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. 2018 Dec 20;18(1):394.
doi: 10.1186/s12888-018-1973-7.

Time trends in depression prevalence and health-related correlates: results from population-based surveys in Germany 1997-1999 vs. 2009-2012

Julia Bretschneider  1 , Silke Janitza  2 , Frank Jacobi  3 , Julia Thom  2 , Ulfert Hapke  2 , Tobias Kurth  4 , Ulrike E Maske  2
Affiliations

Time trends in depression prevalence and health-related correlates: results from population-based surveys in Germany 1997-1999 vs. 2009-2012

Julia Bretschneider et al. BMC Psychiatry. .

Abstract

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.

Keywords: Cross-sectional studies; Depression; Disease burden; Epidemiology; General population; Germany; Health-related quality of life; Major depressive disorder; Prevalence; Time trends.

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Conflict of interest statement

Ethics approval and consent to participate

Both surveys DEGS1-MH and GHS-MHS were conducted following the Federal and State Commissioners for Data Protection guidelines and the ethical principles of the Helsinki Declaration. DEGS1 and DEGS1-MH were approved by local ethics committees (Charité-Universitätsmedizin Berlin: No. EA2/047/08; Technische Universität Dresden: No. EK174062009). All participants provided written informed consent prior to participation.

Consent for publication

Not applicable.

Competing interests

In the past 3 years, TK has received honoraria for providing methodological advice to Lilly, for a presentation on neuroepidemiology from Novartis, from providing a presentation about clinical research methods from Daiichi-Sankyo, and for providing editorial services from the BMJ. TK has provided methodological advice to CoLucid and Amgen, for which the Charité – Universitätsmedizin Berlin has received unrestricted funds. The remaining authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
12-month prevalence of MDD 1997–1999 (GHS-MHS: German National Health Interview and Examination Survey 1998, mental health supplement, weighted for population structure as of 12/31/1997) vs. 2009–2012 (DEGS1-MH: German Health Interview and Examination Survey for Adults, mental health module, weighted for population structure as of 12/31/2010). Age range: 18–65; p-values: Rao-Scott chi-square test for testing differences between 1997–1999 and 2009–2012
Fig. 2
Fig. 2
Health-related quality of life in 1997–1999 (GHS-MHS: German National Health Interview and Examination Survey 1998, mental health supplement, weighted for population structure as of 12/31/1997. Age range: 18–65) vs. 2009–2012 (DEGS1-MH: German Health Interview and Examination Survey for Adults, mental health module, weighted for population structure as of 12/31/2010. Age range: 18–65): Mental Component Score (based on SF-36 and norm-based scoring)
See this image and copyright information in PMC

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