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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. Electronic supplementary material The online version of this article (10.1186/s12888-018-1973-7) contains supplementary material, which is available to authorized users.

OBJECTIVE To examine the association of diagnosed depression with the utilization of health care services and preventive measures among men and women in the general population in Germany. METHODS Cross-sectional analysis of data from a representative telephone survey (men N = 18,675, women N = 24,518, 18 years and older). Self-reported health professional-diagnosed depression (past 12 months) and the use of a range of health care and preventive services were assessed. RESULTS Diagnosed depression was associated with increased health care service utilization in both sexes. Diagnosed depression was associated with higher utilization of some preventive services, such as general health check-ups (odds ratio [OR] 1.2), cancer screening (OR 1.2) and flu vaccination (OR 1.3) among women and cancer screening (OR 1.4) among men. CONCLUSIONS Health professional-diagnosed depression is associated with increased health service utilization independent of somatic comorbidity and socio-demographic confounders. There was no indication for specific under-treatment with preventive measures among people with depression diagnosis.

AIMS To examine the association between glycaemic status and depressive symptoms in a nationwide sample of the adult population in Germany. METHODS We conducted a cross-sectional analysis of data from 6385 participants aged 18-79 years in the nationwide German Health Interview and Examination Survey for Adults 2008-2011 (DEGS1). Glycaemic status was classified as follows: diagnosed diabetes (self-reported diagnosis or receiving antidiabetes medication); undiagnosed diabetes (HbA1c ≥48 mmol/mol [≥6.5%]); prediabetes (HbA1c 39-47 mmol/mol [5.7-6.4%]); or normoglycaemia (HbA1c

We recently published findings in this journal on the prevalence of mental disorders from the German Health Interview and Examination Survey for Adults Mental Health Module (DEGS1-MH). The DEGS1-MH paper was also meant to be the major reference publication for this large-scale German study program, allowing future users of the data set to understand how the study was conducted and analyzed. Thus, towards this goal highest standards regarding transparency, consistency and reproducibility should be applied. After publication, unfortunately, the need for an addendum and corrigendum became apparent due to changes in the eligible reference sample, and corresponding corrections of the imputed data. As a consequence the sample description, sample size and some prevalence data needed amendments. Additionally we identified a coding error in the algorithm for major depression that had a significant effect on the prevalence estimates of depression and associated conditions. This addendum and corrigendum highlights all changes and presents the corrected prevalence tables. Copyright © 2015 John Wiley & Sons, Ltd.

Background While the efficacy of Internet interventions for depression has been demonstrated in numerous studies, there is concern that the participants in these studies may systematically differ from depressed subjects in the general population. The goal of this study was to compare participants in a large trial of an Internet intervention for depression with a population-based sample that reported depressive symptomatology in the same range of severity. Methodology The analysis is based on a sample of participants of a randomized controlled trial testing the effectiveness of an Internet intervention for depression in mild to moderate depression (EVIDENT, N = 1013) and a subsample of participants in a representative population-based sample (DEGS1, n = 1978). The DEGS1 subsample was chosen based on the score in the Patient Health Questionnaire-9 (PHQ-9, score 5–14) as this was the main inclusion criterion for the EVIDENT study. Both samples were compared with respect to a range of demographic and clinical variables. Results Compared with the DEGS1 subsample, participants in the EVIDENT sample were significantly more often female (68.6% vs. 56.3%), slightly older (mean age 42.9 vs. 40.4 years), had more often completed highest secondary education (51.3% vs. 22.4%), were clinically more severely affected (moderate depressive symptoms in 62.6% vs. 18.3%) and reported a lower quality of life. Conclusion These findings indicate that participants in this Internet trial were not just internet savvy young males without significant impairment. Future studies should aim to recruit participants with lower educational status to increase the reach of Internet interventions., Highlights • The present study consists of a large sample size with participants from multiple sources. • Differences in characteristics between depressed participants in an Internet trial and in a population-based sample were found. • Participants in the Internet trial were older, more often female, single/divorced, more highly educated and more depressed. • Mild to moderately depressed individuals seeking help in the Internet are substantially impaired.

