Chronische somatische Erkrankungen und Beeinträchtigung der psychischen Gesundheit bei Erwachsenen in Deutschland

Zusammenfassung

Anliegen: Untersuchung des Zusammenhangs von chronischen somatischen Erkrankungen und Beeinträchtigung der psychischen Gesundheit.

Methode: In einer repräsentativen Stichprobe Erwachsener in Deutschland (n = 22 050) wurden 19 somatische Erkrankungen, diagnostizierte Depression und aktuelle psychische Belastung erfasst.

Ergebnisse: Ein Zusammenhang von somatischer Erkrankung und psychischer Gesundheit liegt vor. Dieser ist je nach Lebensalter unterschiedlich stark.

Schlussfolgerungen: Besonders bei somatisch multimorbiden Patienten sollte eine komorbide psychische Störung in Betracht gezogen werden.

Abstract

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.

Schlüsselwörter

chronische Erkrankung - psychische Störung - Komorbidität - Depression - MHI-5

Keywords

chronic disease - psychologic impairment - comorbidity - depression - MHI-5

• Literatur

• 1 Lin WC, Zhang J, Leung GY et al. Chronic physical conditions in older adults with mental illness and/or substance use disorders. J Am Geriatr Soc 2011; 59: 1913-1921
• 2 Iacovides A, Siamouli M. Comorbid mental and somatic disorders: an epidemiological perspective. Curr Opin Psychiatry 2008; 21: 417-421
• 3 Baune BT, Adrian I, Jacobi F. Medical disorders affect health outcome and general functioning depending on comorbid major depression in the general population. J Psychosom Res 2007; 62: 109-118
• 4 Harter M, Baumeister H, Reuter K et al. Increased 12-month prevalence rates of mental disorders in patients with chronic somatic diseases. Psychother Psychosom 2007; 76: 354-360
• 5 Baumeister H, Balke K, Harter M. Psychiatric and somatic comorbidities are negatively associated with quality of life in physically ill patients. J Clin Epidemiol 2005; 58: 1090-1100
• 6 Evans DL, Charney DS, Lewis L et al. Mood disorders in the medically ill: scientific review and recommendations. Biol Psychiatry 2005; 58: 175-189
• 7 Buist-Bouwman MA, de Graaf R, Vollebergh WA et al. Comorbidity of physical and mental disorders and the effect on work-loss days. Acta Psychiatr Scand 2005; 111: 436-443
• 8 van Melle JP, de Jonge P, Spijkerman TA et al. Prognostic association of depression following myocardial infarction with mortality and cardiovascular events: a meta-analysis. Psychosom Med 2004; 66: 814-822
• 9 Scott KM, von Korff M, Alonso J et al. Mental-physical co-morbidity and its relationship with disability: results from the World Mental Health Surveys. Psychol Med 2009; 39: 33-43
• 10 Wittchen HU, Jacobi F et al. Zur Häufigkeit psychischer Störungen in der Bevölkerung 2012. Vortrag auf dem DGPPN Kongress; 21.–24.11. 2012 Berlin:
• 11 Pieper L, Schulz H, Klotsche J et al. Depression as a comorbid disorder in primary care. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2008; 51: 411-421
• 12 Luppa M, Heinrich S, Angermeyer MC et al. Cost-of-illness studies of depression: a systematic review. J Affect Disord 2007; 98: 29-43
• 13 Lehnert T, Konnopka A, Riedel-Heller S et al. Diabetes und komorbide Depression: Systematische Literaturübersicht gesundheitsökonomischer Studien. Psychiat Prax 2011; 38: 369-375
• 14 Wedegärtner F, Arnhold-Kerri S, Sittaro N-A et al. Invalidität und Tod bei Erwerbsfähigen mit Depressionen. Psychiat Prax 2011; 38: 135-141
• 15 Marengoni A, Angleman S, Melis R et al. Aging with multimorbidity: a systematic review of the literature. Ageing Res Rev 2011; 10: 430-439
• 16 Katon WJ. Epidemiology and treatment of depression in patients with chronic medical illness. Dialogues Clin Neurosci 2011; 13: 7-23
• 17 Kessler RC, Birnbaum H, Bromet E et al. Age differences in major depression: results from the National Comorbidity Survey Replication (NCS-R). Psychol Med 2010; 40: 225-237
• 18 Kessler RC, Birnbaum HG, Shahly V et al. Age differences in the prevalence and co-morbidity of DSM-IV major depressive episodes: results from the WHO World Mental Health Survey Initiative. Depress Anxiety 2010; 27: 351-364
