{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T18:34:23Z","timestamp":1772994863454,"version":"3.50.1"},"reference-count":45,"publisher":"BMJ","issue":"12","funder":[{"DOI":"10.13039\/501100003107","name":"Bundesministerium f\u00fcr Gesundheit","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003107","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2018,10,12]]},"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Lifestyle risk factors, such as drinking or unhealthy diet, can expotentiate detrimental health effects. Therefore, it is important to investigate multiple lifestyle risk factors instead of single ones. The study aims at: (1) identifying patterns of lifestyle risk factors within the adult general population in Germany and (2) examining associations between the extracted patterns and external factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross-sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>General German adult population (aged 18\u201364 years).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Participants of the 2015 Epidemiological Survey of Substance Abuse (n=9204).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary outcome measures<\/jats:title>\n                    <jats:p>Lifestyle risk factors (daily smoking, at-risk alcohol consumption, unhealthy diet, low physical activity, weekly use of pharmaceuticals, as well as consumption of cannabis and other illicit drugs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A latent class analysis was applied to identify patterns of lifestyle risk factors, and a multinomial logistic regression was carried out to examine associations between the extracted classes and external factors. A total of four classes were extracted which can be described as healthy lifestyle (58.5%), drinking lifestyle (24.4%), smoking lifestyle (15.4%) and a cumulate risk factors lifestyle (1.7%). Individuals who were male, at younger age and single as well as individuals with various mental health problems were more likely to show multiple lifestyle risk factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Healthcare professionals should be aware of correlations between different lifestyle risk factors as well as between lifestyle risk groups and mental health. Health promotion strategies should further focus especially on younger and single men.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2018-022184","type":"journal-article","created":{"date-parts":[[2018,12,20]],"date-time":"2018-12-20T07:27:46Z","timestamp":1545290866000},"page":"e022184","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":29,"title":["Patterns of multiple lifestyle risk factors and their link to mental health in the German adult population: a cross-sectional study"],"prefix":"10.1136","volume":"8","author":[{"given":"Josefine","family":"Atzendorf","sequence":"first","affiliation":[{"name":"Department for Epidemiology and Diagnostic, IFT Institut f\u00fcr Therapieforschung, Munich, Germany"},{"name":"Medical Sociology, Institute of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3805-8219","authenticated-orcid":false,"given":"Christian","family":"Apfelbacher","sequence":"additional","affiliation":[{"name":"Medical Sociology, Institute of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Gomes de Matos","sequence":"additional","affiliation":[{"name":"Department for Epidemiology and Diagnostic, IFT Institut f\u00fcr Therapieforschung, Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ludwig","family":"Kraus","sequence":"additional","affiliation":[{"name":"Department for Epidemiology and Diagnostic, IFT Institut f\u00fcr Therapieforschung, Munich, Germany"},{"name":"Department of Public Health Sciences, Stockholm University, Stockholm, Sweden"},{"name":"Institute of Psychology, ELTE, E\u00f6tv\u00f6s-Lor\u00e1nd-Universit\u00e4t, Budapest, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela","family":"Piontek","sequence":"additional","affiliation":[{"name":"Department for Epidemiology and Diagnostic, IFT Institut f\u00fcr Therapieforschung, Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,12,19]]},"reference":[{"key":"2025121514142771000_8.12.e022184.1","unstructured":"World Health Organisation,. 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