The results provide evidence that perceptions of weight discrimination by individuals with obesity were common, and its negative consequences are highly relevant issues within society and need to be the focus of potential interventions. © 2015 World Obesity.

BackgroundIndividualized, outreach and structured multicomponent interventions are a promising intervention approach to relieve the burden of informal caregivers of people with dementia. In this study, we adapted and evaluated a multicomponent intervention (Resources for Enhancing Alzheimer’s Caregiver Health II, REACH II), which was developed in the USA, to the German health-care system. Therefore the project is called the German adaptation of REACH II (in German: Deutsche Adaptation der REACH II, DE-REACH).MethodsThe effectiveness of DE-REACH was examined in a randomized, controlled trial on 92 informal caregivers of people with dementia. The intervention comprised 12 individual two-weekly sessions (9 at home with the informal caregiver and 3 via telephone) and combined five modules. The reduction of the burden of the informal caregivers was chosen as the primary outcome.ResultsThe results showed a great stabilizing effect of the intervention on caregiver burden (effect size d = 0.91), that is, comparing pre- and post-measurements the burden decreased very slightly in the intervention group whereas it increased very strongly in the control group. After a three-month follow-up period this effect decreased from a great to a moderate effect. There were also improvements as a result of the intervention in somatization, health-related psychological quality of life and the reaction of the informal caregivers in response to challenging behaviors of the relative with dementia. Moreover, the frequency of challenging behaviors of the affected person itself was reduced in favor of the intervention.ConclusionThe findings of this study provide further evidence for the impact of multicomponent support interventions for informal caregivers of people with dementia.Clinical trial registration NCT01690117. Registered September 17, 2012.

Aim: Currently, health care professionals plead for stabilization of weight and improving health conditions rather than focusing on weight loss only. Individuals with obesity have been shown to report weight loss goals that are much higher than what has been suggested by guidelines. The aim was to determine whether weight discrimination and body dissatisfaction have an impact on how much weight an individual with obesity wants to lose. Methods: In this representative telephone survey, 878 participants with obesity were asked about their experiences with weight stigma, their body image concerns, and about the amount of weight they would like to weigh using random digital dialing and Kish selection grid to ensure random selection of participants. Results: Regression analysis reveals that being female, having a higher BMI, being younger, and trying to lose weight was related to a greater discrepancy between current weight and desired weight. The discrepancy between current weight and desired weight was greater when participants reported discrimination due to their weight as well as internalized stigma and body image concerns. Conclusion: Independent on the weight loss method, treating obesity should include realistic weight loss goals without being affected by social pressure or weight stigma, especially since stigma can result in further weight gain and decline health issues related to obesity and overweight.

Discrimination seems to be an ubiquitary phenomenon at least for some groups that are at special risk, such as heavier individuals and women. Our findings therefore emphasize the need for research and intervention on weight discrimination among adults with obesity, including anti-discrimination legislation.

Perceived weight discrimination was associated with increased depressive symptoms both directly and indirectly through situational coping strategies. Avoidant coping has the potential to exacerbate depressive symptoms, whereas problem-solving strategies were ineffective in dealing with experiences of weight discrimination. We emphasize the importance of coping strategies in dealing with experiences of weight discrimination and the need to distinguish between using a strategy and benefiting from it without detriment.

ZusammenfassungEine psychische Erkrankung bedeutet für viele Betroffene auch eine Auseinandersetzung mit den Reaktionen des Umfelds. Diese werden geprägt durch kulturell vorherrschende Vorstellungen von Ursache, Behandlung, Verlauf und biografischer Bedeutung der Krankheit. Der vorliegende Artikel gibt einen Überblick über die Entwicklung der Einstellungen der deutschen Bevölkerung zu psychischen Erkrankungen zwischen 1990 und 2020 mit Schwerpunkt auf Depression und Schizophrenie.Mit Blick auf die letzten 30 Jahre zeigt sich, dass die Einstellungen zu psychischen Erkrankungen nicht statisch sind, sondern vielmehr einer Dynamik unterliegen, die sich in Abhängigkeit vom Krankheitsbild erheblich unterscheiden kann. Zusammenfassend ruft eine Depression weitaus weniger negative Gefühle hervor, als es bei der Schizophrenie der Fall ist. Dieser Unterschied hat sich in den letzten 30 Jahren vergrößert: Menschen mit Depressionen treffen heute auf mehr Verständnis als vor 30 Jahren, während die Stigmatisierung von Menschen mit Schizophrenie zugenommen hat. Neben einer zunehmenden Offenheit im Umgang mit psychischen Belastungen haben sich auch Normalitätsvorstellungen und Konzepte von psychischer Krankheit verändert. Depressive Zustandsbilder werden heute stärker mit dem eigenen Erleben in Verbindung gebracht als noch vor 10 Jahren. Eine Schizophrenie erscheint den Menschen dagegen heute eher fremdartiger. Während die Empfehlung sowohl von Psychotherapie als auch von Medikamenten für die Behandlung psychischer Krankheiten zunimmt und sowohl Psychotherapeuten als auch Psychiater häufiger als Anlaufstelle empfohlen werden, nimmt die Empfehlung spiritueller Helfer (Pfarrer, Priester) seit den 1990er-Jahren ab. Wir diskutieren mögliche Ursachen und Konsequenzen dieser divergenten Entwicklungen.

Aims Help-seeking for mental health problems is facilitated and hindered by several factors at the individual, interpersonal and community level. The most frequently researched factors contributing to differences in help-seeking behaviour are based on classical socio-demographic variables, such as age, gender and education, but explanations for the observed differences are often absent or remain vague. The present study complements traditional approaches in help-seeking research by introducing a milieu approach, focusing on values and political attitudes as a possible explanation for differences in help-seeking for emotional mental health problems. Methods A representative cross-sectional survey of N = 3,042 respondents in Germany was conducted through face-to-face interviews about past help-seeking for mental health problems, socio-demographic characteristics and values and political attitudes Results Multivariate logistic regression analyses indicated that belonging to a cosmopolitan intellectual milieu group was significantly associated with an increased likelihood of past help-seeking for mental health issues (psychotherapeutic/psychological help-seeking [OR = 2.09, 95% CI: 1.11–3.93, p < 0.05) and primary care (OR = 2.21, 95% CI: 1.15–4.24, p < 0.05]), whereas members of individualist and conservative milieu groups were less likely to report having sought help from a psychotherapist, but not from a general practitioner. Increased odds ratios were also found for a number of socio-demographic variables, such as being aged 26 years and over, a female gender and more than 12 years of formal education. Associations between socio-demographic variables remained significant, and the explained variance of the used models improved considerably when milieu variables were added. Conclusions We discuss how milieu-specific patterns were relevant for explaining differences in mental health service use in addition to socio-demographic factors. It seems promising to consider help-seeking from a milieu perspective to improve disparities in access to and the use of psychotherapy as well as to resource allocation.