Social Psychiatry and Psychiatric Epidemiology

, Volume 42, Issue 9, pp 740–746

Who is treated, and how, for depression?

An analysis of statutory health insurance data in Germany
  • Anke Bramesfeld
  • Thomas Grobe
  • Friedrich Wilhelm Schwartz

DOI: 10.1007/s00127-007-0225-9

Cite this article as:
Bramesfeld, A., Grobe, T. & Schwartz, F.W. Soc Psychiat Epidemiol (2007) 42: 740. doi:10.1007/s00127-007-0225-9



Studies on the treatment of depression using epidemiological survey methods suggest a high level of under-treatment. Little is known about the characteristics of those people receiving treatment and indeed what kind of treatment they are likely to receive.


Analysis of the data of a statutory health insurance company in Germany.


In middle-aged groups, about 50% of those diagnosed as being depressed in outpatient care are prescribed antidepressants and/or psychotherapy in the course of a year. There is more pharmacologic treatment provided in rural areas and more psychotherapy in cities, suggesting that treatment is dependent upon service availability rather than evidence-based treatment decisions. Treatment rates are considerably lower in the very young and the very old and show gender bias. Young females receive less pharmacologic treatment than young males, and elderly men are, in general, treated less than women, suggesting under-treatment at least for these groups.


The low treatment rates following the diagnosis of depression in the young and the old require attention, in particular with respect to gender aspect.

Key words

treatment of depressionsociodemographic characteristicshealth insurance dataepidemiologyhealth service research

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Anke Bramesfeld
    • 1
  • Thomas Grobe
    • 2
  • Friedrich Wilhelm Schwartz
    • 1
  1. 1.Dept. for EpidemiologySocial Medicine, and Health System Research, Medical School Hannover, OE 5410HannoverGermany
  2. 2.Institute for Social Medicine, Epidemiology and Health System Research (ISEG)HannoverGermany