CoChat
Sign Up
Cited by 212Mental Health Treatment and AccessChronic Disease Management StrategiesTreatment of Major Depression

Mental and somatic comorbidity of depression: a comprehensive cross-sectional analysis of 202 diagnosis groups using German nationwide ambulatory claims data

Open access
Steffen, Annika, Nübel, Julia, Jacobi, Frank, Bätzing, Jörg, Holstiege, Jakob·2020·BMC Psychiatry
DOI 10.1186/s12888-020-02546-8PMC PMC7106695
Open this paper in CoChat — free accountOpen PDF

Abstract

Background: Depression is frequently accompanied by other mental disorders and various somatic diseases; however, previous comorbidity studies often relied on self-reported data and have not simultaneously assessed the entire spectrum of mental and somatic diagnoses. The aim is to provide a complete picture of mental and somatic comorbidity of depression in routine outpatient care in a high income country with a relatively well equipped health care system. Methods: Using ambulatory claims data covering 87% of the German population (age 15+), we designed a cross-sectional study by identifying persons diagnosed with mild, moderate and severe depression in 2017 ( N = 6.3 million) and a control group matched 4:1 on sex, 5-year age group and region of residence ( N = 25.2 million). Stratified by severity, we calculated the prevalence of 202 diagnosis groups included in the ICD-10 in persons with depression as compared to matched controls using prevalence ratios (PR). Results: Nearly all mental disorders were at least twice as prevalent in persons with depression relative to controls, showing a dose-response relationship with depression severity. Irrespective of severity, the three most prevalent somatic comorbid diagnosis groups were ‘other dorsopathies’ (M50-M54), ‘hypertensive diseases’ (I10-I15) and ‘metabolic disorders’ (E70-E90), exhibiting PRs in moderate depression of 1.56, 1.23 and 1.33, respectively. Strong associations were revealed with diseases of the central nervous system (i.e. multiple sclerosis) and several neurological diseases, among them sleep disorders, migraine and epilepsy, most of them exhibiting at least 2- to 3-fold higher prevalences in depression relative to controls. Utilization of health care was higher among depression cases compared to controls. Conclusions: The present study based on data from nearly the complete adolescent and adult population in Germany comprehensively illustrates the comorbidity status of persons diagnosed with depression as coded in routine health care. Our study should contribute to increasing the awareness of the strong interconnection of depression with all other mental and the vast majority of somatic diseases. Our findings underscore clinical and health-economic relevance and the necessity of systematically addressing the high comorbidity of depression and somatic as well as other mental diseases through prevention, early identification and adequate management of depressive symptoms.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1186/s12888-020-02546-8

Cites

29 of 29 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Between 33 and 66% of patients suffering from MDD have a psychiatric comorbidity that could potentially exclude them from psychedelic-assisted therapy.

    “Between 33 and 66% of patients suffering from MDD have a psychiatric comorbidity that could potentially exclude them from psychedelic-assisted therapy”

    From Psychedelics and Other Psychoplastogens for Treating Mental Illness. (2021) · cites this paper as [280]

    The Results (Mental comorbidity; page unavailable) report psychiatric comorbidity in 64% of mild, 72% of moderate, and 78% of severe depression cases, supporting the general point but not the stated 33–66% range. The paper does not assess whether those comorbidities could exclude patients from psychedelic-assisted therapy. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 67

