Time trends in depression prevalence and health-related correlates: results from population-based surveys in Germany 1997–1999 vs. 2009–2012

Abstract

BackgroundAlthough an “epidemic” of depression is frequently claimed, empirical evidence is inconsistent, depending on country, study design and depression assessment. Little is known about changes in depression over time in Germany, although health insurance companies report frequency increases. Here we examined time trends in depression prevalence, severity and health-related correlates in the general population.MethodsData were obtained from the mental health module of the “German Health Interview and Examination Survey for Adults” (2009–2012, n = 3265) and the mental health supplement of the “German National Health Interview and Examination Survey 1998” (1997–1999, n = 4176), excluding respondents older than 65. 12-month major depressive disorder (MDD), severity and symptoms were assessed based on the WHO Composite International Diagnostic Interview. Health-related quality of life (SF-36), self-reported sick days or days with limitations in normal daily life activities were examined, too. Calculations were carried out population-weighted. Additional age-standardized analyses were conducted to account for demographic changes.ResultsOverall, MDD 12-month prevalence remained stable at 7.4%. Women showed a shifted age distribution with increased prevalence at younger ages, and increasing MDD severity. Time trends in health-related correlates occurred both in participants with and without MDD. Mental health disability increased over time, particularly among men with MDD, reflected by the mental component score of the SF-36 and days with activity limitation due to mental health problems. Demographic changes had a marginal impact on the time trends.ConclusionsIn contrast to the ongoing international debate regarding increased depression rates in western countries, we found no increase in overall MDD prevalence in Germany over a long period. In conclusion, increased depression frequencies in national health insurance data and growing health care costs associated with depression are not attributable to overall prevalence changes at a population level. However, shifted age distribution and increased severity among women may reflect a rising depression risk within this specific subgroup, and changes in health-related correlates indicate a growing mental health care need for depression, particularly among men.Electronic supplementary materialThe online version of this article (10.1186/s12888-018-1973-7) contains supplementary material, which is available to authorized users.

Nehmen Depressionsdiagnosen bevölkerungsweit zu?

“…Während sich das Hilfesuchverhalten entwickelt, bleibt jedoch die Häufigkeit von Depressionen bei einer standardisierten Erfassung in der Bevölkerung in demselben Zeitraum in Deutschland [5] sowie international [8] stabil. Daher ist ein Zuwachs an Morbidität, der den steilen Anstieg ärztlicher Depressionsdiagnosen in den GKV-Daten allein erklären könnte, unwahrscheinlich.…”

“…Diese Entwicklung korrespondiert jedoch nicht mit einem entsprechenden Anstieg von Depressionsdiagnosen, wenn diese standardisiert und unabhängig von der Inanspruchnahme des Versorgungssystems in der Bevölkerung erfasst werden [5]. Vergleichbare Befunde werden auch international berichtet [6 -9] und u. a. als Veränderungen im Inanspruchnahmeverhalten von Menschen mit psychischen Störungen sowie Diagnoseund Codierverhalten der Behandelnden bei zeitlich stabiler Morbidität interpretiert.…”

Suicidality and associated social, demographic and clinical factors in Thai patients with acutely treated depressive disorder: a cross-sectional study

“…Another interesting issue is the lower mean age of the sample in this study compared with those of other studies, which may affect the level of suicidal behavior, and the results of this study also show that an age of 20 years or lower is associated with a higher level of suicide risk. Nowadays, depressive disorders can be found in the younger age groups, which is often associated with genetic factors and a family history of depression [29], can cause more severe symptoms [30], and may lead to higher rates of suicidality. A previous study found that pre-adult onset MDD patients (age lower than 18 years) were associated with a history of suicide attempts and current suicidal thoughts [31].…”

Mental health is biological health: Why tackling “diseases of the mind” is an imperative for biological anthropology in the 21st century

“…Most studies find that the prevalence of mood and anxiety disorders have remained constant over time (Bretschneider et al, ; Patten et al, ). From 1990 to 2010, for instance, the global prevalence of major depressive disorder (MDD) remained around 4.4% and for anxiety disorders was 4% (Baxter et al, ).…”