Robert Koch Institute, Department of Epidemiology and Health Monitoring; Central Research Institute of Ambulatory Health Care in Germany.
Dtsch Arztebl Int. 2024 May 31;121(11):355-362. doi: 10.3238/arztebl.m2024.0052.
Evaluations by the statutory health insurance carriers in Germany have revealed a rising prevalence of diagnoses of mental disorders, at varying levels and to varying extents. For mental health surveillance purposes, we analyzed prevalence trends across health insurance carriers, before and during the COVID-19 pandemic and stratified by diagnosis group, sex and age.
Nationwide outpatient claims data of all statutorily insured individuals for the years 2012-2022 (Nmin = 68.7 million people, Nmax = 73.7 million people) were used to determine the diagnostic prevalence of mental disorders (ICD-10 F00-F99 and five selected diagnosis groups), with stratification by sex and age. Changes over time in the spectrum of all documented mental disorders are described.
Over the period 2012-2022, the percentage of people with outpatient diagnoses of mental disorders rose from 33.4% to 37.9% (a relative increase of 13.4%). In the selected diagnosis groups, the trends ranged from -11.6% to +115.8% and were generally steady over time, though stronger or stagnating trends were seen in some groups from 2020 onward. Diagnostic prevalence rose to a greater extent in male (+18.3%) than in female individuals (+10.8%) over the period 2012-2022. The greatest increases (> +15%) were seen among 11- to 17-yearolds and in 60- to 84-year-olds. The composition of the diagnosis spectrum was more stable in adults than in children and adolescents.
Trends in diagnostic prevalence differ across mental disorders and population subgroups and have changed in some diagnosis groups since the COVID-19 pandemic. Contextualizing research is needed for a better understanding of these developments.
德国法定健康保险公司的评估显示,精神障碍的诊断率不断上升,程度和范围各不相同。为了进行精神卫生监测,我们分析了 COVID-19 大流行前后不同健康保险公司、诊断组、性别和年龄组的患病率趋势。
我们使用了 2012 年至 2022 年所有法定参保人员的全国性门诊理赔数据(Nmin = 6870 万人,Nmax = 7370 万人),确定了精神障碍(ICD-10 F00-F99 和五个选定的诊断组)的诊断患病率,并按性别和年龄进行分层。描述了所有记录的精神障碍谱随时间的变化。
在 2012 年至 2022 年期间,有门诊诊断为精神障碍的人群比例从 33.4%上升到 37.9%(相对增加 13.4%)。在所选择的诊断组中,趋势范围从-11.6%到+115.8%,总体上随时间保持稳定,但自 2020 年以来,一些组的趋势更加强劲或停滞不前。在 2012 年至 2022 年期间,男性(+18.3%)的诊断患病率增长幅度大于女性(+10.8%)。11 至 17 岁和 60 至 84 岁人群的增幅最大(>+15%)。与儿童和青少年相比,成年人的诊断谱组成更加稳定。
不同精神障碍和人群亚组的诊断患病率趋势不同,自 COVID-19 大流行以来,一些诊断组的趋势发生了变化。需要对这些发展进行背景化研究,以更好地理解这些发展。