Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-28T04:18:20.688Z Has data issue: false hasContentIssue false

Anxiety and depression in an urban population: results of the Mannheim Cohort Study

Published online by Cambridge University Press:  28 April 2020

G. Reister
Affiliation:
University of Heidelberg Mannheim Medical School, Psychosomatic Clinic at the Central Institute of Mental Health, J5, PO Box 5970, D-6800, Mannheim 1, FRG
H. Schepank
Affiliation:
University of Heidelberg Mannheim Medical School, Psychosomatic Clinic at the Central Institute of Mental Health, J5, PO Box 5970, D-6800, Mannheim 1, FRG
Get access

Summary

The Mannheim Cohort Study, from which the results to be displayed below are taken, is an epidemiologic field survey on the prevalence of psychogenic disorders, i.e. the psychoneurotic, psychosomatic, and personality disorders listed as ICD items 300-306 in the 8th revision of the WHO. A representative sample of 600 randomly selected citizens from the city of Mannheim were examined twice from 1979-1985 by means of comprehensive sociological instruments in a semi-standardized psychoanalytical interview.

Instead of a wide birth range, we decided to investigate age classes, and each time took a 200-person sample from the records of the municipal registration office for individuals (both sexes) born in 1935, 1945 and 1955. The aim of this research strategy was to determine the possible influence of various historical and social conditions of development on the pathogenesis of psychogenic disorders.

The qualified interviewers involved in the project went to see the individuals at home. The examination, a biographical investigation which lasted for at least 3 hr, took the form of a semi-standardized structured interview as in dynamic psychotherapy. Thus, a quantity of findings concerning present and past morbidity, development, stress in infancy, aspects of present occupational and family life, and the organization of leisure time interspersed with sociological, psychological and psychoanalytical questions were included. A number of questionnaires (list of complaints, critical life events, personality inventories, measures of attitudes) were also inserted.

The criteria to be met for assessment as a “case” (sick person) were:

  1. 1, the temporal criterion of point prevalence, referring to the 7 days prior to examination;

  2. 2, the qualitative criterion of assessing an ICD diagnosis (Nos 300-306; 8th revision;

  3. 3, the quantitative criterion: grading the psychogenic impairment (Impairment Score = IS).

Five points plus had to be scored, or over 20 points according to the Goldberg-Cooper Interview.

The IS was designed as a conceptual complex rating in order to determine primarily psychogenic (non-organic) impairment on a somatic, psychic, and communication-related dimension. The individual's impairment is graded between 0-4 on each dimension, so that 3 single ratings add up to a maximum score of 12.

According to this definition, 156 out of 600 individuals examined were assessed as cases in the first survey. This means a point prevalence of 26%.

Résumé

Résumé

L‘étude de cohorte de Mannheim dont les résultats de cet article sont tirés est une enquête épidémiologique portant sur la prévalence des maladies psychogènes (items de l'ICD 300-306 dans la 8e édition de l'OMS) dans la population urbaine en Allemagne fédérale, et examinant la fréquence et les différents aspects des symptomes dépressifs et anxieux. Un échantillon représentatif de 600 habitants de Mannheim sélectionnés au hasard a fait l'objet d'une etude psychoanalytique semi-standardisée effectuée en 2 étapes entre 1979 et 1985 par des cliniciens, des psychothirapeutes et des psychosomaticiens qualifiés. Les sujets, des 2 sexes, appartenaient, par groupes de 200, à 3 classes d'âge, selon qu'ils étaient nés en 1935, 1945 et 1955. Le but de cette etude etait de determiner /'influence possible des conditions historiques et sociales sur le développement des maladies psychogènes.

Les critères utilisés pour etablir les diagnostics d'anxiété ou de dépression sont de 2 ordres: jugement d'un expert d'après une liste de symptômes établie au cours d'un entretien semi-standardisé (Goldberg-Cooper Interview) et du point de vue diagnostique (clé ICD de la 8e édition de I'OMS). L‘influence des événements biographiques sur les traits de la personnalite a été évaluée d'après une liste, modifiée, du travail de Siegrist (inventaire fribourgeois de la personnalité, FPI). Les tests du χ2 et du t de Student ont été utilisés.

