Respondents’ report of a clinician-diagnosed depression in health surveys: comparison with DSM-IV mental disorders in the general adult population in Germany

Abstract

BackgroundRespondents’ report of a previously diagnosed depression by a health professional is frequently used to estimate depression prevalence. This study contributes to a better understanding of survey results based on this measure by comparing it with a comprehensive standardized diagnostic interview.MethodsData came from the cross-sectional nationwide German Health Interview and Examination Survey for Adults (DEGS1) and its mental health module (DEGS1-MH, n = 4483). In DEGS1, participants were asked whether they have been diagnosed with depression by a physician or psychotherapist (last 12-month). DSM-IV-based 12-month major depressive disorder (MDD) and other mental disorders were assessed with the German version of the Composite International Diagnostic Interview (CIDI). Time lag between both assessments was 6 weeks (median).Results73.4% of participants reporting clinician-diagnosed depression met criteria for any mental disorder in the CIDI (any affective disorder: 51.8%, any anxiety disorder: 54.7%). The proportion of participants reporting a clinician-diagnosed depression who met MDD criteria was highest among those aged 18–29 years (62.6%) and decreased with age (65–79 years: 29.8%). Among participants with MDD, the proportion with clinician-diagnosed depression was 33.0%, highest among those aged 45–64 years (49.3%) and lowest among those aged 18–29 years (22.7%) and 30–44 years (20.3%). MDD severity was positively associated with clinician-diagnosed depression.ConclusionsRespondents’ report of a clinician-diagnosed depression and major depression assessed with the CIDI substantially differ. Concordance of both measures varies with age and severity of depressive symptoms. Health surveys should assess a range of depression indicators in order to cover a wide spectrum.Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-017-1203-8) contains supplementary material, which is available to authorized users.

Persistent depressive disorder across the adult lifespan: results from clinical and population-based surveys in Germany

“…Moreover, findings from national health care data suggest that the validity of medical depression diagnoses are questionable, particularly in primary care [62], and that improving treatment targeting [63,64] and treatment quality [19,[65][66][67][68] are desirable. In conclusion, these findings highlight the need for national public health initiatives in Germany to reduce barriers to accessing mental health care services in general and in individuals with low education in particular, to strengthen awareness using targeted information campaigns, and to improve the quality of medical recognition and specialized treatment provision for depression and its different courses.…”

Measuring The Lifetime Costs Of Serious Mental Illness And The Mitigating Effects Of Educational Attainment

“…This is consistent with prior research showing that self-reports of depression in conjunction with other mental health conditions are reliable proxies for major depressive disorder. (21,22) Appendix Table A3 shows that this approach yields a conservative estimate of the burden of SMI. To access the Appendix, click on the Appendix link in the box to the right of the article online.…”

Nehmen Depressionsdiagnosen bevölkerungsweit zu?

“…Grundsätzlich kann keine Schließung spezifischer Versorgungslücken nachgewiesen werden, die bspw. für junge Menschen (vor allem Frauen) diskutiert werden [31,32] und einen differenziellen Zuwachs in dieser Bevölkerungsgruppe als wünschenswert nahelegen würden. Im Gegensatz zu den vorliegenden Ergebnissen zeigt sich diese Entwicklung in GKV-Analysen administrativer Depressionsdiagnosen auf Basis eines längeren Beobachtungszeitraums (2005 -2016) [17] sowie in Befragungsdaten zur fachärztlichen Inanspruchnahme psychiatrischer und psychotherapeutischer Behandlung [16], die auf besondere Zuwächse im jungen Erwachsenenalter hinweisen.…”