Neurological and psychiatric diseases
Project goals
Neurological and psychiatric diseases form an important part of the NAKO examination programme. While neurological diseases often, but not exclusively, affect people at an advanced age and can be accompanied by considerable physical or cognitive limitations, mental illnesses, especially depression and anxiety disorders, often occur early in life and in all age groups. Mental health is essential for quality of life, performance and social participation. Mental health disorders are widespread and range from mild limitations of mental well-being to severe mental disorders.
The aim of the expert group is to process the resulting data from the NAKO in the field of neurological-psychiatric diseases through quality assurance of the raw data, to derive and categorise functional scores from the scales and examination results collected and to jointly carry out comprehensive data evaluations in the subject area. To this end, the expert group has set itself the following work programme:
1) Quality assurance of initial examination data and related publication (see below) of results of important scales, scores and examination procedures in the field of neurological and psychiatric diseases (completed since 1/2022)
2) Quality assurance of the data from the second study from the subject area (completed since 5/2025)
3) Validation of disease diagnoses from the initial examination from the subject area by comparison with health insurance diagnoses (for NAKO participants with corresponding consent, project ongoing)
4) Conducting joint analyses (initiated by several group members in each case) of questions on the frequency and development of depression and/or anxiety disorders, as well as selected neurological diseases, with the long-term aim of better understanding diseases and improving prevention strategies.
5) Scientific public relations by organising talks and symposia to inform the public as well as the German and international research community about the activities of the expert group and about the possibilities of using NAKO data for research purposes on neurological-psychiatric issues.
Points 1) and 2) have resulted in various classifications of scales or scores (e.g. domain scores and categorical classification of cognitive functions, categorical classification of headache types, classification of olfactory function), which are available for evaluations by data users. The group coordinators are available for counselling. Point 4) has already resulted in a number of publications and new ones are constantly being added (see below). As part of point 5), various symposia have already been organised by the expert group at the conferences of various specialist associations.
Speakers
Prof. Dr. Klaus Berger
Dr. Fabian Streit (Deputy Spokesperson)
Results
Selection:
Childhood traumas: Researchers were able to show that traumatic experiences in childhood were associated with a higher risk of physical and mental illness in adulthood.
Rheumatism and osteoarthritis: The study showed that people with inflammatory rheumatic diseases suffered more frequently from depression or anxiety disorders than people with osteoarthritis. However, there was no difference between the two groups in cognitive function tests.
Loneliness and the pandemic: 32 per cent of NAKO participants considered themselves lonely during the first lockdown in Germany – 26 per cent of men and 37 per cent of women. Older people were less affected than young people. Overall, 80 per cent of participants stated that they sometimes or often felt that they lacked the company of others.
Publications
Rodriguez FS, Röhr S, Dragano N, et al. Low income, being without employment, and living alone: how they are associated with cognitive functioning—Results from the German national cohort (NAKO). Aging, Neuropsychology, and Cognition. 2024:1-16. http://doi.org/10.1080/13825585.2024.2438825
Klinger-König J, Erhardt A, Streit F, et al. Childhood trauma and somatic and mental illness in adulthood—findings of the NAKO health study. Deutsches Ärzteblatt international. 2024. http://doi.org/10.3238/arztebl.m2023.0225
Callhoff J, Berger K, Albrecht K, Strangfeld A. Depression, anxiety and cognitive function in persons with inflammatory rheumatic diseases: cross-sectional results from the German National Cohort (NAKO). RMD Open. 2024;10(4):e004808. http://doi.org/10.1136/rmdopen-2024-004808
Stein J, Pabst A, Berger K, et al. Mental health of individuals with pre-existing mental illnesses at the beginning of the COVID-19 pandemic: results of the German National Cohort (NAKO). Front Public Health. 2024;12:1451631. http://doi.org/10.3389/fpubh.2024.1451631
Streit F, Völker MP, Klinger-König J, et al. The interplay of family history of depression and early trauma: associations with lifetime and current depression in the German national cohort (NAKO). Front Epidemiol. 2023;3:1099235. http://doi.org/10.3389/fepid.2023.1099235
Streit F, Zillich L, Frank J, et al. Lifetime and current depression in the German National Cohort (NAKO). The World Journal of Biological Psychiatry. 2023;24(10):865-880. http://doi.org/10.1080/15622975.2021.2014152
Kleineidam L, Stark M, Riedel-Heller SG, et al. The assessment of cognitive function in the German National Cohort (NAKO) – Associations of demographics and psychiatric symptoms with cognitive test performance. The World Journal of Biological Psychiatry. 2023;24(10):909-923. http://doi.org/10.1080/15622975.2021.2011408
Schmiedek F, Kroehne U, Goldhammer F, et al. General cognitive ability assessment in the German National Cohort (NAKO) – The block-adaptive number series task. The World Journal of Biological Psychiatry. 2023;24(10):924-935. http://doi.org/10.1080/15622975.2021.2011407
Erhardt A, Gelbrich G, Klinger-König J, et al. Generalised anxiety and panic symptoms in the German National Cohort (NAKO). The World Journal of Biological Psychiatry. 2023;24(10):881-896. http://doi.org/10.1080/15622975.2021.2011409
Koschig, M, Conrad I, Berger K, Baune BT, Grabe H, Gerstorf D, Meinke-Franze C, Völzke H, Mikolajczyk R, Leitzmann M, Fricke J, Keil T, Koch-Gallenkamp L, Perna L, Obi N, Pabst A, Riedel-Heller S: The mediating role of personality traits in the association between childhood trauma and depressive symptoms in young adulthood. J Affect Dis 338 (2023), 373-379. doi: 10.1016/j.jad.2023.06.027
Berger K, Rietschel M, Rujescu D: The value of ‘mega cohorts’ for psychiatric research. World J Biol Psychiatry (2022), 1-5, doi: 10.1080/15622975.2021.2011405
Klinger-König J, Streit F, Erhard A, Kleineidam L, Schmiedek F, Schmidt B, NAKO Investigators, Wagner M, Deckert J, Rietschel M, Berger K, Grabe HJ: The Assessment of Childhood Maltreatment and its Associations with Affective Symptoms in Adulthood: Results of the German National Cohort. World J Biol Psychiatry (2022), 1-12. doi: 10.1080/15622975.2021.2011406
Berger, K., Riedel-Heller, S., Pabst, A. et al. Einsamkeit während der ersten Welle der SARS-CoV-2-Pandemie – Ergebnisse der NAKO-Gesundheitsstudie. Bundesgesundheitsbl 64, 1157–1164 (2021). https://doi.org/10.1007/s00103-021-03393-y