To examine the association of diagnosed depression with the utilization of health care services and preventive measures among men and women in the general population in Germany.Cross-sectional analysis of data from a representative telephone survey (men N = 18,675, women N = 24,518, 18 years and older). Self-reported health professional-diagnosed depression (past 12 months) and the use of a range of health care and preventive services were assessed.Diagnosed depression was associated with increased health care service utilization in both sexes. Diagnosed depression was associated with higher utilization of some preventive services, such as general health check-ups (odds ratio [OR] 1.2), cancer screening (OR 1.2) and flu vaccination (OR 1.3) among women and cancer screening (OR 1.4) among men.Health professional-diagnosed depression is associated with increased health service utilization independent of somatic comorbidity and socio-demographic confounders. There was no indication for specific under-treatment with preventive measures among people with depression diagnosis.ZIEL: Untersuchung des Zusammenhangs einer Depressionsdiagnose mit der Inanspruchnahme von Gesundheitsleistungen.In einer repräsentativen Querschnittstudie Erwachsener (Männer N = 18 675, Frauen N = 24 518) wurde eine diagnostizierte Depression und medizinische Versorgungs- und Vorsorgeleistungen erhoben.Eine Depressionsdiagnose war mit einer erhöhten Inanspruchnahme aller Versorgungsleistungen und einzelner Vorsorgeleistungen assoziiert.Es gibt keinen Hinweis auf eine Unterversorgung bzgl. Vorsorgeleistungen speziell bei Personen mit einer Depressionsdiagnose.

Ziel: Darstellung der Haufigkeit von selbstberichtetem diagnostiziertem Burnout-Syndrom und psychiatrische Komorbiditaten. Methode: Bundesweite Studie, n = 7987. Burnout-Syndrom: selbstberichtete arztl./psychother. Diagnose. Psychische Storungen: diagnostisches Interview, n = 4483. Ergebnisse: Pravalenz: Lebenszeit 4,2 %, 12 Monate 1,5 %. Irgendeine psychische Storung: 70,9 % derer mit Burnout-Diagnose. Assoziierte Storungen: somatoforme, affektive, Angststorungen. Schlussfolgerung: Burnout-Diagnosen werden seltener berichtet als erwartet. Betroffene haben haufig eine manifeste psychische Storung.

Ziel der Studie: Untersuchung der Komorbiditat von Diabetes und Depression. Methode: In einer bundesweiten Stichprobe Erwachsener (n = 43 312) wurden 19 diagnostizierte chronische Krankheiten und diagnostizierte Depression erfasst. Ergebnisse: 12-Monats-Pravalenzen: diagnostizierter Diabetes 7,4 %, diagnostizierte Depression 6,7 %, deren Komorbiditat 0,8 %. Eine Assoziation beider Erkrankungen lag bei Personen unter 50 und bei Frauen von 50 – 64 Jahren vor. Sie war abhangig von der Anzahl weiterer Erkrankungen. Schlussfolgerung: Trotz niedriger Pravalenz der Komorbiditat besteht Versorgungsrelevanz.

This paper provides up to date prevalence estimates of mental disorders in Germany derived from a national survey (German Health Interview and Examination Survey for Adults, Mental Health Module [DEGS1-MH]). A nationally representative sample (N = 5318) of the adult (18–79) population was examined by clinically trained interviewers with a modified version of the Composite International Diagnostic Interview (DEGS-CIDI) to assess symptoms, syndromes and diagnoses according to DSM-IV-TR (25 diagnoses covered). Of the participants 27.7% met criteria for at least one mental disorder during the past 12 months, among them 44% with more than one disorder and 22% with three or more diagnoses. Most frequent were anxiety (15.3%), mood (9.3%) and substance use disorders (5.7%). Overall rates for mental disorders were substantially higher in women (33% versus 22% in men), younger age group (18–34: 37% versus 20% in age group 65–79), when living without a partner (37% versus 26% with partnership) or with low (38%) versus high socio-economic status (22%). High degree of urbanization (> 500,000 inhabitants versus

