Who receives depression-specific treatment? A secondary data-based analysis of outpatient care received by over 780,000 statutory health-insured individuals diagnosed with depression

Abstract

Purpose: This study examined the effects of individual and regional characteristics on receiving depression-specific treatment in the statutory health-insured population of Bavaria (83% of the population).

Methods: Data of the Association of Statutory Health Insurance Physicians in Bavaria were analysed for prevalence, diagnosis of and treatment for depression in outpatient care by considering individual and regional characteristics.

Results: Prevalence of diagnosed depression was 9.2% for the statutory health-insured population aged 18-100 years. More than half of all individuals diagnosed with depression (F32.x/F33.x) and more than one-third of persons diagnosed with severe depression (F32.2/.3 and F33.2/.3) did not receive depression-specific treatment. Rates of a depression-specific treatment were higher for females, the middle aged, individuals with more severe depression diagnoses, those with psychiatric comorbidity and those without physical comorbidity and for individuals living in more rural areas.

Conclusions: The pathways to depression-specific treatment for persons diagnosed with moderate and severe depression need to be improved. Training for physicians, stepped care approaches, psycho-education for patients and anti-stigma campaigns are possible measures to reach this goal. The knowledge on individual characteristics that influence receiving a depression-specific treatment is important to target the groups at increased risk for under-treatment.