Time trends in depression prevalence and health-related correlates: results from population-based surveys in Germany 1997–1999 vs. 2009–2012
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BACKGROUND: Although 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. METHODS: Data 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. RESULTS: Overall, 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. CONCLUSIONS: In 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.
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The prevalence estimates of probable depressive disorder in the present study are similar to those observed in the same year in other high-income countries using the PHQ-8 such as Germany (around 7.4%) and Spain (approximately 6.5%).
“The prevalence estimates of probable depressive disorder reported in the present study are slightly higher than those reported by the APMS in 2014 using a different measure (CIS-R) (NHS Digital, 2014), but are similar to those observed in the same year in other high-income countries using the PHQ-8 such as Germany (around 7.4%) and Spain (approximately 6.5%) (Arias-de la Torre et al., 2018;Bretsch”
From Prevalence and age patterns of depression in the United Kingdom. A population-based study (2021) · cites this paper as Bretschneider et al., 2018
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- Authors
- Bretschneider, J., Janitza, S., Jacobi, F., Thom, J., Hapke, U., Kurth, T., & Maske, U. E.
- Affiliations
- Robert Koch Institute (DE)
- Psychologische Hochschule Berlin (DE)
- Charité – Universitätsmedizin Berlin (DE)
- Corresponding author
- Bretschneider, Julia
- Venue
- BMC Psychiatry
- Published
- 2018-12
- Volume
- 18
- Issue
- 1
- Pages
- 394-394
- ISSN
- 1471-244X (ISSN-L)
- PMC
- PMC6302526
- OpenAlex
- W2906034042
- Cited by
- 91
- References
- 78
- Citations by year
- 2026: 9 · 2025: 5 · 2024: 5 · 2023: 16 · 2022: 18 · 2021: 19 · 2020: 12 · 2019: 7
- FWCI
- 12.86
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Psychiatry (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Publication server of the Robert Koch Institute (Robert Kock Institute) (submittedVersion, cc-by)
- Funders
- Bundesministerium für Gesundheit (ZMV1-2516-FSB-703)
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Health Sciences › Health Professions › General Health Professions › Health and Medical Studies
- Keywords
- depression prevalence, temporal trends, major depressive disorder, depression severity, health-related quality of life, mental health disabilities, sick days, activity limitation, sex differences, Germany, mental health needs
- MeSH terms
- Activities of Daily Living, Adult, Age Factors, Aged, Depression, Depressive Disorder, Major, Major Depressive Disorder, Female, Germany, Health Surveys, Humans, Male, Mental Health, Middle Aged, Psychiatric Status Rating Scales, Quality of Life, Sex Factors, Time Factors, Prevalence
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