This paper provides up-to-date data on service use for mental health problems and disorders among adults aged 18-79 years in Germany derived from the Mental Health Module of the German Health Interview and Examination Survey for Adults (DEGS1-MH; N=4483). Data are based exclusively on self-report. Respondents were examined by clinically trained interviewers with a modified version of the Composite International Diagnostic Interview DIA-X/M-CIDI to assess diagnoses according to the criteria of DSM-IV-TR. Service use, i.e. contact to mental health care services, due to mental health problems was assessed for the past 12 months and lifetime, by type of sector and type of institution. Among respondents with a 12-month diagnosis of a mental disorder, 23.5% of the women and 11.6% of the men reported any service use in the past 12 months. Service use depends on type of diagnosis, comorbidity and socio-demographic characteristics. Lowest 12-month utilization rates were found for substance use disorders (15.6%; lifetime use 37.3%), highest for psychotic disorders (40.5%; lifetime 72.1%). Further, a considerable time lap was found between disorder onset and subsequent service use among the majority of cases with anxiety and mood disorders. This paper provides self-reported epidemiological data on mental health service use in Germany, complementing administrative statistics and the predecessor mental health module of the German Health Interview and Examination Survey (GHS-MHS) from 1998. Despite considerable changes in the mental health field in Germany and the existence of a comprehensive mental health care system without major financial barriers, we find no indications of substantially higher utilization rates for mental disorders as compared to other comparable European countries. Further, no indications of major overall changes in utilization rates are apparent. To pinpoint areas with unmet needs, more detailed analyses of the data are needed taking into account type, frequency, and adequacy of service use and treatment of mental disorders. Appropriately matched comparisons with the GHS-MHS are needed to identify changes in patterns of utilization and interventions by type of disorder. Copyright © 2014 John Wiley & Sons, Ltd.

Die „Studie zur Gesundheit Erwachsener in Deutschland“ (DEGS1) und ihr Zusatzmodul „Psychische Gesundheit“ (DEGS1-MH) erlauben erstmals seit dem 15 Jahre zuruckliegenden Bundesgesundheitssurvey (BGS98) aktuelle Abschatzungen zu Morbiditat, Einschrankungsprofilen und Inanspruchnahmeverhalten der deutschen Erwachsenen. Es werden die wichtigsten Ergebnisse zu Pravalenzen psychischer Storungen, zu damit assoziierten Beeintrachtigungen sowie zu Kontaktraten mit Gesundheitsdiensten berichtet. Der Studie liegt eine bevolkerungsreprasentative Erwachsenenstichprobe (18–79 Jahre, n = 5317) zugrunde, die uberwiegend personlich mit ausfuhrlichen klinischen Interviews (Composite International Diagnostic Interview; CIDI) untersucht wurde. Die 12-Monats-Pravalenz psychischer Storungen betragt insgesamt 27,7 %, wobei grose Unterschiede in verschiedenen Gruppen (z. B. Geschlecht, Alter, sozialer Status) zu verzeichnen sind. Psychische Storungen stellten sich als besonders beeintrachtigend heraus (erhohte Zahl an Einschrankungstagen). Weniger als die Halfte der Betroffenen berichtet, aktuell wegen psychischer Probleme in Behandlung zu stehen (10–40 % in Abhangigkeit von der Anzahl der Diagnosen). Psychische Storungen sind haufig. Die im Vergleich zu Personen ohne aktuelle psychische Diagnose deutlich erhohte Rate an Beeintrachtigungstagen signalisiert neben dem individuellen Leiden der Betroffenen eine grose gesellschaftliche Krankheitslast – auch verglichen mit vielen korperlichen Erkrankungen. Trotz des in Deutschland vergleichsweise gut ausgebauten Versorgungssystems fur psychische Storungen ist Optimierungsbedarf hinsichtlich der Behandlungsrate zu vermuten.

