Christoph Correll forscht am Einstein Center for Population Diversity zu den Auswirkungen wachsender Bevölkerungsvielfalt auf soziale Ungleichheit und Gesundheitsdisparitäten. Der Fokus liegt auf der Rolle von Familien als zentrale Orte, wo Ungleichheiten zwischen und innerhalb von Generationen entstehen und weitergegeben werden — dabei untersucht er auch verändernde Familienkonzepte und -strukturen. Für Unternehmen und öffentliche Institutionen relevant sind Erkenntnisse über Mechanismen sozialer Ungleichheit, die bei der Gestaltung von Sozial-, Bildungs- und Gesundheitspolitik sowie bei der Entwicklung inklusiver Organisationsstrukturen anwendbar sind.
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Christoph Correll
HU-FIS-Profil ↗The Einstein Center for Population Diversity (ECPD) will study the consequences of increasing population diversity for social inequality and health disparities by focusing on the growing diversity of families, including changing conceptions and boundaries of the family itself. The family is a crucial, if not the primary, arena where inequalities are (re-)produced within and across generations, in and through the continuous interaction with social policy, the labor market, and educational institutions. Thus, changing family patterns and behavior are both a source of growing population diversity on the societal level and a driver of social inequality and wellbeing on the individual and household level. For example, when people get married, have children and divorce, they define the population structure. Union formation, marriage and union dissolution also have, however, immediate consequences for socialinequality, poverty, wellbeing and health of individuals and households. The strong relation between family patterns or family behavior and social inequality is maybe most obvious in the case of the large fraction of women who transit into poverty and welfare dependence after separation and divorce. It was also very evident during the COVID-19 pandemic, when families took over many tasks that are usually performed by the welfare state including care for children and care-dependent older adults. While this development was instrumental in maintaining key societal functions, it also put many families under intense pressure and strain, depending on the individual family constellation and its resources. The pandemic thus illustrates how families become the “place” where causes and consequences of population diversity and societal challenges play out. The ECPD will transcend disciplinary silos by linking biomedical sciences and social sciences to conduct collaborative research on the interrelations between family diversity, health, education, and social inequalities in aging societies. This will be done by a group of leading scholars in demography, sociology, medicine, psychology, and health sciences. The ECPD will be thus uniquely situated to investigate the biological, psychological, social, and environmental pathways and mechanisms as well as their interrelations operating at the family level. To unravel the longitudinal nature of the intra- and intergenerational effects of diversity in family trajectories and patterns, the ECPD will be committed to a holistic life course approach. Further, as a cross-cutting theme, the ECPD will investigate the role of global and regional crises and their multiple relations with population and family diversity. We will combine household panel data and register-based information with biomarker and genetic data to better understand biosocial pathways along the life course.
Molecular Psychiatry · DOI
Most mental disorders have a typical onset between 12 and 25 years of age, highlighting the importance of this period for the pathogenesis, diagnosis, and treatment of mental ill-health. This perspective addresses interactions between risk and protective factors and brain development as key pillars accounting for the emergence of psychopathology in youth. Moreover, we propose that novel approaches towards early diagnosis and interventions are required that reflect the evolution of emerging psychopathology, the importance of novel service models, and knowledge exchange between science and practitioners. Taken together, we propose a transformative early intervention paradigm for research and clinical care that could significantly enhance mental health in young people and initiate a shift towards the prevention of severe mental disorders.
Current Opinion in Psychiatry · DOI
PURPOSE OF REVIEW: Eating disorders are associated with numerous medical complications. The aim of this study was to review recent progress in improving the medical management of patients with eating disorders. RECENT FINDINGS: With close medical monitoring and electrolyte supplementation, accelerated refeeding protocols improve weight restoration without increasing the risk of refeeding syndrome. Olanzapine improves weight restoration better than placebo, without leading to adverse metabolic effects seen in individuals not in starvation. Alterations of the gut microbiome in anorexia nervosa have been demonstrated, but their clinical relevance remains unclear. SUMMARY: Medical complications of eating disorders may facilitate the first contact with health professionals and treatment initiation. Medical complications of anorexia nervosa generally occur due to starvation, malnutrition and their associated physiological effects, whereas medical complications of bulimia nervosa are generally due to purging behaviors. Most medical complications in patients with binge eating disorder are secondary to obesity. Most medical complications of eating disorders can be effectively treated with nutritional management, weight normalization and the termination of purging behaviors. In summary, eating disorders are associated with many medical complications that have to be carefully assessed and managed as early as possible to improve long-term outcomes.
BMC Psychiatry · DOI
BACKGROUND: Minimal/non-response to antipsychotic treatment, and persistent positive symptoms despite treatment, are common among patients with schizophrenia. The aim of this study was to characterize a US treatment-resistant schizophrenia (TRS) population in terms of patient demographics, burden of symptoms, treatment history, and factors influencing therapeutic choice. METHODS: In an online survey, 204 psychiatrists self-selected and completed three patient records: two TRS and one schizophrenia ('non-TRS'). RESULTS: Respondents reported that 29.5% of their schizophrenia caseload had TRS. Selected TRS (n = 408) vs non-TRS (n = 204) patients were more likely to be unemployed (74.5% vs 45.1%, p < 0.001), hospitalized at least once (93.4% vs 74.0%, p < 0.001), and to have physical/psychiatric comorbidities including obesity (40.2% vs 23.5%, p < 0.001) and depression (38.7% vs 25.0%, p = 0.001). Psychiatric symptoms were more frequent and severe in TRS, and interfered more with social and functioning domains. Of positive symptoms, eliminating delusions and hallucinations was considered most important to improve a patient's long-term prognosis. In TRS, clozapine monotherapy was the most common treatment (15.9%), though ranked fifth of ten options to treat TRS. Psychiatrists typically increased the antipsychotic dose or added a second antipsychotic before initiating clozapine or switching antipsychotics. Antipsychotic switches were most commonly due to lack of efficacy (TRS = 71.4% vs non-TRS = 54.3%, p < 0.001) and intolerability (34.4% vs 38.4%, p = 0.22) with the prior antipsychotic. Persistent hallucinatory behavior was the top symptom leading to treatment switches in TRS (63.9% vs 37.1%, p < 0.001). CONCLUSIONS: According to psychiatrists, symptoms have a greater clinical burden on patients with TRS than non-TRS. TRS is commonly managed by antipsychotic dose increases/combinations, with clozapine the fifth preference despite being the only approved TRS medication. New treatments are needed for patients who do not respond to available antipsychotics.