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Depression and schizophrenia filling German hospital beds
Photo: DPA

Depression and schizophrenia filling German hospital beds

Published: 27 Jul 2010 14:19 GMT+02:00
Updated: 27 Jul 2010 14:19 GMT+02:00

Mental illness has emerged as the overwhelmingly dominant cause of hospitalisation in Germany, with depression and schizophrenia accounting for the highest number of days spent by patients in clinic beds, a report revealed Tuesday.

The figures from the Hospital Report 2010, released in Berlin on Tuesday by the health insurer Barmer GEK, also show that elderly Germans are having hip and knee replacements in record numbers.

Depressive disturbances accounted for 511 days in hospital per 10,000 people, followed by schizophrenia with 504 days and depressive episodes with 496 days. Part of the reason they rank so highly is that each sufferer tends to spend a long time in hospital – at least 30 days on average for all of those illnesses.

By comparison, childbirth, which came in as the number four reason for hospitalisation, kept women in hospital for an average of just 4.7 days, amounting to a total of 335 days per 10,000 people.

Mental illness is bucking the trend of shorter hospital stays. Since 1990, the average time a patients spends in a hospital bed with a mental illness has risen 54 percent, the report says.

Psychological disturbances due to alcohol were the fifth most common reason for hospitalisations, with 334 days per 10,000 people.

This was followed by heart failure, heart attack, femoral neck (or hip) fractures, arthritis of the knee and arthritis of the hip.

The report also shows that growing numbers of elderly people in Germany are having knee and hip replacements. In 2009, some 209,000 people had a hip replacement and 175,000 had knee replacements.

“If the trend continues, soon nearly every pensioner aged 60 to 65 will have a new knee or hip,” said the deputy head of the health insurer, Rolf-Ulrich Schlenker.

DDP/DPA/The Local (news@thelocal.de)

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Your comments about this article

15:00 July 27, 2010 by moistvelvet
What is it with The Local and choice of photographs today, is depression and schizophrenia contageous? :-o Sometimes it seems that any old photograph will do, may I suggest that if I'm overreacting and the choice of photographs is actually irrelevant to the actual story, then why bother posting them?

Otherwise depression and schizophrenia on the increase, shocking, but is this because more people are becoming ill or because it is more acceptable to say you have a problem and easier to get treatment.
17:35 July 27, 2010 by mixxim
I suspect that many of those suffering should be told to get a grip and pull themselves together. We all get depressed at times.
18:25 July 27, 2010 by Logic Guy
Well, depression is just like all other things. If a person doesn't know how to deal with it, then it becomes a very difficult issue.

This is just enother reason why psychology should become the foundation of all education. History, social studies, science, math, finance and other things are totaly useless, if you don't know how to think.
00:10 July 28, 2010 by BR549
From my honest perspective (opinion), the main reason why depression and mental illness occurs in Germany in such high numbers, is because (again, only my opinion)of German cultural expectations. This society is inflexible,and has every reason to prevent someone to fulfill their dreams or aspirations. It is too focused on credentials, area of study and tries to keep people in their "lane". After decades of trying to fulfill societal / cultural obligations, people begin to "crack".
00:22 July 28, 2010 by pepsionice
I believe BR549 is absolutely correct. This amusing nature in the work place of massive stress....and then going to the doctor to get time off and even a recommendation for de-stress 'hotels'....makes me often laugh.

These people put massive beliefs into their vacations...in that two weeks of Spain or Turkey will relieve them of their burden. They believe this, and within a month after coming back to work....they've got regular stress back in full swing.

I agree...aspirations are a tremendous part of this. When you look at the Germans who pack up and move to Canada...you suddenly see some happy and smiling Germans. These 'left-Germany-and-restarted' episodes are fascinating now to watch on TV. All of these people tend to believe in a brand new life.
03:43 July 28, 2010 by cklb
@pepsionice, as a German. Got my diploma in the same university as my dad and in the same major as him and my grandpa. Now studying in grad school in a American university. But to emphasise: all of us chose to study in the same field as we were interested in it. What I consider rather depressing is, that Germany is going down economically and socially. We got a lot of problems because we have a messed up integration policy, no one dares (and dared) to say a thing against misbehaving imigrants and now we got areas where teachers refuse to teach because they are afraid of the kids...
09:20 July 28, 2010 by LancashireLad
First, @BR549 and pepsionice - spot on. If large parts of a society are suffering from certain mental illnesses then it does well to look at the society in general. I never bother with keeping up with the Jonses or what others think of me (to a certain extent - I also can't stand rudeness) - I find it too stressful :-)

@cklb - could you please extrapolate as to what exactly immigration has to do with the mental illnesses of a society? You seem to be trying to indicate that it is the root cause - please do not forget that you currently are also an immigrant - albeit possibly temporarily.
09:46 July 28, 2010 by Clapoti
I had the same feeling as anyone else while reading the article and I was wondering if I was insensitive to think that people should get a grip, but apparently I'm not the only one with that opinion.
11:15 July 28, 2010 by LancashireLad
Hi Rimini,

That is indeed a very fair point and I would also be very interested to see what these comparisons showed., but the statistics you mention don't appear to be readily available. Wolfram Alpha only gives stats for the US (0.61%), whereas another site with more numnbers in it quote the US rate at 5.3%. This same site lists many more countries but only gives raw numbers and no percentages to enable comparison. Not only that, it warns about the accuracy of these numbers as they are only extrapolated.

