Zusammenfassung Die fortlaufende und systematische Beobachtung der Bevölkerungsgesundheit ist grundlegend für eine effektive Public-Health-Praxis. Angesichts der wachsenden Bedeutung psychischer Gesundheit für die Bevölkerungsgesundheit wird am Robert Koch-Institut eine Mental Health Surveillance für Deutschland aufgebaut. Deren Ziel ist es, kontinuierlich verlässliche Einschätzungen zur psychischen Gesundheit der Bevölkerung und ihrer Entwicklung zur Verfügung zu stellen. Aktuell werden 3 Surveillance-Strategien verfolgt: 1) Regelmäßige Bestandsaufnahmen sollen den psychischen Gesundheitszustand der Bevölkerung über eine Vielfalt an Indikatoren und Datengrundlagen umfassend beschreiben und langfristige Veränderungen aufzeigen. Sie knüpfen an bereits vorliegende Arbeiten aus Epidemiologie und Versorgungsforschung an. 2) Die hochfrequente Beobachtung einer Auswahl an Indikatoren dient der frühen Erkennung von Trends. 3) Das kontinuierliche Literaturreview erfasst monatlich die aktuelle Evidenzlage zur Entwicklung der psychischen Gesundheit in der COVID-19-Pandemie. Die beiden letzten Strategien entstanden in Reaktion auf veränderte Informationsbedarfe während der Pandemie. In diesem Beitrag werden die 3 Strategien, ihre Funktionen, Grenzen und Entwicklungspotenziale beschrieben und diskutiert. Vermittelt über verschiedene Formate der Berichterstattung können sie Handlungs- und Forschungsbedarfe im Bereich Public Mental Health aufzeigen. Bei weiterem Aufbau und Betrieb hat Mental Health Surveillance insgesamt das Potenzial, die Erreichung von Zielsetzungen im Bereich Public Mental Health zu unterstützen und auf verschiedenen Ebenen zur Verbesserung der gesundheitlichen Lage beizutragen.

Background:This rapid review examines changes in the mental health of the German child and adolescent population during the COVID-19 pandemic.Methods:The basis are 39 publications, which were identified by means of systematic literature search (until 19.11.2021) and manual search. The databases of the included publications were systematized with regard to their representativeness for the general population, and the indicators used were categorized with regard to the depicted constructs and their reliability.Results:The large majority of the studies took place at the beginning of the pandemic until the summer plateau 2020. Representative studies mainly reported high levels of pandemic-related stress, increases in mental health problems, and negative impacts on the quality of life. Non-representative studies showed mixed results. Vulnerable groups could only be identified to a limited extent. Both routine and care-related data showed declines in the outpatient and inpatient service utilisation during the various waves of the pandemic followed by catch-up effects. Children and adolescents turned out to be more vulnerable during the pandemic compared to adults, but their stress levels varied with the waves of the pandemic and the related containment measures.Conclusions:A future forward-looking crisis and pandemic management requires a close-knit and continuous surveillance of the mental health of children as well as an improved identification of risk groups.

IntroductionDuring the COVID-19 pandemic, questions about both consequences and helpful strategies to maintain quality of life (QoL) have become increasingly important. Thus, the aim of this study was to investigate the distribution of coping factors during the COVID-19 pandemic, their associations with QoL and the moderating role of certain sociodemographic characteristics.MethodsAnalyses were based on cross-sectional self-reports from German adult participants (N = 2,137, 18–84 years, 52.1% female) of the CORONA HEALTH APP Study from July 2020 to July 2021. Multivariate regression analyses were used to predict (a) coping factors assessed with the Brief COPE and (b) QoL assessed with the WHOQOL-BREF while taking measurement time, central sociodemographic, and health characteristics into account.ResultsDuring the COVID-19 pandemic, German adults mostly pursued problem- and meaning-focused coping factors and showed a relatively good QoL [Mean values (M) from 57.2 to 73.6, standard deviations (SD) = 16.3−22.6], except for the social domain (M = 57.2, SD = 22.6), and with a decreasing trend over time (β from −0.06 to −0.11, ps < 0.01). Whereas, escape-avoidance coping was negatively related to all QoL domains (β = −0.35, p < 0.001 for psychological, β = −0.22, p < 0.001 for physical, β = −0.13, p = 0.045 for social, β = −0.49, p < 0.001 for environmental QoL), support- and meaning-focused coping showed positive associations with various QoL domains (β from 0.19 to 0.45, ps < 0.01). The results also suggested differences in the pursuit of coping factors as well as in the strength of associations with QoL by sociodemographic characteristics. Escape-avoidance-focused coping was negatively associated with QoL levels in older and less educated adults (simple slopes differed at ps < 0.001), in particular.ConclusionsThe results demonstrated what types of coping may be helpful to avoid QoL deterioration (i.e., support- and meaning-focused coping) and provide implications for future universal or targeted health promotion (i.e., older or less educated adults who lack social or instrumental support) and preparedness in the face of unknown challenging societal situations similar to that of the COVID-19 pandemic. Cross-sectional trends of enhanced use of escape-avoidance-focused coping and QoL deterioration point toward a need for increased attention from public health and policy.

