1.
Self-reported utilization of mental health services in the adult German population - evidence for unmet needs? Results of the DEGS1-Mental Health Module (DEGS1-MH)
Mack, Simon; Jacobi, Frank; Gerschler, Anja ...
International Journal of Methods in Psychiatric Research,
September 2014, Letnik:
23, Številka:
3
Journal Article
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.
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Dostopno za:
DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, SIK, UILJ, UKNU, UL, UM, UPUK
2.
Twelve-month prevalence, comorbidity and correlates of mental disorders in Germany: the Mental Health Module of the German Health Interview and Examination Survey for Adults (DEGS1-MH)
Jacobi, Frank; Höfler, Michael; Siegert, Jens ...
International Journal of Methods in Psychiatric Research,
September 2014, Letnik:
23, Številka:
3
Journal Article
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 < 20,000) was associated with elevated rates of psychotic (5.2% versus 2.5%) and mood disorders (13.9% versus 7.8%). The findings confirm that almost one third of the general population is affected by mental disorders and inform about subsets in the population who are particularly affected. Copyright © 2014 John Wiley & Sons, Ltd.
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Dostopno za:
DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, SIK, UILJ, UKNU, UL, UM, UPUK
3.
Twelve-months prevalence of mental disorders in the German Health Interview and Examination Survey for Adults - Mental Health Module (DEGS1-MH): a methodological addendum and correction
Jacobi, Frank; Höfler, Michael; Strehle, Jens ...
International Journal of Methods in Psychiatric Research,
December 2015, Letnik:
24, Številka:
4
Journal Article
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.
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Dostopno za:
DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, SIK, UILJ, UKNU, UL, UM, UPUK
4.
Functional disability and quality of life decrements in mental disorders: Results from the Mental Health Module of the German Health Interview and Examination Survey for Adults (DEGS1-MH)
Mack, Simon; Jacobi, Frank; Beesdo-Baum, Katja ...
European psychiatry,
09/2015, Letnik:
30, Številka:
6
Journal Article
Abstract Background This paper provides nationally representative data on how current and past mental disorders are related to functional disability and health-related quality of life (QoL). Methods ...
Results 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). Results In 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. Conclusions By 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.
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Dostopno za:
NUK, UL, UM, UPUK
5.
The design and methods of the mental health module in the German Health Interview and Examination Survey for Adults (DEGS1-MH)
Jacobi, Frank; Mack, Simon; Gerschler, Anja ...
International Journal of Methods in Psychiatric Research,
June 2013, Letnik:
22, Številka:
2
Journal Article
DEGS1‐MH is part of the first wave of the German Health Interview and Examination Survey (DEGS1) covering all relevant health issues. Aims of DEGS1‐MH are to supplement DEGS1 by describing (1) the ...
distribution and frequency, the severity and the impairments of a wide range of mental disorders, (2) risk factors as well as patterns of help‐seeking and health care utilization, and (3) associations between mental and somatic disorders, (4) and by comparisons with a similar survey in the late 1990s (GHS‐MHS), longitudinal trends and changes in morbidity over time. Out of all eligible DEGS1 respondents (nationally representative sample aged 18–79), N = 5318 subjects (conditional response rate 88%) were examined at their place of residence by clinically trained interviewers with a modified version of the standardized, computer‐assisted Composite International Diagnostic Interview (DEGS‐CIDI). Innovative additions were: a comprehensive neuropsychological examination, a broader assessment of psychosis‐like experiences, disorder‐specific disabilities, help‐seeking and health care utilization. The mental health module and its combination with the assessment of somatic and other health issues in DEGS1 allow for internationally unique, detailed and comprehensive analyses about mental disorders and the association of mental and somatic health issues in the community, constituting an improved basis for regular future surveys of this sort. Copyright © 2013 John Wiley & Sons, Ltd.
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Dostopno za:
DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, SIK, UILJ, UKNU, UL, UM, UPUK
6.
Measuring symptoms and diagnosing mental disorders in the elderly community: the test-retest reliability of the CIDI65
Wittchen, Hans-Ulrich; Strehle, Jens; Gerschler, Anja ...
International Journal of Methods in Psychiatric Research,
June 2015, Letnik:
24, Številka:
2
Journal Article
Prevalence findings for the elderly are artificially low, most likely due to insufficient consideration of age‐related cognitive abilities in diagnostic interviews.
Aims
(1) To describe the rationale ...
for the development of an age‐adapted Composite International Diagnostic Interview (CIDI65+) for use in a European project (MentDis_ICF65+). (2) To examine its test–retest reliability.
Methods
Based on substantive pilot work the CIDI standard questions were shortened, broken down into shorter subsets and combined with sensitization questions and dimensional measures. Test–retest was determined in N = 68 subjects aged 60–79 years via two independent examinations by clinical interviewers using kappa (sensitivity, specificity) for categorical and intraclass correlation (ICC) coefficients for dimensional measures.
Results
Test–retest reliability was good for any mental disorder (κ = 0.63), major depression (κ = 0.55), anxiety (κ = 0.62, range = 0.30–0.78), substance (κ = 0.77, range = 0.71–0.82), obsessive‐compulsive disorder (κ = 1.00) and most core symptoms/syndromes (κ range = 0.48–1.00). Agreement for some disorders (i.e. somatoform/pain) attenuated, partly due to time lapse effects. ICC for age of onset, recency, quantity, frequency and duration questions ranged between κ = 0.60–0.90. Dimensional agreement measures were not consistently higher.
Conclusion
The age‐adapted CIDI65+ is reliable for assessing most mental disorders, distress, impairment and time‐related information in the elderly, prompting the need to examine validity. Copyright © 2014 John Wiley & Sons, Ltd.
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Dostopno za:
DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, SIK, UILJ, UKNU, UL, UM, UPUK
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