Schlafstorungen sind mit einer Vielzahl von korperlichen und psychischen Gesundheitsstorungen verbunden und verursachen hohe gesundheitsokonomische und volkswirtschaftliche Folgekosten. Ziel der hier vorliegenden Studie war es, die Haufigkeit und Verteilung von Ein- und Durchschlafstorungen, der Schlafqualitat, der Schlafdauer, des Schlafmittelkonsums sowie des Insomniesyndroms in der deutschen Erwachsenenbevolkerung zu berichten. Etwa ein Drittel der Befragten hatte wahrend der letzten 4 Wochen potenziell klinisch relevante Ein- oder Durchschlafstorungen, etwa ein Funftel berichtete zusatzlich uber eine schlechte Schlafqualitat. Unter zusatzlicher Berucksichtigung von Tagesbeeintrachtigungen wie Mudigkeit und/oder Erschopfung ergab sich eine Pravalenz von 5,7 % fur ein Insomniesyndrom. Frauen waren doppelt so haufig von Insomnie betroffen wie Manner, signifikante Altersunterschiede gab es nicht. Personen mit niedrigem Sozialstatus (OR: 3,44) und Personen mit Wohnsitz in Westdeutschland (OR: 1,53) hatten ein erhohtes Risiko fur Insomnie, wobei Frauen mit niedrigem Sozialstatus (OR: 4,12) und westdeutsche Manner (OR: 1,79) starker betroffen waren. Die Ergebnisse verdeutlichen die hohe Public-Health-Relevanz von Insomnie-bezogenen Schlafstorungen.

In der Studie zur Gesundheit Erwachsener in Deutschland (DEGS1) wurden von 2008 bis 2011 in einer bevolkerungsreprasentativen Stichprobe von 7988 Personen im Alter von 18 bis 79 Jahren aktuelle depressive Symptome mit dem „Patient Health Questionnaire“ (PHQ-9) erfasst. Zusatzlich wurden diagnostizierte Depressionen in einem arztlichen Interview erfragt. Eine depressive Symptomatik (PHQ-9 ≥ 10 Punkte) besteht bei 8,1 % der Erwachsenen (Frauen 10,2 %; Manner 6,1 %). Bei beiden Geschlechtern ist die Pravalenz bei 18- bis 29-Jahrigen am hochsten und fallt danach ab. Bei Mannern und Frauen mit hoherem soziookonomischem Status besteht seltener eine depressive Symptomatik. Die Lebenszeitpravalenz einer diagnostizierten Depression betragt 11,6 % (Frauen 15,4 %; Manner 7,8 %) und ist am hochsten bei 60- bis 69-Jahrigen; die 12-Monats-Pravalenz liegt bei 6,0 % (Frauen 8,1 %; Manner 3,8 %) und ist am hochsten bei 50- bis 59-Jahrigen. Bei Frauen, aber nicht bei Mannern sinken die Diagnosepravalenzen mit steigendem soziookonomischem Status. Die Ergebnisse beschreiben die weite Verbreitung von depressiver Symptomatik und diagnostizierter Depression in der Erwachsenenbevolkerung in Deutschland und bestatigen bekannte Zusammenhange von Depression mit Alter, Geschlecht und soziookonomischem Status.

OBJECTIVE To assess the association of chronic somatic diseases and mental health problems in the general population in Germany. METHODS The data (n = 22 050) derived from the representative cross-sectional telephone survey "Gesundheit in Deutschland aktuell (GEDA) 2010". It included self-reported information on diagnosis of 19 chronic physical conditions for at least 18-year-old people. Mental health problems encompass self-reported diagnosis of depression and recent mental distress according to the Mental Health Inventory (MHI-5). Age-specific adjusted logistic regressions were calculated. RESULTS There was an association of chronic physical illness and mental health problems in all age groups. In 18 - 44 and 45 - 64-year-olds the association got stronger with each additional chronic disease. In all age groups mental health problems were most common in multimorbid subjects. CONCLUSION Comorbid mental health problems should be accounted for particularly in multimorbid subjects of all ages. In younger patients mental health problems should be considered even if only one chronic disease is present.

