gms | German Medical Science

Background: The prevalence of depression in Germany is about 8%. However, this prevalence is much higher in chronically ill patients. In patients with rheumatoid arthritis (RA), it can be up to three times higher than in the standard population, reaching 20%. Therefore, it can be assumed that depression is frequently documented in patient files kept by rheumatologists. This study investigated the documentation frequency of depression diagnoses made in rheumatological practices in Germany.

Methods: The present secondary analysis is based on data from the Disease Analyzer database (IQVIA), which enables access to a select anonymized sample of private practices and patients. The data contained in the Disease Analyzer are generated directly by practice computers via standardized interfaces and provide information on actual therapy and disease progression in everyday practice. For the current analysis, the number of patients with at least one visit and at least one documented depression diagnosis in 2018 (ICD-10: F32, F33) was determined for each group of specialists. The prevalence of documented depression was calculated as the proportion of patients with documented depression among all patients in the year in question. The analysis was repeated for patients with at least two or at least four visits in 2018.

Results: The average prevalence of documented depression was 7.4%. It was highest among psychiatrists (54.5%) and lowest among gastroenterologists (1.1%). Among the specialist groups (excluding GPs and psychiatrists), rheumatologists were the second most frequent after gynecologist to diagnose depression, with an annual prevalence of documented depression of 4.3% (1,450 of 33,750 patients in 21 practices). The prevalence increased to 5.4% (219 of 4,047 patients) when only those patients who visited the practice at least once in each of the four quarters were considered.

Conclusion: Rheumatologists documented depression much less frequently than expected. This trend was observed in all specialist groups except GPs and psychiatrists. Since documenting non-rheumatological diagnoses is not required, an overall view of the patients based on the data provided by rheumatological practices is relatively difficult to obtain.