DZPG targets risk factors

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24.06.2024 13:07

Using research to reduce mental illnesses in children and adolescents: DZPG targets risk factors

Up to 20 percent of children and young people in Germany have a mental disorder. But not all children are equally at risk. The German Center for Mental Health (DZPG) is conducting many projects specifically for groups affected by risk factors. The aim is to make earlier diagnoses and to create a broad network of prevention and support services for every age group in Germany.

“Mental illnesses are one of the most important health problems in Germany. Prevention measures can help protect some children and young people. The DZPG is committed to this with translational research,” emphasizes Prof. Dr. Peter Falkai, Director of Psychiatry and Psychotherapy at the LMU Clinic and spokesperson for the DZPG in Munich.

Anxiety disorders, hyperkinetic syndrome, learning disorders, depression, addictions and eating disorders: the list of mental disorders that affect children and young people is significant. If mental problems are not treated in childhood and adolescence, they often continue into adulthood. “One in five children and young people is affected by mental disorders,” says Falkai. “In adults, the proportion rises to one in four. This makes mental illness one of the greatest challenges in the medical field.”

Risk factor growing up: The risk of mental illness increases with age

As they get older, adolescents are exposed to stress through graduating from school, training, establishing their own social groups and finding social roles. But the risk of mental illness does not arise solely from the maturation process. Research at the DZPG focuses on specific risk factors. Falkai explains: “During the corona pandemic with contact restrictions, loneliness and more domestic violence, the number of mental disorders among children and adolescents has increased significantly.” The increase is documented by a study by the BKK umbrella association on behalf of the Children’s Health Foundation. It shows that in the pandemic years 2020 and 2021, 15- to 19-year-old female insured persons in particular suffered from mental symptoms. Anxiety and adjustment disorders were observed more frequently than average.¹ And the next crisis is long overdue: “We are also observing an increase in post-traumatic stress disorders and depression in the case of external stressors such as armed conflicts.”

Prevention comes before treatment

“Numerous research projects within the DZPG are aimed at prevention,” says Prof. Falkai. “Even before many mental disorders appear, those affected develop their first symptoms.” In practice, these first signs often look unspecific from the outside: “These include sleep disorders, inner restlessness and physical complaints such as stomach, head and back pain. Ultimately, this development can flow into anxiety disorders. A deterioration in concentration and thus in school performance is also frequently observed.” Here, too, experts are registering growing numbers of cases: among school children, potentially psychosomatic complaints such as headaches, stomach and back pain, but also problems falling asleep and depression have increased significantly over the years. This is a result of the WHO’s Health Behavior in School-aged Children (HBSC) study.²

Preventing mental illness in young people

The DZPG’s research into primary prevention is aimed at this preliminary phase: the aim is to reduce the likelihood that children and young people will develop mental disorders. Prof. Dr. Andreas Meyer-Lindenberg, Director of the Central Institute of Mental Health in Mannheim and DZPG spokesman, explains: “The first step is to measure mental health in the first place. Such a measurement is currently being implemented by the DZPG at the Bochum site with the German Health Barometer. For this purpose, a representative sample of the population is regularly surveyed about their mental well-being. In this way, changes in the mental health of the population – for example during an economic crisis or pandemic – can be measured in order to take measures if necessary to prevent it from tipping over.”

Research for children at increased risk

The risk of mental illness is not the same for all children and young people in Germany: “We know risk factors that can trigger or worsen mental illnesses. This includes premature birth,” says Falkai. This circumstance is the focus of the DZPG site in Tübingen. There, the families of premature babies are closely monitored as part of an early detection program in order to identify possible early symptoms of mental illness and reduce the stress in the family caused by the premature birth. At the same time, a large cohort of twins is being followed in order to understand risk and resilience factors here too, to identify early symptoms and to offer intervention options.

But risks also arise in the further course of the disease. Prof. Dr. Dr. Andreas Heinz, Director of the Clinic for Psychiatry and Psychotherapy CCM at the Charité – Universitätsmedizin Berlin and spokesperson for the DZPG: “One factor is socioeconomic status, especially with regard to barriers to access to health care, but also mental health literacy: How much do I know about mental health?” A particular risk factor for mental disorders is growing up in urban areas and unemployment of one or both parents. Minority status is also a risk factor. This is why the DZPG started a project in the Wattenscheid district of Bochum. An above-average number of people live there in precarious conditions, with a migrant background or affected by unemployment. The Research and Treatment Center for Mental Health (FBZ) at the Ruhr University Bochum is developing a new prevention concept under the motto “Urban Mental Health” (UMH). For the first time, it brings together science, politics and practice to sustainably improve the mental health of children and young people. The project is aimed at the mental health of teachers, who are to increase their resilience and a curriculum for students to increase their mental health literacy. If successful, it could become a blueprint for the whole of Germany.

Risk factor: psychological problems of parents

At the FU Berlin, researchers are focusing on children of parents who experience difficulties in dealing with their children due to their own psychological stress. This can mean, for example, that one or more parents have a mental illness (e.g. depression or anxiety disorders) or that only limited social or financial resources are available. Research shows that such stress can be accompanied by increased parental stress, which in turn can make communication and dealing with one’s own children more difficult. An app is currently being developed as a low-threshold offering that enables parents to strengthen their own mental health and promote positive parenting behavior.

Earlier diagnoses for an easier start into adult life

But the DZPG is also researching secondary prevention, the improvement of treatment opportunities through early detection of illnesses. Falkai: “The DZPG is currently evaluating centers for early detection and initial treatment of mental illnesses and wants to improve the information available to the population.” The goal: children, young people and their families should have competent early detection centers that specialize in mental disorders as contact points. “Only experts can distinguish symptoms that indicate a mental illness from those that appear as part of normal maturation and development processes.”

About the DZPG

Since May 2023, experts at the German Center for Mental Health (DZPG) have been working to improve the mental health of the population and destigmatize mental illnesses through joint research. At six locations in Germany, researchers and clinicians work together with experienced experts, i.e. those affected and those close to them, as well as international scientists. At www.dzpg.org, interested parties can find information about the organization, research projects and goals as well as informative texts and helpful links on the subject of mental health.

Sources

Children’s Health Report 2023 of the Children’s Health Foundation: https://www.kindergesundheit.de/Die-Stiftung/Kindergesundheitsberichte/Kinderges…

Health Behaviour in School-aged Children (HBSC) study, WHO: https://www.who.int/europe/initiatives/health-behaviour-in-school-aged-children-…

Scientific contacts:

Prof. Dr. Peter Falkai, Director of Psychiatry and Psychotherapy at the LMU Clinic, [email protected]

Pictures

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Prof. Dr. Peter Falkai, spokesman for the DZPG Munich-Augsburg location

© DZPG

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Biology, Society, Medicine, Education, Psychology
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