  1. [4]Jacobi F Hofler M Strehle J Mack S Gerschler A Scholl L Busch MA Hapke U Maske U Seiffert I Twelve-months prevalence of mental disorders in the German health interview and examination survey for adults - mental health module (DEGS1-MH): a methodological addendum and correction Int J Methods Psychiatr Res 2015 24 4 305 313 10.1002/mpr.1479 26184561 PMC6878329 · DOI
  2. [6]Disease GBD Injury I Prevalence C Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the global burden of Disease study 2017 Lancet 2018 392 10159 1789 1858 10.1016/S0140-6736(18)32279-7 30496104 PMC6227754 · DOI · Paper page
  3. [8]Gilman SE Sucha E Kingsbury M Horton NJ Murphy JM Colman I Depression and mortality in a longitudinal study: 1952-2011 CMAJ 2017 189 42 E1304 E1310 10.1503/cmaj.170125 29061855 PMC5654987 · DOI
  4. [9]Pequignot R Dufouil C Peres K Artero S Tzourio C Empana JP Depression increases the risk of death independently from vascular events in elderly individuals: the Three-City study J Am Geriatr Soc 2019 67 3 546 552 10.1111/jgs.15731 30652829 · DOI
  5. [10]Kessler RC Merikangas KR Wang PS Prevalence, comorbidity, and service utilization for mood disorders in the United States at the beginning of the twenty-first century Annu Rev Clin Psychol 2007 3 137 158 10.1146/annurev.clinpsy.3.022806.091444 17716051 · DOI · Paper page
  6. [11]Kaufman J Charney D Comorbidity of mood and anxiety disorders Depress Anxiety 2000 12 Suppl 1 69 76 10.1002/1520-6394(2000)12:1+<69::AID-DA9>3.0.CO;2-K 11098417 · DOI
  7. [13]Hasin DS Goodwin RD Stinson FS Grant BF Epidemiology of major depressive disorder: results from the National Epidemiologic Survey on alcoholism and related conditions Arch Gen Psychiatry 2005 62 10 1097 1106 10.1001/archpsyc.62.10.1097 16203955 · DOI · Paper page
  8. [15]Wiethoff K Bauer M Baghai TC Moller HJ Fisher R Hollinde D Kiermeir J Hauth I Laux G Cordes J Prevalence and treatment outcome in anxious versus nonanxious depression: results from the German algorithm project J Clin Psychiatry 2010 71 8 1047 1054 10.4088/JCP.09m05650blu 20673545 · DOI
  9. [16]Richards D Prevalence and clinical course of depression: a review Clin Psychol Rev 2011 31 7 1117 1125 10.1016/j.cpr.2011.07.004 21820991 · DOI · Paper page
  10. [18]Voinov B Richie WD Bailey RK Depression and chronic diseases: it is time for a synergistic mental health and primary care approach Prim Care Companion CNS Disord 2013 15 2 PMC3733529 23930236
  11. [21]Lotfaliany M Bowe SJ Kowal P Orellana L Berk M Mohebbi M Depression and chronic diseases: co-occurrence and communality of risk factors J Affect Disord 2018 241 461 468 10.1016/j.jad.2018.08.011 30149333 · DOI
  12. [22]Maske UE Scheidt-Nave C Busch MA Jacobi F Weikert B Riedel-Heller SG Hapke U: [comorbidity of diabetes mellitus and depression in the general population in Germany] Psychiatr Prax 2015 42 4 202 207 24858432
  13. [23]Maske UE Busch MA Jacobi F Riedel-Heller SG Scheidt-Nave C Hapke U Chronic somatic conditions and mental health problems in the general population in Germany. Results of the national telephone health interview survey “German health update (GEDA)” 2010 Psychiatr Prax 2013 40 4 207 213 10.1055/s-0033-1343103 23564354 · DOI
  14. [24]Evans DL Charney DS Lewis L Golden RN Gorman JM Krishnan KR Nemeroff CB Bremner JD Carney RM Coyne JC Mood disorders in the medically ill: scientific review and recommendations Biol Psychiatry 2005 58 3 175 189 10.1016/j.biopsych.2005.05.001 16084838 · DOI · Paper page
  15. [25]Vaccarino V Badimon L Bremner JD Cenko E Cubedo J Dorobantu M Duncker DJ Koller A Manfrini O Milicic D Depression and coronary heart disease: 2018 ESC position paper of the working group of coronary pathophysiology and microcirculation developed under the auspices of the ESC Committee for practice guidelines Eur Heart J 2019 1 28 PMC10941327 30698764
  16. [27]Welch CA Czerwinski D Ghimire B Bertsimas D Depression and costs of health care Psychosomatics 2009 50 4 392 401 10.1176/appi.psy.50.4.392 19687180 · DOI