Type
Original article
Copyright
Copyright © European Psychiatric Association 1989

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Agras, S. (1969) The epidemiology of common fears and phobias. Compr. Psychiatry 10, 151156CrossRefGoogle Scholar
Agnst, J. & Dobler-Mikola, A. (1983) Anxiety states, panic, and phobia in a young general population.In: World Psychiatric Congress Proceedings, Vienna. Plenum, NYGoogle Scholar
Angst, J. (1984) The Zurich Study. A prospective epidemiological study of depressive, neurotic, and psycho-somatic syndromes. I. Problem, Methodology. Eur. Arch. Psychiatr. Neurol. Sci. 234, 1320CrossRefGoogle Scholar
Boyd, J.H. & Weissman, M.M. (1982) Epidemiology.In: Handbook of Affective Disorders (Paykel, E.S., ed.), Churchill Livingstone, Edinburgh, pp. 218224Google Scholar
Brown, G.W. (1985) Lebensereignisse, Vulnerabilität und der Beginn depressiver Störungen, einige Verfeinerungen. Unveröffentl. Manuskript. Vortrag auf den 21. Hamburger psychiatrisch/medizinischen Gesprächen, Nov. 1985 (Angermeyer, , ed.)Google Scholar
Carey, G. (1980) Prevalence rates for the neuroses: pitfalls in the evaluation of familiarity. Psychol. Med. 10, 437444CrossRefGoogle Scholar
Costello, C.G. (1982) Fears and phobias in women: a community study. J. Abnorm. Psychol. 91, 280286CrossRefGoogle ScholarPubMed
Degkwitz, R. (1980) Diagnoseschlüssel und Glossar psychiatrischer Krankheiten. Deutsche Ausgabe der internationalen Klassifikation der WHO, ICD 8. Rev., und des internationalen Glossars. Springer, BerlinGoogle Scholar
Dilling, H. (1984) Psychische Erkrankungen in der Bevölkerung. Enke, StuttgartGoogle Scholar
Dohrenwend, B.S. & Dohrenwend, B.P. (1978) Some issues in research on stressful life events. J. Nerv. Ment. Dis. 166, 715CrossRefGoogle ScholarPubMed
Fahrenberg, J. (1978) Das Freiburger Persönlichkeitsinventar. EPI, Handanweisung. III. Aufl. Hogrefe, GöttingenGoogle Scholar
Goldberg, D.P. (1970) A standardized psychiatric interview for use in community surveys. Br. J. Prev. Soc. Med. 24, 1823Google ScholarPubMed
Hand, I. & Wittchen, H.U. (eds.) (1986) Panic and Phobias. Springer, BerlinCrossRefGoogle Scholar
Helgason, T. (1964) Epidemiology of mental disorders in Iceland. A psychiatric and demographic investigation of 5 395 Icelanders. Acta Psychiatr. Scand. (suppl.), 40, 173Google Scholar
Henderson, S. (1981) Neurosis and the Social Environment. Academic Press, New YorkGoogle Scholar
Hönmann, H. & Schepank, H. (1984) Angst und Phobie als Krankheit und Symptom in der Allgemeinbevö lkerung.In: Neurotische und eale Angst (Rüger, U., ed), Verlag für Medizinische Psychologie im Verlag Vandenhoeck und Ruprecht, Göttingen, 111123Google Scholar
Janke, W. (1978) Streβverarbeitungsfragebogen (SVF). Hogrefe, GöttingenGoogle Scholar
Marks, M. (1987) Fears, Phobias, and Rituals. Oxford University Press, OxfordGoogle Scholar
Marks, I.M. & Lader, M.H. (1973) Anxiety states (anxiety neurosis): a review. J. Nerv. Ment. Dis. 156, 318CrossRefGoogle ScholarPubMed
Myers, J.K. (1984) Six-month prevalence of psychiatric disorders in three communities. Arch. Gen. Psychiatry 41, 959967CrossRefGoogle ScholarPubMed
Orley, J. & Wing, J.K. (1979) Psychiatric disorders in two African villages. Arch. Gen. Psychiatry 36, 513520CrossRefGoogle ScholarPubMed
Paykel, E.S. (1978) Contributions of life events to causation of psychiatric illness. Psychol. Med. 8, 245253CrossRefGoogle Scholar