Background While standardized diagnostic interviews using established criteria are the gold standard for assessing depression, less time consuming measures of depression and depressive symptoms are commonly used in large population health surveys. We examine the prevalence and health-related correlates of three depression measures among adults aged 18–79 years in Germany. Methods Using cross-sectional data from the national German Health Interview and Examination Survey for Adults (DEGS1) (n=7987) and its mental health module (DEGS1-MH) (n=4483), we analysed prevalence and socio-demographic and health-related correlates of (a) major depressive disorder (MDD) established by Composite International Diagnostic Interview (CIDI) using DSM-IV-TR criteria (CIDI–MDD) in the last 12 months, (b) self-reported physician or psychotherapist diagnosed depression in the last 12 months, and (c) current depressive symptoms in the last two weeks (PHQ-9, score ≥10). Results Prevalence of 12-month CIDI–MDD was 4.2% in men and 9.9% in women. Prevalence of 12-month self-reported health professional-diagnosed depression was 3.8% and 8.1% and of current depressive symptoms 6.1% and 10.2% in men and women, respectively. Case-overlap between measures was only moderate (32–45%). In adjusted multivariable analyses, depression according to all three measures was associated with lower self-rated health, lower physical and social functioning, higher somatic comorbidity (except for women with 12-month CIDI–MDD), more sick leave and higher health service utilization. Limitations Persons with severe depression may be underrepresented. Associations between CIDI–MDD and correlates and overlap with other measures may be underestimated due to time lag between DEGS1 and DEGS1-MH. Conclusions Prevalence and identified cases varied between these three depression measures, but all measures were consistently associated with a wide range of adverse health outcomes.

BackgroundThis paper provides nationally representative data on how current and past mental disorders are related to functional disability and health-related quality of life (QoL).MethodsResults are based on a nationally representative sample (DEGS1-MH; n = 4483 aged 18–79). Respondents were examined by clinical interviewers with the DSM-IV Composite International Diagnostic Interview (DIA-X/M-CIDI). Functional disability, i.e. number of disability days in the past 4 weeks, and QoL, i.e. mental (MCS) and physical (PCS) component scale of the SF-36V2, were examined in subjects with 12-month mental disorders (= active cases [AC]) and compared to (a) subjects who never met diagnostic criteria (= unaffected individuals [UAI]), and (b) those with a history of mental disorders but not meeting the diagnostic criteria in the past 12 months (= non-active cases [NAC]; partially or fully remitted).ResultsIn comparison to UAI (mean: 1.9), AC reveals a 2–3 fold disability days/month (5.4, P < .001) and a substantially reduced MCS (UAI: 52.1; AC: 43.3, P < .001). NAC had a similar number of disability days as UAI, but significantly reduced MCS scores (49.9; P < .001). Disability days and QoL decrements were highest in internalizing disorders including somatoform disorders and most pronounced in comorbid cases.ConclusionsBy and large, findings of a previous study were confirmed and extended for this nationally representative German sample. 12-month mental disorders, particularly internalizing, including somatoform disorders, are associated with high levels of disability and increased health-related QoL decrements. Partial or complete remission of the mental disorders is associated with a normalization of the numbers of disability days.