  17. [28]Kang HJ Kim SY Bae KY Kim SW Shin IS Yoon JS Kim JM Comorbidity of depression with physical disorders: research and clinical implications Chonnam Med J 2015 51 1 8 18 10.4068/cmj.2015.51.1.8 25914875 PMC4406996 · DOI
  18. [29]Scott KM Von Korff M Alonso J Angermeyer MC Bromet E Fayyad J de Girolamo G Demyttenaere K Gasquet I Gureje O Mental-physical co-morbidity and its relationship with disability: results from the world mental health surveys Psychol Med 2009 39 1 33 43 10.1017/S0033291708003188 18366819 PMC2637813 · DOI
  19. [30]Greenberg PE Fournier AA Sisitsky T Pike CT Kessler RC The economic burden of adults with major depressive disorder in the United States (2005 and 2010) J Clin Psychiatry 2015 76 2 155 162 10.4088/JCP.14m09298 25742202 · DOI · Paper page
  20. [32]Sartorius N Depression and diabetes Dialogues Clin Neurosci 2018 20 1 47 52 29946211 PMC6016052
  21. [33]Martini L Hoffmann F Comorbidity of chronic back pain and depression in Germany: results from the GEDA study, 2009 and 2010 Z Evid Fortbild Qual Gesundhwes 2018 137-138 62 68 10.1016/j.zefq.2018.10.003 30415830 · DOI
  22. [34]Gerald JK Moreno FA Asthma and depression: It's complicated J Allergy Clin Immunol Pract 2016 4 1 74 75 10.1016/j.jaip.2015.11.020 26772927 · DOI · Paper page
  23. [36]Deschenes SS Burns RJ Schmitz N Associations between depression, chronic physical health conditions, and disability in a community sample: a focus on the persistence of depression J Affect Disord 2015 179 6 13 10.1016/j.jad.2015.03.020 25841076 · DOI
  24. [37]van Melle JP de Jonge P Spijkerman TA Tijssen JG Ormel J van Veldhuisen DJ van den Brink RH van den Berg MP Prognostic association of depression following myocardial infarction with mortality and cardiovascular events: a meta-analysis Psychosom Med 2004 66 6 814 822 10.1097/01.psy.0000146294.82810.9c 15564344 · DOI · Paper page
  25. [38]Buist-Bouwman MA de Graaf R Vollebergh WA Ormel J Comorbidity of physical and mental disorders and the effect on work-loss days Acta Psychiatr Scand 2005 111 6 436 443 10.1111/j.1600-0447.2005.00513.x 15877710 · DOI · Paper page
  26. [42]Kessler RC Nelson CB McGonagle KA Liu J Swartz M Blazer DG Comorbidity of DSM-III-R major depressive disorder in the general population: results from the US National Comorbidity Survey Br J Psychiatry Suppl 1996 30 17 30 10.1192/S0007125000298371 8864145 · DOI
  27. [43]de Graaf R Bijl RV Smit F Vollebergh WA Spijker J Risk factors for 12-month comorbidity of mood, anxiety, and substance use disorders: findings from the Netherlands mental health survey and incidence study Am J Psychiatry 2002 159 4 620 629 10.1176/appi.ajp.159.4.620 11925301 · DOI
  28. [44]Scott KM McGee MA Oakley Browne MA Wells JE New Zealand mental health survey research T: mental disorder comorbidity in Te Rau Hinengaro: the New Zealand mental health survey Aust N Z J Psychiatry 2006 40 10 875 881 10.1080/j.1440-1614.2006.01906.x 16959013 · DOI
  29. [46]Smoller JW The genetics of stress-related disorders: PTSD, depression, and anxiety disorders Neuropsychopharmacology 2015 41 297 10.1038/npp.2015.266 26321314 PMC4677147 · DOI
  30. [47]Spinhoven P Elzinga BM Hovens JG Roelofs K Zitman FG van Oppen P Penninx BW The specificity of childhood adversities and negative life events across the life span to anxiety and depressive disorders J Affect Disord 2010 126 1–2 103 112 10.1016/j.jad.2010.02.132 20304501 · DOI
  31. [51]Smith DT Mouzon DM Elliott M Reviewing the assumptions about Men's mental health: an exploration of the gender binary Am J Mens Health 2018 12 1 78 89 10.1177/1557988316630953 26864440 PMC5734543 · DOI · Paper page
  32. [52]Steffen A Thom J Jacobi F Holstiege J Bätzing J Trends in prevalence of depression in Germany between 2009 and 2017 based on nationwide ambulatory claims data (in revision with journal of affective disorders) 2019 32479322
