Zi study on incidence trends of mental illnesses and behavioral disorders in children and adolescents in 2014-2021
21.06.2023 13:00
Sharp increase in depression and eating disorders among girls in the first two years of the corona pandemic. Behavioral disorders are mostly declining, especially in boys.
With far-reaching containment measures such as at times drastic restrictions on social interaction, the Covid-19 pandemic has led to a significant deterioration in mental health among children and young people. Adolescent girls were particularly hard hit by this. Especially in the pandemic years 2020 and 2021, there was a significantly disproportionate increase in newly diagnosed depression and eating disorders. From 2019 to 2021 alone, the incidence of depressive disorders increased by a total of 27 percent. In the age group of 15 to 17 year old girls it was three times as high as in boys of the same age. During the same period, the incidence of diagnosis of anorexia (eating disorder) increased by 74 percent. In 2021, adolescent girls were 14 times more likely to be diagnosed with eating disorders than boys.
The incidence of behavioral and emotional disorders was at a high level throughout the entire study period from 2014 to 2021 - regularly significantly higher for boys than for girls (2021: 514.9 vs. 351.5/10,000, gender ratio boys/girls: 1.5 ). However, the statutory medical billing data showed an overall downward trend, with a one-off interruption in 2019 and a rise again in 2021 (boys: -12.5 percent, girls: -1.9 percent). Overall, the incidence fell by eight percent during the study period. This corresponds to an average annual reduction rate of 1.2 percent. The age-specific analysis also showed that the peak incidence was in the 7 to 10 year old age group - for both boys and girls.
These are the central results of a current care atlas study by the Central Institute for Statutory Health Insurance (Zi) on “incidence trends of mental illnesses as well as developmental and behavioral disorders in children and adolescents in outpatient care between 2014 and 2021”.
Significant deterioration in the mental health of children and young people in the Corona pandemic years
“Like other public health studies, the billing data we evaluated indicates a sometimes significant deterioration in the mental health of children and young people in the corona pandemic years 2020 and 2021. Overall, we were able to gain insight into the contractual medical and psychotherapeutic health data of almost 12 million young insured persons and thus 84 percent of the young population in Germany - from birth to the threshold of adulthood," said Zi CEO Dr. Dominik von Stillfried. The diagnosis incidence calculations take into account young people with statutory health insurance who have already used medical or psychotherapeutic services.
“However, we must assume that due to more difficult and delayed access, especially to psychotherapeutic care, the incidence of mental and behavioral disorders requiring treatment and the number of children and young people suffering from psychological distress are even higher. In 2022, another global crisis arose with the Russian war of aggression against Ukraine, which, in addition to the increasingly heated social debate about international climate goals, could potentially have a negative impact on the mental state of the younger population in Germany. Due to their specific developmental stages and growing age-dependent demands, childhood and adolescence represent a particularly vulnerable phase of life that can influence both physical and mental health throughout the rest of the life course. “It is also and especially against this background that our current study can sharpen our focus on carefully observing the development of the mental health of children and young people and taking appropriate prevention and care measures at an early stage,” continued von Stillfried.
The data basis for the present evaluations is the nationwide pseudonymized, cross-health insurance provider billing data for statutory health insurance and psychotherapy in accordance with Section 295 SGB V for the period January 2012 to September 2022. The study population consists of legally insured children and young people aged 0 to 17 years. Incidence trends were determined for a total of 45 diagnoses or diagnostic groups in the period 2014 to 2021. Children and adolescents were counted as incidentally ill for whom a confirmed diagnosis was coded, which was either confirmed again in the patient-specific three subsequent quarters or for whom a corresponding service was billed in the quarter in which the diagnosis was made or in the first subsequent quarter.