It can also be said that modern life in general is enough, but if the statistics show that mental illnesses are a society's main reported illness, then maybe that society ought to try to find out why. And if that society does find out what the problem is then maybe that society can tell others what they should do ;-)
11:27 July 28, 2010 by Gerd1965
"Get a grip"

Most people feel sometimes sad, depressed or desperate. Thats just normal and no disease. Depression is a real disease: It has different causes and characteristics and requires a special treatment for each individual. Some patients can be treated with ambulant psychotherapy or medicinal treatment by a psychatrist. Some other must be taken out of their old life to give them a protected life to calm down (and to prevent them from suicide). This special space can be given in a psychological hospital, later the treatment shall be continued ambulatory.
11:45 July 28, 2010 by LancashireLad
Hi Gerd1965,

Thanks for the clarification. What would now be interesting are the respective statistics as to how many need to be "hospitalised" as detailed in the article as to how many are treated as outpatients. This number is not detailed in the article as it talks about a hospital report.

I would also be interested to know how much influence the pharma industry has on individual doctor's diagnoses - I doubt it is negligible but that's just the sceptic in me.
12:52 July 28, 2010 by michael4096
@LancashireLad

One of the problems is the test for clinical depression - there isn't one. If someone has some funny sympthoms that doctors suspect are caused by depression then the only real way forward is to test for every possible physical cause from brain tumours through hormone imbalance and if every other test fails then it's 'depression'.
13:38 July 28, 2010 by LancashireLad
Fair point, but to my mind that actually makes it more open to big pharma pressure - if in doubt chuck em a placebo.
14:11 July 28, 2010 by Prufrock2010
To those who say to the clinically depressed "get a grip," as though to suggest that clinical depression isn't really a treatable medical condition, you would find yourselves aligned with that noted expert on clinical psychology, Tom Cruise. Perhaps Scientology is really your bag after all.
16:57 July 28, 2010 by michael4096
Prufrock is correct and I hope I didn't mislead when I said there was no test. There are a number of chemical imbalances in the brain associated with many types of depression which are very real, very physical, can be measured and can be treated. However, they cannot, as far as I know be used in diagnosis at the moment.
23:27 July 28, 2010 by Logic Guy
Well, I do agree that social pressures/expectations often causes stress and depression, especially if you are not as successful as you think you should be.

Look at the huge suicide problem in Japan. Workers over there are under an enormous amount of pressure.

There is nothing wrong with aiming for perfection. However, the goal in life should be to "Do your very best" and accept the results, whatever they are.
09:19 July 29, 2010 by LancashireLad
The maxim "Do your very best and accept the results, whatever they are" is indeed an admirable one, but sadly our evolution as social animals with a social heirarchy has instilled a comparative and competitive edge to our thinking - it had to really for us to survive. It was essential when we were still on a par with monkeys and other primates but in today's society it is much less necessary and often leads to psychological problems.

I am not surprised that there are no real, verifiable tests for clinical depression, and very probably many other recognised disorders - human nature and the diversity of the human character would make it almost impossible.
09:45 July 29, 2010 by Talonx
Facts:

1.) The rates of Depression and Schizophrenia differ in proportion to the severity of socio-economic status differences, healthcare availablity, and social services availablity. Here's a good pop-sci article on why the U.S. tops the charts for depression prevalence, http://www.forbes.com/2007/02/15/depression-world-rate-forbeslife-cx_avd_0216depressed.html .

2.) I actually agree with Logic-Guy for once, we need to teach children how their brains work starting from a very young age. The most effective treatments for depression tend not to be medical interventions, but rather cognitive and behavioral therapies (e.g. mindfulness therapy). Medical intervention only works for immobilization and/or getting people high, which are necessary for violent episodics (some bipolar individuals) or people so depressed they want to die, but otherwise medicine should not be viewed as 'treatment' for these folks in the same sense as an antidote to a poison is. We live in an exciting time were proper psychological proffesionals attempt to cure bipolar spectrum problems instead of treating them with drugs till death.

3.) Having worked with schizophrenics in a neurology and brain sciences institute, I can tell those of you that say 'they just need to pull themselves together' that you are way of base. Schizophrenics couldn't even organize their own thoughts if they wanted to. The most basic symptom in schizophrenia is called 'thought disorder' and it corresponds to known changes in the brain (specifically; the hippocampus, the cerebellum, and the fronto-pariatel loop).
11:42 July 29, 2010 by LancashireLad
Thanks for your insights, Talonx, especially as they are based on real experience and understanding.

I also agree we need to teach our children how to think, but I also think we need to teach them how best to get on with other people. The cause of a lot of stress in life is friction with other people, no matter how brief the encounter.

A friend of mine in London is actually a diagnosed schizophrenic, and it seems to be treated very well with his medicine. If no one had told me, I still would not know and I've known him over 10 years now. Perhaps he maybe only has a mild form if such a thing is possible.
15:37 July 29, 2010 by LancashireLad
World's mobbing capital?
17:53 July 29, 2010 by michael4096
@onemark - I agree with the above, what on earth are you talking about?
12:03 July 30, 2010 by Talonx
@ Lancashirelad

There are a range of psychological conditions that can be labled as schizotypal, everything from schizophrenia to schizoptypal personality disorder to subclinical classifications based on the big 5 personality traits. There are definately more and less mild forms, but all share certain features. As more cognitive research is done, the similarities across these classifications are becoming more and more clear. One finding made very clear is that environmental factors play as large, if not a larger role than genetics when it comes to the etiology and occurence of schizotypies. Unfortunaely, unlike depression, treatment for Schizophrenics has not advanced too much beyond the drug realm. Though cognitive and behavioral therapies are available and though certain researchers are starting intervention programs for those displaying early signs and symptoms there are not currently many proven non-drug therapies available. Sadly, often times, severe schizophrenics can incur greater physiological side-effects than mental benefits from these drugs, for instance, induced parkinsonian symptoms

@ onemark

can you forward us some research on this issue? I was pretty sure the U.S. lead the pack for bullying.
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