Background There is substantial evidence that lower objective socioeconomic status (SES)—as measured by education, occupation, and income—is associated with a higher risk of depression. Less is known, however, about associations between perceptions of social status and the prevalence of depression. This study investigated associations of both objective SES and subjective social status (SSS) with depressive symptoms among adults in Germany. Methods Data were obtained from the 2013 special wave of the German Health Update study, a national health survey of the adult population in Germany. Objective SES was determined using a composite index based on education, occupation, and income. The three single dimensions of the index were also used individually. SSS was measured using the MacArthur Scale, which asks respondents to place themselves on a 10-rung ‘social ladder’. Regression models were employed to examine associations of objective SES and SSS with current depressive symptoms, as assessed with the eight-item Patient Health Questionnaire depression scale (PHQ-8 sum score ≥10). Results After mutual adjustment, lower objective SES and lower SSS were independently associated with current depressive symptoms. The associations were found in both sexes and persisted after further adjustment for sociodemographic factors, long-term chronic conditions, and functional limitations. Mediation analyses revealed a significant indirect relationship between objective SES and depressive symptoms through SSS. When the three individual dimensions of objective SES were mutually adjusted, occupation and income were independently associated with depressive symptoms. After additional adjustment for SSS, these associations attenuated but remained significant. Conclusions The findings suggest that perceptions of low social status in adults may be involved in the pathogenesis of depression and play a mediating role in the relationship between objective SES and depressive symptoms. Prospective studies are needed to establish the direction of effects and to address questions of causality.

To determine the prevalence and comorbid mental disorders of self-reported diagnosis of burnout syndrome in the general population of Germany.In the German Health Interview and Examination Survey (DEGS1) self-reported diagnosis of a burnout syndrome made by a physician or psychotherapist was assessed in a standardized interview (N = 7987). For N = 4483 mental disorders were determined with the Composite International Diagnostic Interview (CIDI). Weighted lifetime and 12-month prevalences were calculated.Lifetime prevalence of diagnosed burnout syndrome was 4.2 % (women 5.2 %, men 3.3 %), 12-month prevalence was 1.5 % (women 1.9 %, men 1.1 %). Highest prevalences were found in 40 - 59 year olds, in people with middle and high socio economic status and in women with low and men with high social support. Among the 12-month cases, 70.9 % had at least one DSM-IV disorder. Associations were found for the diagnosis of burnout syndrome with somatoform, affective and anxiety disorders.The diagnosis of burnout syndrome is less frequently given and reported than expected. People with a burnout diagnosis often have a manifest mental disorder.

To assess the comorbidity of diabetes and depression in the adult general population of Germany.Data (n = 43 312) derived from the representative cross-sectional telephone survey "German Health Update (GEDA)". Information about diagnosed chronic somatic diseases including diabetes and diagnosed depression was available for residents in private households. Age- and sex-specific adjusted logistic regressions were used to examine the association between diabetes and depression.12-month prevalences: diagnosed diabetes 7.4 %, diagnosed depression 6.7 %, comorbidity of both 0.8 %. An association of diabetes and depression was found in people 50 years and in women aged 50 - 64 years. This association was dependent on the number of additional chronic diseases.Comorbidity of diabetes and depression was quite rare. Yet according to our results every 10(th) adult with diagnosed diabetes gets a depression diagnosis and every 9(th) adult with diagnosed depression has known diabetes. Underestimation for men and older adults due to diagnostic bias is possible. The combination of diabetes and depression is relevant for medical care because of its health burden.

This paper provides up‐to‐date data on service use for mental health problems and disorders among adults aged 18‐79 years in Germany derived from the Mental Health Module of the German Health Interview and Examination Survey for Adults (DEGS1‐MH; N=4483). Data are based exclusively on self‐report. Respondents were examined by clinically trained interviewers with a modified version of the Composite International Diagnostic Interview DIA‐X/M‐CIDI to assess diagnoses according to the criteria of DSM‐IV‐TR. Service use, i.e. contact to mental health care services, due to mental health problems was assessed for the past 12 months and lifetime, by type of sector and type of institution. Among respondents with a 12‐month diagnosis of a mental disorder, 23.5% of the women and 11.6% of the men reported any service use in the past 12 months. Service use depends on type of diagnosis, comorbidity and socio‐demographic characteristics. Lowest 12‐month utilization rates were found for substance use disorders (15.6%; lifetime use 37.3%), highest for psychotic disorders (40.5%; lifetime 72.1%). Further, a considerable time lap was found between disorder onset and subsequent service use among the majority of cases with anxiety and mood disorders. This paper provides self‐reported epidemiological data on mental health service use in Germany, complementing administrative statistics and the predecessor mental health module of the German Health Interview and Examination Survey (GHS‐MHS) from 1998. Despite considerable changes in the mental health field in Germany and the existence of a comprehensive mental health care system without major financial barriers, we find no indications of substantially higher utilization rates for mental disorders as compared to other comparable European countries. Further, no indications of major overall changes in utilization rates are apparent. To pinpoint areas with unmet needs, more detailed analyses of the data are needed taking into account type, frequency, and adequacy of service use and treatment of mental disorders. Appropriately matched comparisons with the GHS‐MHS are needed to identify changes in patterns of utilization and interventions by type of disorder. Copyright © 2014 John Wiley & Sons, Ltd.

