is an important issue. A representative face-to-face survey was conducted to assess mental health consequences in the general population and to identify mental health risk factors. In a representative German sample ( N  = 2,503), we assessed depression and anxiety symptoms by the PHQ-4 and loneliness by a validated item. An earlier survey (2018) which used the same methods and had comparable response rates served as comparison. Scores of depression and anxiety symptoms increased from an average of 0.89 ( SD  = 1.21) and 0.77 ( SD  = 1.17) in 2018 to 1.14 ( SD  = 1.23) and 1.05 ( SD  = 1.31) in 2020. Loneliness did not increase ( M  = 1.35, SD  = 0.68 in 2018; M  = 1.38, SD  = 0.78 in 2020), affecting about one in four participants to some degree. Younger participants and women were most likely to report depression, anxiety, and loneliness. As in the previous survey, social inequality factors contributed to distress and loneliness. The small overall increase of distress was consistent with recent German panel studies. In future studies and mental health interventions female sex, younger age, and socioeconomic disparities need to be considered as vulnerability factors for distress.

The COVID-19 pandemic led to a shutdown of universities in Germany. In a longitudinal design, we compared mental health (depression, anxiety, somatic complaints) of university students in Germany before (June to August 2019) and in the course of the COVID-19 pandemic (June 2020) and determined the impact of pandemic-related stress and loneliness on students’ mental health in self-report online surveys. We investigated 443 participants (mean age 22.8 years), among them 77% female, and 10.4% medical students. A small increase of depression mean scores was observed ( F (1,420) = 5.21; p  = .023), anxiety and somatic complaints have not significantly changed. There was a medium increase in loneliness from pre-pandemic scores to the pandemic situation ( F (1,423) = 30.56; p  < .001). Analyzed with regression analyses, current loneliness and pre-pandemic distress represented the strongest associations with mental health during the pandemic. Additionally, health-related concerns during the pandemic were associated with symptoms of depression [ b  = 0.21; 95%CI(0.08; 0.34); t  = 3.12; p  = .002], anxiety [ b  = 0.07; 95%CI(0.01; 0.12); t  = 2.50; p  = .013], somatic complaints [ b  = 0.33; 95%CI(0.18; 0.47); t  = 4.49; p  < .001], and loneliness [ b  = 0.10; 95%CI(0.03; 0.17); t  = 2.74; p  = .006]. Social stress due to the pandemic situation was associated with loneliness [ b  = 0.38; 95%CI(0.32; 0.45); t  = 11.75; p  < .001]. The results imply that university students represent a risk group for psychosocial long-term ramifications of the pandemic.

Background The growing prevalence of gambling-related problems underscores the importance of effective player protection measures and highlights gambling addiction prevention as a critical public health challenge. However, the perspective of gamblers has so far rarely been taken into account in the development of player protection measures in Germany. Furthermore, research indicates that gamblers’ awareness and use of available information and support services for gambling problems are relatively low to moderate. Methods To address this gap, a focus group study was conducted with a total of 19 gamblers to gather in-depth information into their views on player protection measures. Participants were screened for problem gambling behaviour using the Problem Gambling Severity Index prior to the discussions. Using a structured interview guide, participants were asked about their awareness and assessment of player protection measures as defined in the State Treaty on Gambling. They also evaluated various examples of both online and offline player protection information and suggested potential improvements. The interviews were recorded, transcribed and analysed through qualitative content analysis. Results Information and messages on player protection were barely noticed and did not address the actual information needs of gamblers. Participants reported that their memories of responsible gambling messages were often vague and superficial, many were unaware of available counselling services. The critique highlighted issues such as poor visibility on websites, excessive text content and the preponderance of advertising vs. responsible gambling messages. The study identifies key improvements for responsible gambling (RG) communication: increasing RG visibility, using concise messaging, including social media and videos, implementing interactive tools and personalized feedback, and employing proactive warnings. RG content should be developed by independent organizations to increase credibility. Conclusion Including gamblers in the development of player protection measures and messages, along with identifying their information needs, can contribute to the evidence-based discussion on player protection and enhance its effectiveness.

Background While loneliness has been regarded as a risk to mental and physical health, there is a lack of current community data covering a broad age range. This study used a large and representative German adult sample to investigate loneliness. Methods Baseline data of the Gutenberg Health Study (GHS) collected between April 2007 and April 2012 ( N  = 15,010; 35–74 years), were analyzed. Recruitment for the community-based, prospective, observational cohort study was performed in equal strata for gender, residence and age decades. Measures were provided by self-report and interview. Loneliness was used as a predictor for distress (depression, generalized anxiety, and suicidal ideation) in logistic regression analyses adjusting for sociodemographic variables and mental distress. Results A total of 10.5% of participants reported some degree of loneliness (4.9% slight, 3.9% moderate and 1.7% severely distressed by loneliness). Loneliness declined across age groups. Loneliness was stronger in women, in participants without a partner, and in those living alone and without children. Controlling for demographic variables and other sources of distress loneliness was associated with depression (OR = 1.91), generalized anxiety (OR = 1.21) and suicidal ideation (OR = 1.35). Lonely participants also smoked more and visited physicians more frequently. Conclusions The findings support the view that loneliness poses a significant health problem for a sizeable part of the population with increased risks in terms of distress (depression, anxiety), suicidal ideation, health behavior and health care utilization.

Glomerular filtration rate (GFR) declines with age by approx. 1 ml/min/m 2 per year beginning in the third decade of life. At 70 years of age > 40 ml/min/m 2 of GFR will be lost. Thus, factors affecting loss of GFR have significant public health implications. Furthermore, the definition of chronic kidney disease based on GFR may not be appropriate for the elderly. We analyzed factors affecting absolute and relative change of eGFR over a 5 year period in 12,381 participants of the Gutenberg Health Study. We estimated GFR at baseline and after 5 years of follow-up by two different equations. Association with the decline of estimated GFR (eGFR) was assessed by multivariable regression analysis. We confirmed a median loss of eGFR per year of approx. 1 ml/min/m 2 . Aside from albuminuria systolic blood pressure was most strongly associated with faster decline of eGFR followed by echocardiographic evidence of left ventricular diastolic dysfunction and reduced ejection fraction. White blood cell count showed a moderate association with eGFR loss. Diastolic blood pressure, serum uric acid and serum albumin were associated with slower GFR decline in multivariable analysis. Sensitivity analysis with exclusion of individuals taking diuretics, antihypertensive, antidiabetic, or lipid lowering drugs confirmed these associations.