  33. [53]Friborg O Martinsen EW Martinussen M Kaiser S Overgard KT Rosenvinge JH Comorbidity of personality disorders in mood disorders: a meta-analytic review of 122 studies from 1988 to 2010 J Affect Disord 2014 152-154 1 11 10.1016/j.jad.2013.08.023 24120406 · DOI · Paper page
  34. [54]Lenzenweger MF Lane MC Loranger AW Kessler RC DSM-IV personality disorders in the National Comorbidity Survey Replication Biol Psychiatry 2007 62 6 553 564 10.1016/j.biopsych.2006.09.019 17217923 PMC2044500 · DOI · Paper page
  35. [55]Reed GM Progress in developing a classification of personality disorders for ICD-11 World Psychiatry 2018 17 2 227 229 10.1002/wps.20533 29856549 PMC5980531 · DOI
  36. [56]Tyrer P Crawford M Mulder R Blashfield R Farnam A Fossati A Kim Y-R Koldobsky N Lecic-Tosevski D Ndetei D The rationale for the reclassification of personality disorder in the 11th revision of the international classification of diseases (ICD-11) Personal Ment Health 2011 5 4 246 259 10.1002/pmh.190 · DOI
  37. [58]Speed MS Jefsen OH Børglum AD Speed D Østergaard SD Investigating the association between body fat and depression via Mendelian randomization Transl Psychiatry 2019 9 1 184 10.1038/s41398-019-0516-4 31383844 PMC6683191 · DOI
  38. [59]Yang Y Ligthart L Terwindt GM Boomsma DI Rodriguez-Acevedo AJ Nyholt DR Genetic epidemiology of migraine and depression Cephalalgia 2016 36 7 679 691 10.1177/0333102416638520 26966318 · DOI
  39. [60]Hsu Y-T Liao C-C Chang S-N Yang Y-W Tsai C-H Chen T-L Sung F-C Increased risk of depression in patients with Parkinson Disease: a Nationwide cohort study Am J Geriatr Psychiatry 2015 23 9 934 940 10.1016/j.jagp.2014.10.011 25529799 · DOI
  40. [61]Sotelo JL Musselman D Nemeroff C The biology of depression in cancer and the relationship between depression and cancer progression Int Rev Psychiatry 2014 26 1 16 30 10.3109/09540261.2013.875891 24716498 · DOI
  41. [62]Marrie RA Hitchon CA Walld R Patten SB Bolton JM Sareen J Walker JR Singer A Lix LM El-Gabalawy R Increased burden of psychiatric disorders in rheumatoid arthritis Arthritis Care Res 2018 70 7 970 978 10.1002/acr.23539 PMC6033023 29438604 · DOI
  42. [63]Marrie RA Walld R Bolton JM Sareen J Patten SB Singer A Lix LM Hitchon CA El-Gabalawy R Katz A Psychiatric comorbidity increases mortality in immune-mediated inflammatory diseases Gen Hosp Psychiatry 2018 53 65 72 10.1016/j.genhosppsych.2018.06.001 29929117 · DOI
  43. [64]Bernstein CN Hitchon CA Walld R Bolton JM Sareen J Walker JR Graff LA Patten SB Singer A Lix LM Increased burden of psychiatric disorders in inflammatory bowel Disease Inflamm Bowel Dis 2018 25 2 360 368 10.1093/ibd/izy235 29986021 PMC6391845 · DOI · Paper page
  44. [65]Nerurkar L Siebert S McInnes IB Cavanagh J Rheumatoid arthritis and depression: an inflammatory perspective Lancet Psychiatry 2019 6 2 164 173 10.1016/S2215-0366(18)30255-4 30366684 · DOI
  45. [67]Bletzer J Gantz S Voigt T Neubauer E Schiltenwolf M Chronische untere Rückenschmerzen und psychische Komorbidität Schmerz 2017 31 2 93 101 10.1007/s00482-016-0143-4 27501800 · DOI
  46. [68]Currie SR Wang J Chronic back pain and major depression in the general Canadian population Pain 2004 107 1–2 54 60 10.1016/j.pain.2003.09.015 14715389 · DOI · Paper page
  47. [70]Pinheiro MB Ferreira ML Refshauge K Ordonana JR Machado GC Prado LR Maher CG Ferreira PH Symptoms of depression and risk of new episodes of low Back pain: a systematic review and meta-analysis Arthritis Care Res 2015 67 11 1591 1603 10.1002/acr.22619 25989342 · DOI
  48. [71]Bletzer J Gantz S Voigt T Neubauer E Schiltenwolf M Chronic low back pain and psychological comorbidity: a review Schmerz 2017 31 2 93 101 10.1007/s00482-016-0143-4 27501800 · DOI
  49. [73]Meng L Chen D Yang Y Zheng Y Hui R Depression increases the risk of hypertension incidence: a meta-analysis of prospective cohort studies J Hypertens 2012 30 5 842 851 10.1097/HJH.0b013e32835080b7 22343537 · DOI · Paper page
