Glycaemic status and depressive symptoms among adults in Germany: results from the German Health Interview and Examination Survey for Adults (DEGS1).

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 <39 mmol/mol [<5.7%]). Current depressive symptoms were measured using the Patient Health Questionnaire depression scale (PHQ-9) and defined as elevated depressive symptoms (PHQ-9 score ≥10 points; dichotomous variable) and severity of depressive symptoms (PHQ-9 score, range 0-27 points; continuous variable). Associations of glycaemic status and HbA1c with both depressive symptoms variables were analysed using multivariable logistic (elevated depressive symptoms) and linear (severity of depressive symptoms) regression models. RESULTS: Compared with normoglycaemia, diagnosed diabetes, but not prediabetes or undiagnosed diabetes, was associated with elevated depressive symptoms (odds ratio 1.55, 95% CI 1.00-2.41) and severity of depressive symptoms (ß coefficient 0.71, 95% CI 0.23-1.19) in models adjusting for sociodemographics and health behaviours. Associations were similar among people with diagnosed diabetes taking and not taking antidiabetes medication. Among people without diagnosed diabetes, no associations between HbA1c and depressive symptoms were found. CONCLUSIONS: Diagnosed diabetes, but not prediabetes, undiagnosed diabetes or HbA1c , was associated with depressive symptoms among adults in Germany. Studies examining psychosocial and biological mechanisms that may potentially explain relationships between diagnosed diabetes and depressive symptoms are needed.

[Mental disorders in the general population : Study on the health of adults in Germany and the additional module mental health (DEGS1-MH)]. / Psychische Störungen in der Allgemeinbevölkerung : Studie zur Gesundheit Erwachsener in Deutschland und ihr Zusatzmodul Psychische Gesundheit (DEGS1-MH).

BACKGROUND AND OBJECTIVES: The German health interview and examination survey for adults (DEGS1) with the mental health module (DEGS1-MH) is the successor to the last survey of mental disorders in the general German population 15 years ago (GHS-MHS). This paper reports the basic findings on the 12-month prevalence of mental disorders, associated disabilities and self-reported healthcare utilization. METHODS: A representative national cohort (age range 18-79 years, n = 5,317) was selected and individuals were personally examined (87.5 % face to face and 12.5 % via telephone) by a comprehensive clinical interview using the composite international diagnostic interview (CIDI) questionnaire. RESULTS: The overall 12-month prevalence of mental disorders was 27.7 % with substantial differences between subgroups (e.g. sex, age, socioeconomic status). Mental disorders were found to be particularly impairing (elevated number of disability days). Less than 50 % of those affected reported to be in contact with health services due to mental health problems within the last 12 months (range 10-40 % depending on the number of diagnoses). CONCLUSIONS: Mental disorders were found to be commonplace with a prevalence level comparable to that found in the 1998 predecessor study but several further adjustments will have to be made for a sound methodological comparison between the studies. Apart from individual distress, elevated self-reported disability indicated a high societal disease burden of mental disorders (also in comparison with many somatic diseases). Despite a relatively comprehensive and well developed mental healthcare system in Germany there are still optimisation needs for treatment rates.

[Prevalence of depressive symptoms and diagnosed depression among adults in Germany: results of the German Health Interview and Examination Survey for Adults (DEGS1)]. / Prävalenz von depressiver Symptomatik und diagnostizierter Depression bei Erwachsenen in Deutschland: Ergebnisse der Studie zur Gesundheit Erwachsener in Deutschland (DEGS1).

In the German Health Interview and Examination Survey (DEGS1), current depressive symptoms were assessed with the "Patient Health Questionnaire" (PHQ-9) in a representative population-based sample of 7,988 adults 18-79 years old. In addition, previously diagnosed depression was assessed by physician interview. The prevalence of current depressive symptoms (PHQ-9 ≥ 10 points) is 8.1 % (women: 10.2 %; men: 6.1 %). For both sexes, the prevalence is highest among 18- to 29-year-olds and decreases with age. Persons with higher socioeconomic status (SES) are less likely to have current depressive symptoms. The lifetime prevalence of diagnosed depression is 11.6 % (women: 15.4 %; men: 7.8 %) and is highest among persons 60-69 years old. The 12 month prevalence is 6.0 % (women: 8.1 %; men: 3.8 %) and is highest among 50- to 59-year-olds. In women, but not in men, prevalences decrease with increasing SES. The results describe the distribution of two important aspects of depression among the adult population in Germany and confirm previously observed associations with age, gender and SES. An English full-text version of this article is available at SpringerLink as supplemental.

[Frequency and distribution of sleep problems and insomnia in the adult population in Germany: results of the German Health Interview and Examination Survey for Adults (DEGS1)]. / Häufigkeit und Verteilung von Schlafproblemen und Insomnie in der deutschen Erwachsenenbevölkerung: Ergebnisse der Studie zur Gesundheit Erwachsener in Deutschland (DEGS1).

Sleep disturbances are associated with a variety of physical and mental health disorders and cause high direct and indirect economic costs. The aim of this study was to report the frequency and distribution of problems of sleep onset and maintaining sleep, sleep quality, effective sleep time, and the consumption of sleeping pills in the adult population in Germany. During the 4 weeks prior to the interview, about one third of the respondents reported potentially clinically relevant problems initiating or maintaining sleep; about one-fifth reported poor quality of sleep. When additionally considering impairments during the daytime such as daytime fatigue or exhaustion, a prevalence of 5.7 % for an insomnia syndrome was found. Women were twice as likely to be affected by insomnia-syndrome as men. Significant age differences were not seen. Persons with low socioeconomic status had an increased risk of insomnia (OR: 3.44) as did people residing in West Germany (OR: 1.53). Women with low socioeconomic status (OR: 4.12) and West German men (OR: 1.79) were more affected. The results illustrate the considerable public health relevance of insomnia-related sleep disturbances. An English full-text version of this article is available at SpringerLink as supplemental.

[Chronic stress among adults in Germany: results of the German Health Interview and Examination Survey for Adults (DEGS1)]. / Chronischer Stress bei Erwachsenen in Deutschland : Ergebnisse der Studie zur Gesundheit Erwachsener in Deutschland (DEGS1).

The "German Health Interview and Examination Survey for Adults" (DEGS1) was conducted from 2008 to 2011 and comprised interviews, examinations and tests. The target population was the resident population of Germany aged 18 to 79 years. A total of 8152 persons participated. Chronic stress was assessed to examine its effects on health and mental wellbeing. The Screening Scale of the Trier Inventory for the Assessment of Chronic Stress was used to assess stress burden among participants up to the age of 64 years (N = 5850). High levels of stress are significantly more often reported by women (13.9%) than by men (8.2%). The prevalence of high stress levels decreases with a higher socioeconomic status (SES); it falls from 17.3% with low SES to 7.6% with high SES. High chronic stress levels are particularly common (26.2%) in persons who report low levels of social support. Depressive symptoms, burnout syndrome and sleep disturbances are more common in people who have high levels of chronic stress than in those without high levels of stress. The results confirm the importance of chronic stress as a health risk and underline the public health relevance of chronic stress. An English full-text version of this article is available at SpringerLink as supplemental.