Background Times of crisis such as the COVID-19 pandemic are expected to compromise mental health. Despite a large number of studies, evidence on the development of mental health in general populations during the pandemic is inconclusive. One reason may be that representative data spanning the whole pandemic and allowing for comparisons to pre-pandemic data are scarce. Methods We analyzed representative data from telephone surveys of Germany's adults. Three mental health indicators were observed in ~1,000 and later up to 3,000 randomly sampled participants monthly until June 2022: symptoms of depression (observed since April 2019, PHQ-2), symptoms of anxiety (GAD-2), and self-rated mental health (latter two observed since March 2021). We produced time series graphs including estimated three-month moving means and proportions of positive screens (PHQ/GAD-2 score ≥ 3) and reports of very good/excellent mental health, as well as smoothing curves. We also compared time periods between years. Analyses were stratified by sex, age, and level of education. Results While mean depressive symptom scores declined from the first wave of the pandemic to summer 2020, they increased from October 2020 and remained consistently elevated throughout 2021 with another increase between 2021 and 2022. Correspondingly, the proportion of positive screens first decreased from 11.1% in spring/summer 2019 to 9.3% in the same period in 2020 and then rose to 13.1% in 2021 and to 16.9% in 2022. While depressive symptoms increased in all subgroups at different times, developments among women (earlier increase), the youngest (notable increase in 2021) and eldest adults, as well as the high level of education group (both latter groups: early, continuous increases) stand out. However, the social gradient in symptom levels between education groups remained unchanged. Symptoms of anxiety also increased while self-rated mental health decreased between 2021 and 2022. Conclusion Elevated symptom levels and reduced self-rated mental health at the end of our observation period in June 2022 call for further continuous mental health surveillance. Mental healthcare needs of the population should be monitored closely. Findings should serve to inform policymakers and clinicians of ongoing dynamics to guide health promotion, prevention, and care.

This rapid review examines how the mental health of adults in the general population in Germany changed during the COVID-19 pandemic. We conducted a systematic literature search and included 68 publications as of July 30 2021. The underlying studies were classified according to their suitability for representative statements for the general population and for estimating changes in mental health over time. In addition, the observation period and operationalisation of outcomes were considered. The first wave of infection and the summer plateau were mapped by 65% of the studies. Studies that were particularly suitable for representative statements due to their research design showed mixed results, which tend to indicate a largely resilient adult population with a proportion of vulnerable individuals. A predominantly negative development of mental health was described by results from more bias-prone study designs. Routine data analyses showed decreases in outpatient and especially inpatient care, increased use of a crisis service, mixed results for outpatient diagnoses, incapacity to work and mortality as well as indications of shifts in the spectrum of diagnoses. As the current evidence is ambiguous, generalised statements should be reflected in favour of a differentiated view. There is a need for research on the further course of the pandemic, specific risk groups and the prevalence of mental disorders.

Dieser Rapid Review untersucht Veränderungen der psychischen Gesundheit von Kindern und Jugendlichen in der Allgemeinbevölkerung in Deutschland während der COVID-19-Pandemie auf Grundlage von 39 Publikationen, die mittels systematischer Literaturrecherche (Stand 19.11.2022) und Handrecherche identifiziert wurden. Die Datengrundlagen der eingeschlossenen Publikationen wurden bezüglich ihrer Repräsentativität für die Allgemeinbevölkerung systematisiert, die verwendeten Indikatoren hinsichtlich der abgebildeten Konstrukte und ihrer Verlässlichkeit kategorisiert. Die große Mehrzahl der Studien bezog sich auf den Pandemiebeginn bis zum Sommerplateau 2020. Aus repräsentativen Studien wurde überwiegend ein hohes Ausmaß an pandemiebezogenen Belastungen, Zunahmen psychischer Auffälligkeiten und Beeinträchtigungen der Lebensqualität berichtet. Nichtrepräsentative Studien zeigten gemischte Ergebnisse. Vulnerable Gruppen ließen sich nur eingeschränkt identifizieren. Routine- und versorgungsbezogene Daten wiesen Rückgänge der ambulanten und stationären Inanspruchnahme während der Pandemiewellen mit Nachholeffekten aus. Kinder und Jugendliche erweisen sich in der Pandemie als vulnerabler im Vergleich zu Erwachsenen, ihre Belastung variierte jedoch mit den Pandemiewellen und den assoziierten Eindämmungsmaßnahmen. Ein zukünftiges vorausschauendes Krisen- und Pandemiemanagement erfordert eine engmaschige und kontinuierliche Surveillance der psychischen Kindergesundheit sowie eine bessere Identifikation von Risikogruppen.

