Zusammenfassung
Anliegen Untersucht wurden Frühberentung
und Frühversterben im Zusammenhang mit rein ambulant und auch
stationär behandelten Depressionen. Methode
Hierfür wurden 128 001 Verläufe mit bis zu 10 Jahren
Beobachtungsdauer multivariat untersucht. Ergebnisse Ein
erhöhtes relatives Risiko (RR) für Frühberentung besteht bei
rein ambulanter und stärker bei stationärer Behandlung. Dies betrifft
besonders junge depressive Männer. Erhöhtes Frühversterben
ließ sich nicht nachweisen, bei jüngeren, ambulant behandelten
Frauen fand sich eher eine leicht verringerte Sterblichkeit. Schlussfolgerungen Auch in ambulanter Behandlung muss auf
die berufliche Wiedereingliederung geachtet werden, für Männer und
Frauen auf unterschiedliche Weise.
Abstract
Objective It was the aim of this study to
estimate effects of depression on permanent disability and death in a statutory
health insurance population. Methods Data from
128 001 clients were used with a mean follow up of 6.4 years. Excess
risks were calculated with Cox regression models adjusted for age, gender,
education and job classification. Results Outpatient
treatment for depression was associated with an elevated relative risk for
permanent disability, but inpatient treatment even more so. Life table analysis
suggests higher risks of early retirement for males who get ill early in life.
Depression treated solely in an outpatient setting may be associated with lower
mortality early in life, but this was only significant for women.
Conclusions Outpatient treatment should include an
emphasis on occupational functioning, but also a gender-specific approach is
needed.
Schlüsselwörter
Depression - Behandlung - Invalidität - Mortalität - Berufsunfähigkeit
Keywords
depression - treatment - invalidity - mortality - occupational disability
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Dr. med. Felix Wedegärtner, MPH
Medizinische Hochschule Hannover, Zentrum für seelische
Gesundheit, Klinik für Psychiatrie, Sozialpsychiatrie und
Psychotherapie
Carl-Neuberg-Straße 1
30625 Hannover
Email: wedegaertner.felix@mh-hannover.de