Selected Joint Projects
MultiCare Research Network
Central focus of the MultiCare Research Network has been and still is the research of multi-morbidity, i.e., the simultaneous presence of several chronic medical conditions in one person over a longer period of time.
The goals of the studies can be described as follows:
- Examination of the internal links of medical conditions in cases of multi-morbidity: specific combinations, interactions between medical conditions, developments over the course of time.
- Examination of the consequences of multi-morbidity for the patients (burden of disease, quality of life, functional status etc.)
- Identification of personal and social markers (risk factors and resources) of patients for developing and coping with multi-morbidity.
- Examination of the health care services utilisation by multimorbid patients and the resulting costs.
- Strategy trials to improve the medical care provided by the general practitioners (GPs) of multimorbid patients.
psychenet - The Hamburg Network for Mental Health
psychenet consists of eleven sub-projects.
Five sub-projects promote mental health in Hamburg across different areas of disease. This is achieved by improving knowledge about mental illnesses in the population and and by fostering occupational health. Moreover, the projects aim to improve GP care and to integrate patients and their family members.
- Sub-project I: Awareness and education about mental illness
- Sub-project II: Communication platform and interactive internet portal
- Sub-project III: Occupational health management
- Sub-project IV: Self-management in GP care
- Sub-project V: Peer counselling/ Self-help and family help
In addition, there are five disease-specific health networks which aim to improve the structure, effectiveness and economic efficiency of healthcare provision for patients with mental illnesses. The health networks are concentrated on important mental illnesses.
- Sub-project VI: Health network psychosis
- Sub-project VII: Health network depression - stepped care
- Sub-project VIII: Health network somatoform and functional disorders
- Sub-project IX: Health network anorexia and bulimia
- Sub-project X: Addiction illnesses in adolescence
An overriding sub-project serves purposes of methodological quality assurance and scientific evaluation of the general project and the individual sub-projects.
- Subproject XI: Methodological quality assurance and evaluation
Childhood Abuse and Neglect as a cause and consequence of Substance Abuse – The CANSAS-Network
2012-2016; German Ministry for Education and Research
Substance use disorders (SUD) belong to the most frequent behavioural consequences of childhood abuse and neglect (CAN). Lifetime diagnoses of SUD are found in about 20% of adult survivors of CAN in community samples and in 30% of individuals who seek treatment for the consequences of CAN. Conversely, 24% - 67% of all patients in treatment for SUD have a history of CAN, which makes them one of the groups with the highest burden of CAN in the health care system. Moreover, parental substance abuse and dependence is one of the most important risk factors for the perpetration of CAN. Studies of court registers indicate that about 40% to 60% of all significant CAN cases involve parents with substance use problems.
Recent findings suggest that psychological and biological mechanisms involved in the regulation of stress and emotions might mediate the relationship between CAN and the later development of SUD. Emotion regulation deficits are also a risk factor for the perpetration of CAN by parents with SUD, but other factors, some of them more specific for SUD populations, are also of importance. Regarding both perspectives, CAN as cause and as a consequence of SUD, a better understanding of relevant mediators and risk factors is necessary, to improve prevention and develop adequate treatments.This is all the more important, as patients with (comorbid) SUD often do not fit in current treatment models for the consequences of CAN. Because of the high prevalence of (comorbid) SUD, this represents a substantial gap in the provision of services for survivors. Only few treatments for Posttraumatic Stress Disorder (PTSD) and other consequences of CAN for patients with SUD exist so far. A present-focused cognitive-behavioural treatment (“Seeking Safety”) has been shown to be effective in the US. Trauma-focused treatments, although not widely used in patients with SUD, also proved effective in first studies and need to be further adapted to this population.
Given the high prevalence of SUD in survivors of CAN, and its important role as a risk factor for the perpetration of CAN, the objectives of the proposed network (“CANSAS”) are
1.) to gain a better understanding of the relationships between these two important public health problems,
2.) to provide evidence-based treatments for survivors of CAN with SUD, and
3.) to provide services with trainings to improve the assessment of CAN among clients with SUD assess risk factors for the perpetration of CAN in this population.
In a multi-disciplinary approach, the CANSAS-network brings together experts in the fields of trauma treatment for patients with (comorbid) SUD, epidemiology and risk factor research, biological and psychological moderators, as well as health services research, and will collaborate with leading international experts.
CANSAS will have the opportunity to build on existing collaborations in the federal state of Hamburg and therefore get the chance to act as a regional model on how to sustainably implement structures to screen for, prevent and treat CAN and SUD in German health care services.