  50. [74]Ginty AT Carroll D Roseboom TJ Phillips AC de Rooij SR Depression and anxiety are associated with a diagnosis of hypertension 5 years later in a cohort of late middle-aged men and women J Hum Hypertens 2013 27 3 187 190 10.1038/jhh.2012.18 22592133 · DOI
  51. [75]Carroll D Phillips AC Gale CR Batty GD Generalized anxiety and major depressive disorders, their comorbidity and hypertension in middle-aged men Psychosom Med 2010 72 1 16 19 10.1097/PSY.0b013e3181c4fca1 19933507 · DOI
  52. [76]Pan A Sun Q Okereke OI Rexrode KM Hu FB Depression and risk of stroke morbidity and mortality: a meta-analysis and systematic review JAMA 2011 306 11 1241 1249 10.1001/jama.2011.1282 21934057 PMC3242806 · DOI · Paper page
  53. [77]Davidson KW Depression and coronary heart disease ISRN Cardiol 2012 2012 743813 10.5402/2012/743813 23227360 PMC3514821 · DOI
  54. [78]Tyrovolas S Lionis C Zeimbekis A Bountziouka V Micheli M Katsarou A Papairakleous N Metallinos G Makri K Polychronopoulos E Increased body mass and depressive symptomatology are associated with hypercholesterolemia, among elderly individuals; results from the MEDIS study Lipids Health Dis 2009 8 1 10 10.1186/1476-511X-8-10 19331683 PMC2667507 · DOI
  55. [81]Marrie RA Walld R Bolton JM Sareen J Walker JR Patten SB Singer A Lix LM Hitchon CA El-Gabalawy R Increased incidence of psychiatric disorders in immune-mediated inflammatory disease J Psychosom Res 2017 101 17 23 10.1016/j.jpsychores.2017.07.015 28867419 · DOI
  56. [82]Barry JJ The recognition and Management of Mood Disorders as a comorbidity of epilepsy Epilepsia 2003 44 s4 30 40 10.1046/j.1528-1157.44.s4.4.x 12823567 · DOI
  57. [83]Williams KE Marsh WK Rasgon NL Mood disorders and fertility in women: a critical review of the literature and implications for future research Hum Reprod Update 2007 13 6 607 616 10.1093/humupd/dmm019 17895237 · DOI · Paper page
  58. [84]Nillni YI Wesselink AK Gradus JL Hatch EE Rothman KJ Mikkelsen EM Wise LA Depression, anxiety, and psychotropic medication use and fecundability Am J Obstet Gynecol 2016 215 4 453 e451 453 e458 10.1016/j.ajog.2016.04.022 27131586 PMC11064128 · DOI
  59. [85]Dhar AK Barton DA Depression and the link with cardiovascular Disease Front Psychiatry 2016 7 33 10.3389/fpsyt.2016.00033 27047396 PMC4800172 · DOI
  60. [87]Lippi G Montagnana M Favaloro EJ Franchini M Mental depression and cardiovascular disease: a multifaceted, bidirectional association Semin Thromb Hemost 2009 35 3 325 336 10.1055/s-0029-1222611 19452408 · DOI
  61. [88]Wium-Andersen MK Wium-Andersen IK Prescott EIB Overvad K Jørgensen MB Osler M An attempt to explain the bidirectional association between ischaemic heart disease, stroke and depression: a cohort and meta-analytic approach Br J Psychiatry 2019 1 1 8 10.1192/bjp.2019.130 31179963 · DOI · Paper page
  62. [89]Khandaker GM, Zuber V, Rees JMB, Carvalho L, Mason AM, Foley CN, Gkatzionis A, Jones PB, Burgess S. Shared mechanisms between coronary heart disease and depression: findings from a large UK general population-based cohort. Mol Psychiatry. 2019. https://www.ncbi.nlm.nih.gov/pubmed/30886334. PMC7303009 30886334
  63. [90]Ivbijaro GO Enum Y Khan AA Lam SS Gabzdyl A Collaborative care: models for treatment of patients with complex medical-psychiatric conditions Curr Psychiatry Rep 2014 16 11 506 10.1007/s11920-014-0506-4 25218604 PMC4163191 · DOI
  64. [92]American Diabetes Association 4. Comprehensive medical evaluation and assessment of comorbidities: standards of medical Care in Diabetes-2019 Diabetes Care 2019 42 Suppl 1 S34 S45 10.2337/dc19-S004 30559230 · DOI
  65. [93]What are disease management programs (DMPs)? [ https://www.ncbi.nlm.nih.gov/books/NBK279412/].
  66. [95]Johnson EK Nelson CP Values and pitfalls of the use of administrative databases for outcomes assessment J Urol 2013 190 1 17 18 10.1016/j.juro.2013.04.048 23608038 PMC4114235 · DOI
  67. [97]Schneider F Erhart M Hewer W Loeffler LA Jacobi F Mortality and medical comorbidity in the severely mentally ill Dtsch Arztebl Int 2019 116 23–24 405 411 31366432 PMC6683445