• 19 Jacobi F, Wittchen HU, Holting C et al. Prevalence, co-morbidity and correlates of mental disorders in the general population: results from the German Health Interview and Examination Survey (GHS). Psychol Med 2004; 34: 597-611
• 20 Scheidt-Nave C, Kamtsiuris P, Goesswald A et al. German health interview and examination survey for adults (DEGS) – design, objectives and implementation of the first data collection wave. BMC Public Health 2012; 12: 730
• 21 Robert Koch-Institut (RKI). Daten und Fakten: Ergebnisse der Studie »Gesundheit in Deutschland aktuell 2010«. Berlin: RKI; 2012
• 22 Gabler S, Häder S Hrsg. Generierung von Telefonstichproben mit TelSuSaAufl. Mannheim: Zentrum für Umfragen, Methoden und Analysen (ZUMA); 1999
• 23 CDC. Behavioral Risk Factor Surveillance System 2009. Summary Data Quality Report. Atlanta: U.S. Department of Health and Human Services; 2010
• 24 Berwick DM, Murphy JM, Goldman PA et al. Performance of a five-item mental health screening test. Med Care 1991; 29: 169-176
• 25 Cuijpers P, Smits N, Donker T et al. Screening for mood and anxiety disorders with the five-item, the three-item, and the two-item Mental Health Inventory. Psychiatry Res 2009; 168: 250-255
• 26 Rumpf HJ, Meyer C, Hapke U et al. Screening for mental health: validity of the MHI-5 using DSM-IV Axis I psychiatric disorders as gold standard. Psychiatry Res 2001; 105: 243-253
• 27 Kelly MJ, Dunstan FD, Lloyd K et al. Evaluating cutpoints for the MHI-5 and MCS using the GHQ-12: a comparison of five different methods. BMC Psychiatry 2008; 8: 10
• 28 Schienkiewitz A, Mensink GB, Scheidt-Nave C. Comorbidity of overweight and obesity in a nationally representative sample of German adults aged 18-79 years. BMC Public Health 2012; 12: 658
• 29 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
• 30 World Health Organisation (WHO). Obesity: Preventing and Managing the Global Epidemic. Report of a WHO consultation. Geneva: WHO; 2000
• 31 Brauns H, Scherer S, Steinmann S. The CASMIN educational classification in international comparative research. A European working book for demographic and socio-economic variables. In: Hoffmeyer-Zlotnik JHP, Wolf C, eds. Advances in Cross-National Comparison. New York: Kluwer; 2003: 221-244
• 32 Dalgard OS, Dowrick C, Lehtinen V et al. Negative life events, social support and gender difference in depression: a multinational community survey with data from the ODIN study. Soc Psychiatry Psychiatr Epidemiol 2006; 41: 444-451
• 33 Blazer DG. Depression in late life: review and commentary. J Gerontol A Biol Sci Med Sci 2003; 58: 249-265
• 34 Jacobi F, Klose M, Wittchen HU. Mental disorders in the community: healthcare utilization and disability days. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2004; 47: 736-744
• 35 Höfler M, Wittchen H-U. Why do primary care doctors diagnose depression when diagnostic criteria are not met?. Int J Methods Psychiatr Res 2000; 9: 110-120
• 36 Pilars de Pilar M, Abholz H-H, Becker N et al. Was erzählen Hausärzte über ihre Patienten, bei denen sie eine vorliegende Depression nicht diagnostiziert haben?. Psychiat Prax 2012; 39: 71-78
• 37 Wittchen HU, Winter S, Höfler M et al. Häufigkeit und Erkennensrate von Depression in der hausärztlichen Praxis. Fortschritte der Medizin 2000; 118: 22-30
• 38 Weyerer S, Bickel H. Epidemiologie psychischer Erkrankungen im höheren Lebensalter. Stuttgart: W. Kohlhammer; 2007
• 39 Behrends S, Kott K. Zuhause in Deutschland. Ausstattung und Wohnsituation privater Haushalte. Wiesbaden: Statistisches Bundesamt; 2009
• 40 Patten SB, Williams JV, Lavorato DH et al. Major depression as a risk factor for chronic disease incidence: longitudinal analyses in a general population cohort. Gen Hosp Psychiatry 2008; 30: 407-413
• 41 Lim SS, Vos T, Flaxman AD et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990 – 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2013; 380: 2224-2260
• 42 Katon WJ, Lin EH, von Korff M et al. Collaborative care for patients with depression and chronic illnesses. N Engl J Med 2010; 363: 2611-2620