Trends in prevalence of depression in Germany between 2009 and 2017 based on nationwide ambulatory claims data.
Journal
Journal of affective disorders
ISSN: 1573-2517
Titre abrégé: J Affect Disord
Pays: Netherlands
ID NLM: 7906073
Informations de publication
Date de publication:
15 06 2020
15 06 2020
Historique:
received:
23
09
2019
revised:
21
01
2020
accepted:
25
03
2020
entrez:
2
6
2020
pubmed:
2
6
2020
medline:
16
2
2021
Statut:
ppublish
Résumé
Studies based on health insurance funds unanimously indicate a rise in administrative prevalence of depression, while population surveys with standardized diagnostic procedures do not. We describe recent trends in the prevalence of depressive disorders as diagnosed in routine care from 2009-2017 in Germany. We used nationwide ambulatory claims data from all residents with statutory health insurance, covering 87% of the total population. Cases were defined as persons with at least one documented diagnosis of depression (ICD-10-GM codes: F32, F33 or F34.1). The administrative prevalence was computed for each year according to age, sex, degree of urbanization and severity of depression diagnosis. The prevalence increased from 12.5% in 2009 to 15.7% in 2017 (+26%). Overall, women were twice as likely as men to receive a diagnosis, although the prevalence increased more strongly in men compared to women (+40% vs. +20%). Age- and sex-stratified analyses revealed the highest prevalence increase in adolescents and young men at the ages of 15-19 years (+95%) and 20-25 years (+72%). Rural areas with a low population density showed the highest rise in administrative prevalence (+34%), while big urban municipalities showed the lowest (+25%). Administrative claims data rely on diagnoses coded for billing purposes and thus depend on coding practice as well as patients' help seeking behavior. Depressive disorders are of increasing importance in ambulatory health care in Germany. Parts of the increase may be attributed to changing cultural constructions of mental health along with the expansion of mental health care supply.
Sections du résumé
BACKGROUND
Studies based on health insurance funds unanimously indicate a rise in administrative prevalence of depression, while population surveys with standardized diagnostic procedures do not. We describe recent trends in the prevalence of depressive disorders as diagnosed in routine care from 2009-2017 in Germany.
METHODS
We used nationwide ambulatory claims data from all residents with statutory health insurance, covering 87% of the total population. Cases were defined as persons with at least one documented diagnosis of depression (ICD-10-GM codes: F32, F33 or F34.1). The administrative prevalence was computed for each year according to age, sex, degree of urbanization and severity of depression diagnosis.
RESULTS
The prevalence increased from 12.5% in 2009 to 15.7% in 2017 (+26%). Overall, women were twice as likely as men to receive a diagnosis, although the prevalence increased more strongly in men compared to women (+40% vs. +20%). Age- and sex-stratified analyses revealed the highest prevalence increase in adolescents and young men at the ages of 15-19 years (+95%) and 20-25 years (+72%). Rural areas with a low population density showed the highest rise in administrative prevalence (+34%), while big urban municipalities showed the lowest (+25%).
LIMITATIONS
Administrative claims data rely on diagnoses coded for billing purposes and thus depend on coding practice as well as patients' help seeking behavior.
CONCLUSIONS
Depressive disorders are of increasing importance in ambulatory health care in Germany. Parts of the increase may be attributed to changing cultural constructions of mental health along with the expansion of mental health care supply.
Identifiants
pubmed: 32479322
pii: S0165-0327(19)32571-6
doi: 10.1016/j.jad.2020.03.082
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
239-247Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2020 The Authors. Published by Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interests The authors declare that they have no competing interests.