Background:Study results on the impact of the COVID-19 pandemic on mental health in the first year of the pandemic are contradictory. The GEDA 2019/2020 study makes it possible to examine changes in depressive symptoms in the population. Methods:A standardised telephone interview was used to survey a random sample of the population in Germany aged 15 and older. To exclude seasonal effects, 10,220 interviewees from the period April 2019 to January 2020 were compared with 11,900 from the period April 2020 to January 2021. Depressive symptoms were assessed with the internationally established 8-item Patient Health Questionnaire (PHQ-8). Results:The prevalence of depressive symptoms decreased from 9.2% to 7.6% in the first year of the pandemic. Changes differ between women and men as well as between age and education groups. The analysis of individual symptoms suggests that it is not about a reduction of mental disorders of the depressive type in the narrower sense, but rather a decrease in stress-associated individual symptoms. Conclusions:The decrease in stress-associated depressive symptoms in parts of the population can be interpreted as an indication that pandemic-related changes in everyday life and the working environment may have had a positive effect on individual areas of mental health in certain groups, at least temporarily in the first year of the pandemic. The continuing strong social inequality in depressive symptoms to the disadvantage of low education groups confirms that the need for social situation-related health promotion and prevention with regard to the living and working conditions of socially disadvantaged people must not be lost sight of in times of pandemic. For groups in the population that partly showed a worsening of symptoms in this phase of the pandemic, e.g. the diminished ability to concentrate of very old men, targeted support options should be created in the future.

The COVID-19 pandemic has brought about great changes to the everyday lives of the population in Germany. Social distancing, working from home and other measures to contain the pandemic are essentially dominating everyday life. With data from the CORONA HEALTH App study we analysed the quality of life of the adult population in Germany during the COVID-19 pandemic and identified possible risk factors for a poor quality of life. In the app-based survey carried out between July and December 2020, 1,396 respondents (women 46.5%, men 52.7%, diverse 0.9%; mean age (mean) 42.0 years (standard deviation=13.4)) provided information on their quality of life using the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF). Univariate and multivariate regression was used to examine differences in quality of life between different groups of people during the COVID-19 pandemic and their associations with selected predictors. In summary, women, younger persons and job seekers or those who saw their work hours reduced or who could not pursue their regular jobs presented a lower quality of life in individual areas of life than the respective reference group. On the other hand, a setting that combines working from home and at the regular workplace, as well as living together with other people, showed partly positive associations with quality of life. The results have implications for public health interventions as they highlight groups requiring closer attention and sufficient support services.

Several governments introduced or promoted the use of contact-tracing apps during the ongoing COVID-19 pandemic. In Germany, the related app is called Corona-Warn-App, and by end of 2020, it had 22.8 million downloads. Contact tracing is a promising approach for containing the spread of the novel coronavirus. It is only effective if there is a large user base, which brings new challenges like app users unfamiliar with using smartphones or apps. As Corona-Warn-App is voluntary to use, reaching many users and gaining a positive public perception is crucial for its effectiveness. Based on app reviews and tweets, we are analyzing the public perception of Corona-Warn-App. We collected and analyzed all 78,963 app reviews for the Android and iOS versions from release (June 2020) to beginning of February 2021, as well as all original tweets until February 2021 containing #CoronaWarnApp (43,082). For the reviews, the most common words and n-grams point towards technical issues, but it remains unclear, to what extent this is due to the app itself, the used Exposure Notification Framework, system settings on the user's phone, or the user's misinterpretations of app content. For Twitter data, overall, based on tweet content, frequent hashtags, and interactions with tweets, we conclude that the German Twitter-sphere widely reports adopting the app and promotes its use.