Otten Daniëlle, Heller Ayline, Schmidt Peter, Beutel Manfred E, Brähler Elmar
Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131, Mainz, Germany.
Department of Psychiatry and Psychotherapy, Leipzig University Medical Center, Leipzig, Germany.
Soc Psychiatry Psychiatr Epidemiol. 2024 Feb;59(2):315-328. doi: 10.1007/s00127-023-02479-z. Epub 2023 Apr 11.
Mental distress has become a major public health concern. Temporal trends in psychological distress are complex and depend on numerous factors. In this study, we examined age-period-cohort effects for mental distress including gender and German region over a 15 years' time span.
Data on mental distress from ten cross-sectional surveys of the general German population, covering the years from 2006 to 2021, was used. Hierarchical age-period-cohort analyses including gender and German region as predictors were performed to disentangle age, period, and cohort effects. The Patient Health Questionnaire-4 was used as a brief screener for mental distress.
We found significant period and cohort effects, with peek values for mental distress in the years 2017 and 2020 and for the oldest birth cohort (born before 1946). Age did not affect mental distress when cohort- and period effects as well as gender and German region were considered. An interaction effect for gender and the German region was found. Women in West Germany reported significantly higher mental distress compared to women in East Germany. Compared to men, women reported the highest prevalence in both regions.
Important political events as well as major crises can lead to an increase of mental distress in societies. Furthermore, an association between birth cohort and mental distress could be linked to socialization effects of that certain time, causing traumatic experiences or a specific coping style within this cohort group. Prevention and intervention strategies could benefit from acknowledging structural differences linked to period and cohort effects.
精神困扰已成为一个主要的公共卫生问题。心理困扰的时间趋势很复杂，取决于众多因素。在本研究中，我们考察了15年间精神困扰的年龄-时期-队列效应，包括性别和德国地区。
使用了来自德国普通人群十次横断面调查的精神困扰数据，涵盖2006年至2021年。进行了分层年龄-时期-队列分析，将性别和德国地区作为预测因素，以区分年龄、时期和队列效应。患者健康问卷-4被用作精神困扰的简短筛查工具。
我们发现了显著的时期和队列效应，精神困扰的峰值出现在2017年和2020年以及最年长的出生队列（1946年以前出生）。在考虑队列和时期效应以及性别和德国地区时，年龄并未影响精神困扰。发现了性别和德国地区的交互效应。西德的女性报告的精神困扰显著高于东德的女性。与男性相比，两个地区的女性报告的患病率最高。
重要的政治事件以及重大危机可能导致社会中精神困扰的增加。此外，出生队列与精神困扰之间的关联可能与特定时期的社会化效应有关，导致该队列群体内的创伤经历或特定应对方式。预防和干预策略可能会受益于认识到与时期和队列效应相关的结构差异。
