Background

Epidemiological studies indicate a disproportionate increase of depression incidence among adolescent girls, compared with boys. Since results regarding the age of onset of this sex difference are heterogeneous, this study aimed to investigate this difference on a large and representative sample. A second investigation sought to clarify whether there is a relevant sex difference in prepubertal onset of depression regarding the further course.

Methods

Health insurance data of 6–18-year-old Barmer insured patients, representing a 7.9% sample of the German population born in 1999 (N = 61.199), were analyzed. The incidence of depression episodes (ICD-10 F32.x) was evaluated. Subsequently, the absolute and relative risk of a depression diagnosis (F32.x/F33.x) in early/late adolescence was analyzed based on the diagnosis of depression in primary school age in unstratified and stratified univariate analyses performed in SAS.

Results

From 13 years of age, we found a significantly higher incidence of depressive disorders in girls than in boys. More than a fifth of the children with a depression diagnoses in primary school age had a depression relapse in early or late adolescence (early: 23.2%; 95% CI 19.6–26.9/late: 22.9%; 95% CI 19.3–26.5). Boys with depression in primary school age have a significantly higher relative risk for a depression relapse in late adolescence than girls (boys RR 4.2, 95% CI 3.3–5.2, girls RR: 2.1, 95% CI 1.7–2.7).

Limitations

The analysis is based on administrative data. Low sensitivity for depression in primary care setting and low service utilization leads to an underestimation of the incidence.

Conclusions

During puberty the risk for a first depressive episode increases more steeply in girls than in boys. Childhood depression has a high risk of relapse for both sexes, but is much more pronounced for boys.

中文翻译：

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从幼儿期到青春期的抑郁症的年龄和性别特定发病率：德国医疗保险数据的13年纵向分析。

背景

流行病学研究表明，与男孩相比，青春期女孩的抑郁症发病率成比例增加。由于有关这种性别差异的发病年龄的结果是异质的，因此本研究旨在调查大量代表性样本中的这种差异。第二项调查试图弄清青春期抑郁症在进一步病程方面是否存在相关的性别差异。

方法

分析了6-18岁的Barmer受保患者的健康保险数据，这些患者占1999年出生的德国人口的7.9％（N = 61.199）。评价了抑郁发作（ICD-10 F32.x）的发生率。随后，根据在SAS中进行的未分层和分层单变量分析中小学年龄段抑郁症的诊断，分析了青春期早期/晚期抑郁症诊断（F32.x / F33.x）的绝对和相对风险。

结果

从13岁开始，我们发现女孩的抑郁症发病率明显高于男孩。在小学年龄段被诊断患有抑郁症的儿童中，超过五分之一在青春早期或晚期青春期复发（早期：23.2％； 95％CI 19.6-26.9 /晚期：22.9％； 95％CI 19.3-26.5）。小学年龄患有抑郁症的男孩在青春期晚期抑郁症复发的相对风险明显高于女孩（男孩RR 4.2，95％CI 3.3-5.2，女孩RR：2.1，95％CI 1.7-2.7）。

局限性

该分析基于管理数据。基层医疗机构对抑郁症的敏感性低，服务利用率低，导致发病率被低估。

结论

在青春期，女孩第一次抑郁发作的风险比男孩更高。童年期抑郁症对男女都有很高的复发风险，但对于男孩而言则更为明显。