Diagnostizierte Depression und Inanspruchnahme von medizinischen Versorgungs- und Vorsorgeleistungen bei Erwachsenen in Deutschland^[1]

Zusammenfassung

Ziel Untersuchung des Zusammenhangs einer Depressionsdiagnose mit der Inanspruchnahme von Gesundheitsleistungen.

Methode In einer repräsentativen Querschnittstudie Erwachsener (Männer N = 18 675, Frauen N = 24 518) wurde eine diagnostizierte Depression und medizinische Versorgungs- und Vorsorgeleistungen erhoben.

Ergebnisse Eine Depressionsdiagnose war mit einer erhöhten Inanspruchnahme aller Versorgungsleistungen und einzelner Vorsorgeleistungen assoziiert.

Schlussfolgerung Es gibt keinen Hinweis auf eine Unterversorgung bzgl. Vorsorgeleistungen speziell bei Personen mit einer Depressionsdiagnose.

Abstract

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.

Schlüsselwörter

Depression - Inanspruchnahme - Versorgungsleistungen - Vorsorgeleistungen - Allgemeinbevölkerung

Keywords

depression - service use - health care services - preventive measures - general population

¹ Der Inhalt dieser Arbeit wurde am 15. März 2016 auf dem Kongress der European Psychiatric Association (EPA) in Madrid als Posterpräsentation mündlich vorgetragen.

^* Geteilte Autorenschaft: Die gekennzeichneten Autoren haben zu gleichen Teilen zu der Arbeit beigetragen.

• Literatur

• 1 Maske UE, Buttery AK, Beesdo-Baum K. et al. Prevalence and correlates of DSM-IV-TR major depressive disorder, self-reported diagnosed depression and current depressive symptoms among adults in Germany. J Affect Disord 2016; 190: 167-177
• 2 Busch MA, Neuner B, Aichberger MC. et al. [Depressive symptoms and health service utilisation among persons 50 years or older in Germany. A population-based cross-sectional study]. Psychiat Prax 2013; 40: 214-219
• 3 Luppa M, Sikorski C, Motzek T. et al. Health service utilization and costs of depressive symptoms in late life – a systematic review. Curr Pharm Des 2012; 18: 5936-5957
• 4 Peytremann-Bridevaux I, Voellinger R, Santos-Eggimann B. Healthcare and preventive services utilization of elderly Europeans with depressive symptoms. J Affect Disord 2008; 105: 247-252
• 5 Ferrari AJ, Charlson FJ, Norman RE. et al. Burden of depressive disorders by country, sex, age, and year: findings from the global burden of disease study 2010. PLoS Med 2013; 10: e1001547
• 6 Gaebel W, Kowitz S, Fritze J. et al. Use of health care services by people with mental illness: secondary data from three statutory health insurers and the German Statutory Pension Insurance Scheme. Dtsch Arztebl Int 2013; 110: 799-808
• 7 Ruo B, Rumsfeld JS, Pipkin S. et al. Relation between depressive symptoms and treadmill exercise capacity in the Heart and Soul Study. Am J Cardiol 2004; 94: 96-99
• 8 Allgower A, Wardle J, Steptoe A. Depressive symptoms, social support, and personal health behaviors in young men and women. Health Psychol 2001; 20: 223-227
• 9 Anttila S, Knuuttila M, Ylostalo P. et al. Symptoms of depression and anxiety in relation to dental health behavior and self-perceived dental treatment need. Eur J Oral Sci 2006; 114: 109-114
• 10 Buttery AK, Mensink GB, Busch MA. Healthy behaviours and mental health: findings from the German Health Update (GEDA). Eur J Public Health 2015; 25: 219-225
• 11 Goodwin RD. Association between physical activity and mental disorders among adults in the United States. Prev Med 2003; 36: 698-703
• 12 Klungsøyr O, Nygård JF, Sørensen T. et al. Cigarette smoking and incidence of first depressive episode: An 11-year, population-based follow-up study. Am J Epidemiol 2006; 163: 421-432
• 13 ten Have M, de Graaf R, Monshouwer K. Physical exercise in adults and mental health status: Findings from the Netherlands Mental Health Survey and Incidence Study (NEMESIS). J Psychosom Res 2011; 71: 342-348
• 14 Okoro CA, Strine TW, Eke PI. et al. The association between depression and anxiety and use of oral health services and tooth loss. Community Dent Oral Epidemiol 2012; 40: 134-144
• 15 Lord O, Malone D, Mitchell AJ. Receipt of preventive medical care and medical screening for patients with mental illness: a comparative analysis. Gen Hosp Psychiatry 2010; 32: 519-543
• 16 Lange C, Jentsch F, Allen J. et al. Data Resource Profile: German Health Update (GEDA) – the health interview survey for adults in Germany. Int J Epidemiol 2015; 44: 442-450
• 17 Gemeinsamer Bundesausschuss (GB-A). Früherkennungsuntersuchungen. Im Internet: https://www.g-ba.de/institution/themenschwerpunkte/frueherkennung/ueberblick/ (Stand: abgerufen am 22.02.2016)
• 18 Ständige Impfkommission am Robert Koch-Institut (RKI). Epidemiologisches Bulletin. 34/ 2015. DOI: 10.17886/EpiBull-2015-001.2
• 19 Lampert T, Kroll LE, Muters S. et al. Messung des soziookonomischen Status in der Studie „Gesundheit in Deutschland aktuell“ (GEDA). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2013; 56: 131-143
• 20 Fuchs J, Busch M, Lange C. et al. Prevalence and patterns of morbidity among adults in Germany. Results of the German telephone health interview survey German Health Update (GEDA) 2009. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2012; 55: 576-586
• 21 Maske UE, Busch MA, Jacobi F. et al. Chronic Somatic Conditions and Mental Health Problems in the General Population in Germany. Psychiat Prax 2013; 40: 207-213
• 22 Himelhoch S, Weller WE, Wu AW. et al. Chronic medical illness, depression, and use of acute medical services among Medicare beneficiaries. Med Care 2004; 42: 512-521
• 23 Bogner HR, Wittink MN. Depression as a risk factor for underuse of mammography. J Womens Health (Larchmt) 2004; 13: 739-742
• 24 Pirraglia PA, Sanyal P, Singer DE. et al. Depressive symptom burden as a barrier to screening for breast and cervical cancers. J Womens Health (Larchmt) 2004; 13: 731-738
• 25 Mojtabai R. Clinician-identified depression in community settings: concordance with structured-interview diagnoses. Psychother Psychosom 2013; 82: 161-169
• 26 Alonso J, Angermeyer MC, Bernert S. et al. Use of mental health services in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project. Acta Psychiatr Scand Suppl 2004; 412: 47-54
• 27 Wittchen HU, Pittrow D. Prevalence, recognition and management of depression in primary care in Germany: the Depression 2000 study. Hum Psychopharmacol 2002; 17 (Suppl. 01) S1-11
• 28 Schomerus G, Matschinger H, Angermeyer MC. The stigma of psychiatric treatment and help-seeking intentions for depression. Eur Arch Psychiatry Clin Neurosci 2009; 259: 298-306