Stahmeyer Jona Theodor, Kuhlmann Kristina, Eberhard Sveja
AOK Niedersachsen, Stabsbereich Gesundheitspolitik und Versorgungsforschung, Hannover.
Psychother Psychosom Med Psychol. 2019 Feb;69(2):72-80. doi: 10.1055/a-0581-4785. Epub 2018 Apr 3.
Depressive disorders are one of the most common type of mental disorders and are associated with a significant loss of social functioning and decrease in quality of life. While survey data from the Robert Koch-Institute show no increase in the prevalence of depression during recent years, data from social insurance agencies demonstrate an increasing social significance. Many people argue that changes in working conditions are a major reason for increasing depression diagnoses. Aim of the current study was to analyze the prevalence of depression diagnoses in health insurance data (administrative prevalence) for different types of insured persons and to examine the development over time with particular regard to working and non-working insured people. We conducted a cross-sectional analysis of administrative depression prevalence for the years 2006 to 2015 using F32 and F33 diagnoses. Analyses were stratified by sex and insured persons were grouped in (1.) employees, (2.) self-employed, (3.) spouses with insurance coverage as family member, (4.) pensioners, (5.) unemployed people receiving unemployment benefit I, (6.) people receiving unemployment benefit II and (7.) students and trainees. During the 10-year period, we found an increase in administrative prevalence from 12.0% in 2006 (women: 16.3%; men: 6.8%) to 16.3% in 2015 (women: 21.3%; men: 10.9%). In 2015, highest administrative prevalence rates were observed in people receiving unemployment benefit I or II and in pensioners. The lowest rates were found in students and trainees as well as self-employed. Employees had significantly lower administrative prevalence rates than people receiving unemployment benefit. We observed large increases in administrative prevalence over time in all groups of insured persons. The results highlight the increasing social significance of depressive disorders. A comparatively greater increase in the working population was not observed. A long-term health objective should be to further improve psychiatric care.
抑郁症是最常见的精神障碍类型之一，与社会功能的显著丧失和生活质量的下降有关。虽然罗伯特·科赫研究所的调查数据显示近年来抑郁症的患病率没有上升，但社会保险机构的数据表明其社会意义在增加。许多人认为工作条件的变化是抑郁症诊断增加的主要原因。本研究的目的是分析不同类型被保险人的健康保险数据中抑郁症诊断的患病率（行政患病率），并特别关注在职和非在职被保险人随时间的变化情况。我们使用F32和F33诊断对2006年至2015年的行政抑郁症患病率进行了横断面分析。分析按性别分层，被保险人分为：（1）雇员；（2）个体经营者；（3）有保险覆盖的配偶作为家庭成员；（4）退休人员；（5）领取第一类失业救济金的失业者；（6）领取第二类失业救济金的人员；（7）学生和实习生。在这10年期间，我们发现行政患病率从2006年的12.0%（女性：16.3%；男性：6.8%）上升到2015年的16.3%（女性：21.3%；男性：10.9%）。2015年，领取第一类或第二类失业救济金的人员以及退休人员的行政患病率最高。最低患病率出现在学生和实习生以及个体经营者中。雇员的行政患病率明显低于领取失业救济金的人员。我们观察到所有被保险人群体的行政患病率随时间大幅上升。结果凸显了抑郁症的社会意义日益增加。在职人群中并未观察到相对更大的增长。一个长期的健康目标应该是进一步改善精神科护理。