Pöldinger, W. (1988) Angst und Angstbewältigung. Huber, BernGoogle Scholar
Rahe, R.H. (1979) Life change events and mental illness: an overview. J. Human Stress 5, 210CrossRefGoogle ScholarPubMed
Regier, (1984) The NIMH Epidemiologic Catchment Area Program. Historical context, major objectives, and study population characteristics. Arch. Gen. Psychiatry 41, 934941CrossRefGoogle ScholarPubMed
Schepank, H. (1971) Erb- und Umwelteinflüsse bei 50 neurotischen Zwillingspaaren. Z. Psychother. Med. Psychol. 21, 4150Google Scholar
Schepank, H. (1974) Erb- und Umwelteinflüsse bei Neurosen. Tiefenpsychologische Untersuchungen an 50 Zwillingspaaren. Springer, BerlinGoogle Scholar
Schepank, H. (1980/81) Instruktion zum Neuroseschwerescore.In: Ursprünge seelisch bedingter Krankheiten (Heigl-Evers, A., Schepank, H., eds), Vandenhoeck und Ruprecht, Göttingen, pp. 473478Google Scholar
Schepank, H. (1987a) Psychogene Erkrankungen der Stadt-bevölkerung. Eine epidemiologisch-tiefenpsychologische Feld-studie in Mannheim. Springer, BerlinGoogle Scholar
Schepank, H. (1987b) Epidemiology of Psychogenic Disorders. The Mannheim Study—Results of a Field Survey in the FRG. Springer, BerlinCrossRefGoogle Scholar
Schwab, J.J. (1979) Social Order and Mental Health. Brunner/Mazel, NYGoogle Scholar
Siegrist, J. (1980) Die Bedeutung von Lebensereignissen für die Entstehung körperlicher und psychosomatischer Erkrankungen. Nervenarzt 51, 313320Google Scholar
Strotzka, H. (1969) Kleinburg, Eine sozialpsychiatrische Feldstudie. Österreichischer Bundesverlag fur Unterricht, Wissenschaft und Kunst, ViennaGoogle Scholar
Surtees, P.G. (1986) Affective disorders amongst women in the general population: a longitudinal study. Br. J. Psychiatry 148, 176186CrossRefGoogle ScholarPubMed
Uhlenhuth, E.H. (1983) Symptom checklist syndromes in the general population: correlations with psychotherapeutic drug use. Arch. Gen. Psychiatry 40, 11671173CrossRefGoogle ScholarPubMed
Väisnen, E. (1975) Psychiatric disorders in Finland. In: Social, Somatic, and Psychiatric Studies of Geographically Defined Populations (Anderson, T., Astrup, C. & Forsdahl, A., eds.), Acta Psychiatr. Scand. (suppl. 263), 27Google Scholar
Weissman, M.M. & Boyd, J.H. (1983) The epidemiology of bipolar and nonbipolar depression: rates and risks.In: The Origins of Depression: Current Concepts and Approaches (Angst, J., ed.), Springer, BerlinGoogle Scholar
Weissman, M.M. (1985) The epidemiology of anxiety disorders: rates, risks and familial patterns.In: Anxiety and Anxiety Disorders (Tuma, H. & Maser, J., eds.) Erlbaum, Hillsdale NJ, pp. 275296Google Scholar
Weissman, M.M. (1978) Psychiatric disorders in an US urban community. Am. J. Psychiatry 135, 459462Google Scholar
Wittchen, U. & von Zerssen, D. (1988) Verlaüfe behandelter und unbehandelter Depressionen und Angststörungen. Springer, BerlinCrossRefGoogle Scholar
von, Zerssen D. (1976) Klinische Selbstbeurteilungs-Skalen (KSb-S) aus dem Münchner Psychiatrischen Informations-System. Beltz, WeinheimGoogle Scholar
Zintl-Wiegand, A. (1978) Psychiatrische Erkrankungen in Mannheimer Allgemeinpraxen.In: Psychiatrische Epidemiologie (Häfner, H., ed), Springer, BerlinGoogle Scholar
Zintl-Wiegand, A. (1980) Psychisch Kranke in der ärztlichen Allgemeinpraxis: Eine Untersuchung in der Stadt Mannheim. Beltz, WeinheimGoogle Scholar
Submit a response

Comments

No Comments have been published for this article.