To assess the association of chronic somatic diseases and mental health problems in the general population in Germany.The data (n = 22 050) derived from the representative cross-sectional telephone survey "Gesundheit in Deutschland aktuell (GEDA) 2010". It included self-reported information on diagnosis of 19 chronic physical conditions for at least 18-year-old people. Mental health problems encompass self-reported diagnosis of depression and recent mental distress according to the Mental Health Inventory (MHI-5). Age-specific adjusted logistic regressions were calculated.There was an association of chronic physical illness and mental health problems in all age groups. In 18 - 44 and 45 - 64-year-olds the association got stronger with each additional chronic disease. In all age groups mental health problems were most common in multimorbid subjects.Comorbid mental health problems should be accounted for particularly in multimorbid subjects of all ages. In younger patients mental health problems should be considered even if only one chronic disease is present.

IntroductionDepressive disorders have been related to increased health service utilization, but specific information about associations between health professional-diagnosed depression and the utilization of health care and preventive services in the general population is limited.ObjectivesTo compare the use of health care and preventive services among men and women with and without diagnosed depression in the general population in Germany.AimsTo examine the association of diagnosed depression with the utilization of healthcare and preventive services.MethodsCross-sectional analysis of data from the representative telephone survey German Health Update (GEDA) 2009 and 2010 (n = 43.312 residents in private households 18 years and older). We analyzed associations between self-reported health professional-diagnosed depression (past 12 months) and the use of a range of healthcare services and preventive services covered by statutory health insurances using multivariable regressions adjusted for age, socio-economic status, marital status, employment and number of chronic somatic conditions.ResultsTwelve-month diagnosed depression was associated with increased health care service utilization (physician contacts, hospital admissions, rehabilitation) in both sexes. Of the preventive services, diagnosed depression was associated with increased use of general health check-ups, cancer screening and flu vaccination among women, while there was no association with dental check-up and tetanus and pertussis vaccination. Among men, no association of diagnosed depression with any preventive service was found except for cancer screening.ConclusionsHealth professional-diagnosed depression is associated with increased health service utilization independent of somatic comorbidity and socio-demographic confounders. This includes some preventive services in women and only one preventive service in men.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Psychotic and psychotic-like experiences (PLEs) are frequently found in the general population when assessed with self-report questionnaires. It is not clear how these assessments can help to predict the future development of mental disorders. The degree of certainty in appraisal or the experience-related distress may add prognostic power of clinical PLE assessments. This study was designed to provide baseline data of PLEs in a representative sample, which will be monitored for the future development. Methods We studied the frequency of PLEs in a representative sample of 4483 participants of the German population recruited through the Mental Health Module of the German Health Interview and Examination Survey for Adults (DEGS1-MH). Participants were asked if they had had psychotic or psychosis-like experiences over their lifetime. We used the psychosis section of the Composite International Diagnostic Interview (CIDI), the Launay-Slade Hallucination Scale (LSHS) and the Peter's Delusion Inventory (PDI). Preliminary Results 33.3% of the participants endorsed at least one item of the CIDI psychosis scale, 68.8% of the PDI and 49.0% of the LSHS. In the PDI assessments, conspiracy-related delusional experiences were most often experienced as distressing, while religious beliefs were experienced less distressing, but with high levels of conviction. Discussion Our findings show frequent endorsement of lifetime psychotic or psychotic-like experiences in the general population in self-report questionnaires with varying degrees of distress and conviction. This provides the needed baseline assessment for follow-up studies observing the development of mental disorders with a view to determine the predictive values of these tests.