Cited by

Sorted by citations

Authors
Steffen, A., Nübel, J., Jacobi, F., Bätzing, J., & Holstiege, J.
Affiliations
  • Zentralinstitut für die Kassenärztliche Versorgung in der Bundesrepublik Deutschland (DE)
  • Robert Koch Institute (DE)
  • Psychologische Hochschule Berlin (DE)
Corresponding author
Steffen, Annika
ORCID
Venue
BMC Psychiatry
Publisher
Springer Science and Business Media LLC
Published
2020-03-30
Volume
20
Issue
1
Pages
142-142
ISSN
1471-244X (ISSN-L)
DOI
10.1186/s12888-020-02546-8
PMC
PMC7106695
OpenAlex
W3013737540
Cited by
212
References
29
Citations by year
2026: 26 · 2025: 40 · 2024: 37 · 2023: 44 · 2022: 36 · 2021: 25 · 2020: 4
FWCI
29.79
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Psychiatry (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Publication server of the Robert Koch Institute (Robert Kock Institute) (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
Keywords
depression, comorbidities, mental illness, somatic diseases, depression severity, dorsopathy, hypertension, metabolic disorders, multiple sclerosis, sleep disorders, migraine, epilepsy, health care utilization, outpatient care, ICD-10 diagnoses, Germany
MeSH terms
Adolescent, Adult, Ambulatory Care, Mental Disorders, Cross-Sectional Studies, Depression, Female, Germany, Humans, Male, Middle Aged, Nervous System Diseases, Psychophysiologic Disorders, Comorbidity, Prevalence, International Classification of Diseases, Young Adult

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review