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. 2017 Feb 9:15:Doc04.
doi: 10.3205/000245. eCollection 2017.

Prevalence of depression, anxiety, adjustment disorders, and somatoform disorders in patients with age-related macular degeneration in Germany

Louis Jacob  1 , Alexandra Spiess  2 , Karel Kostev  2
Affiliations

Prevalence of depression, anxiety, adjustment disorders, and somatoform disorders in patients with age-related macular degeneration in Germany

Louis Jacob et al. Ger Med Sci. .

Abstract
in English, German

Aims: The purpose of this study was to analyze the prevalence of depression, anxiety, adjustment disorders, and somatoform disorders in patients diagnosed with age-related macular degeneration (AMD) in Germany. Methods: This study included 7,580 patients between the ages of 40 and 90 diagnosed with AMD between January 2011 and December 2014 in 1,072 primary care practices (index date). The last follow-up was in July 2016. We also included 7,580 controls without AMD, which were matched (1:1) to the AMD cases by age, sex, type of health insurance (private or statutory), physician, and Charlson comorbidity score as a generic marker of comorbidity. The outcome of the study was the prevalence of depression, anxiety, adjustment disorders, and somatoform disorders recorded in the database between the index date and the end of follow-up. Results: The mean age among subjects was 75.7 years (SD=10.1 years), 34.0% were men, and 7.8% had private health insurance coverage. The Charlson comorbidity index was 2.0 (SD=1.8). Depression was the most frequent disease (33.7% in AMD patients versus 27.3% in controls), followed by somatoform disorders (19.6% and 16.7%), adjustment disorders (14.8% and 10.5%), and anxiety disorders (11.7% and 8.2%). Depression (OR=1.37, 95% CI: 1.27-1.47), anxiety (OR=1.50, 95% CI: 1.35-1.67), adjustment disorders (OR=1.50, 95% CI: 1.36-1.65), and somatoform disorders (OR=1.22, 95% CI: 1.12-1.32) were all positively associated with AMD. Conclusion: Overall, a significant association was found between AMD and depression, anxiety, adjustment disorders, and somatoform disorders.

Ziel: In der vorliegenden Studie wurde die Prävalenz der psychiatrischen Komorbiditäten bei Patienten mit altersbedingten Makuladegeneration (AMD) und Personen ohne MD verglichen.Methoden: Patienten mit einer gesicherten Diagnose der Makuladegeneration (ICD 10: H35.3) im Zeitraum 2011–2014 aus 1.072 allgemeinmedizinischen und internistischen Praxen wurden selektiert. Daten von 7.580 MD-Patienten und 7.580 Personen ohne MD aus allgemeinmedizinischen und internistischen Praxen in Deutschland wurden nach Matching für Alter, Geschlecht, Versicherungsstatus und Indexjahr (der letzte Eintrag in der Datenbank) retrospektiv analysiert. Der Anteil der Patienten mit einer gesicherten Diagnose von Depression, Angststörung, Reaktionen auf schwere Belastungen und Anpassungsstörungen oder somatoformen Störungen wurde ermittelt. Ergebnisse: Patienten waren im Schnitt 75,7 Jahre alt (SD: 10,1), 34,0% waren männlich und 7,8% privat versichert. Charlson Comorbidity Index war im Schnitt 2,0 (SD: 1,8). Depression war die häufigste Diagnose (33,7% bei AMD-Patienten versus 27,3% in der Kontrollgruppe), gefolgt bei somatoformen Störungen (19,6% versus 16,7%), Reaktionen auf schwere Belastungen und Anpassungsstörungen (14,8% versus 10,5%), und Angststörungen (11,7% versus 8,2%). Das Risiko für jede der untersuchten psychiatrischen Kodiagnosen war unter MD-Patienten nach der Adjustierung für Charlson Comorbidity Index insgesamt signifikant höher als bei Patienten ohne MD (Depression (OR: 1,37, 95% CI: 1,27–1,47), Angststörung (OR: 1,50, 95% CI: 1,35–1,67), Reaktionen auf schwere Belastungen und Anpassungsstörungen (OR: 1,50, 95% CI: 1,36–1,65), und somatoforme Störungen (OR: 1,22, 95% CI: 1,12–1,32)).Schlussfolgerung: Makuladegeneration war mit stark erhöhtem Risiko für Depression, Angst-, Belastungs- sowie somatoformer Störung assoziiert.

Keywords: adjustment disorder; age-related macular degeneration; anxiety; depression; somatoform disorder.

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Figures

Table 1
Table 1. Characteristics of patients with age-related macular degeneration (AMD) and controls treated in German general practitioner practices after individual matching
Table 2
Table 2. Association of age-related macular degeneration with depression, anxiety, adjustment disorders, and somatoform disorders (multivariate logistic regression)
Figure 1
Figure 1. Selection of study patients
Figure 2
Figure 2. Prevalence of depression, anxiety, adjustment disorders, and somatoform disorders in patients with age-related macular degeneration (AMD) and controls in general practitioner practices
See this image and copyright information in PMC

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