Background Prevalence estimates for depression vary considerably by the type of assessment instrument, and there is limited information on their overlap in population-based samples. Our aim was to compare the Patient Health Questionnaire-9 (PHQ-9) with the Composite International Diagnostic Interview (CIDI) as measures for current major depressive syndrome (MDS) in a large population-based sample. Methods Data derived from the mental health module of the nationwide cross-sectional German Health Interview and Examination Survey for Adults (DEGS1-MH) (n = 4483; age 18–79 years). MDS in the past two weeks was assessed (a) using the PHQ-9 diagnostic algorithm (PHQ-MDS) and (b) based on CIDI information about the latest symptom occurrence (recency) (CIDI-MDS). Prevalences, overall concordance and percentages of overlap of both MDS measures were determined. Prevalences of affirmed PHQ-9 depression symptoms and the mean and median PHQ-9 sum scores were analyzed per measure. Results Prevalence of current MDS was 2.7% (95% CI: 2.0-3.6) for PHQ-MDS and 3.9% (95% CI: 3.1-5.0) for CIDI-MDS. The overall agreement between both measures was moderate (kappa: 0.43). Of all the participants, 1.5% (95% CI: 1.0-2.2) were classified as MDS cases by both measures, with 54.5% (95% CI: 42.7-65.9) of PHQ-MDS cases and 37.9% (95% CI: 27.8-49.1) of CIDI-MDS cases also being classified as MDS by the respective other MDS measure. However, 94.8% (95% CI: 93.6-95.8) of the participants were classified as non-MDS by both measures, with 97.5% (95% CI: 96.6-98.1) of non-PHQ-MDS and 98.7% (95% CI: 98.2-99.1) of non-CIDI-MDS being classified as non-MDS by the respective other MDS measure. The mean and median PHQ-9 sum score was higher in those with PHQ-MDS than in those with CIDI-MDS. Conclusions Both measures have a high level of agreement for ruling out current MDS, but the overlap in their classification of cases is moderate. Our results indicate that they cannot be interpreted as equal measures of the same construct, suggesting limited comparability of their prevalence estimates. However, further exploration of algorithms and correlates and a proper labeling of measures in epidemiological studies are required.

Background Respondents’ report of a previously diagnosed depression by a health professional is frequently used to estimate depression prevalence. This study contributes to a better understanding of survey results based on this measure by comparing it with a comprehensive standardized diagnostic interview. Methods Data came from the cross-sectional nationwide German Health Interview and Examination Survey for Adults (DEGS1) and its mental health module (DEGS1-MH, n = 4483). In DEGS1, participants were asked whether they have been diagnosed with depression by a physician or psychotherapist (last 12-month). DSM-IV-based 12-month major depressive disorder (MDD) and other mental disorders were assessed with the German version of the Composite International Diagnostic Interview (CIDI). Time lag between both assessments was 6 weeks (median). Results 73.4% of participants reporting clinician-diagnosed depression met criteria for any mental disorder in the CIDI (any affective disorder: 51.8%, any anxiety disorder: 54.7%). The proportion of participants reporting a clinician-diagnosed depression who met MDD criteria was highest among those aged 18–29 years (62.6%) and decreased with age (65–79 years: 29.8%). Among participants with MDD, the proportion with clinician-diagnosed depression was 33.0%, highest among those aged 45–64 years (49.3%) and lowest among those aged 18–29 years (22.7%) and 30–44 years (20.3%). MDD severity was positively associated with clinician-diagnosed depression. Conclusions Respondents’ report of a clinician-diagnosed depression and major depression assessed with the CIDI substantially differ. Concordance of both measures varies with age and severity of depressive symptoms. Health surveys should assess a range of depression indicators in order to cover a wide spectrum. Electronic supplementary material The online version of this article (doi:10.1186/s12888-017-1203-8) contains supplementary material, which is available to authorized users.