Background information and data
In 1993, 2.2% of days lost from work among compulsory members of the statutory health insurance scheme were due to depressive disorders (a total of about 282,000 cases of work incapacity leading to 10.9 million days absence). Women accounted for about twice as many cases of work incapacity as men (1,285 versus 592 cases per 100,000 compulsory members).
According to statistics from local insurance funds (Allgemeine Ortskrankenkassen AOK) AOK West accounted for more than twice as many cases of work incapacity as AOK East (AOK West: men 748, women 1,670; AOK East: men 314, women 782 cases of work incapacity per 100, 000 compulsory members).*
On average, depression-related work incapacity lasts approximately two and a half times longer than incapacity due to other illnesses. Depressive disorders account for a significant proportion of premature retirements. In 1995 there were 18,629 early retirements (7,146 men, 11,483 women) due to depressive disorders, corresponding to approximately 6.3% of all 297,164 early retirements. The average retirement age was between 50 and 54.
In 1998 the annual average sickness rate for employed compulsory company health fund members was only 4.4 %, the lowest in 30 years, including the old Federal States (4.5%). 1 In 1997, around 81% of absences due to work incapacity could be attributed to six groups of illnesses: muscular and skeletal disorders (29.2%), disorders of the respiratory tracts (16.8%), injuries/poisoning (14.1%), digestive disorders (7.7%), heart and circulation disorders (7.3%) and psychiatric disorders (5.8%). Though there is a downward trend in sick leaves due to the other five illness groups, the figures are up for mental health problems. This is partly due to changes in diagnostic procedures. Though mental health disorders as an illness group remained of secondary importance in the old Federal States through the 1980s, they currently account for 5.9% of all days of illness and occupy sixth place in terms of work incapacity. They are the third most important diagnostic group in hospitals, representing 11% of treatment days.
Suicide and illnesses allied to depression
People with depression are at greater risk of committing suicide. It is estimated in Germany that 3-4% of people with depression commit suicide. In the case of people who are receiving or have received in-patient treatment for major depression, the probability is 15%. In fact, a large proportion of all suicides are attributed to depression.2
Although different mental illnesses can coexist in the same person, this situation is often underestimated. More than 60% of all patients are diagnosed with more than one mental illness. In the case of major depression it can be assumed that a personality disorder is present in approximately 18% of cases and addictive illness and anxiety are present in 60-75%. It is
