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

Published online by Cambridge University Press:  28 April 2020

G. Reister  and
H. Schepank
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
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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.

Keywords

anxiety disordersaffective disordersdepressive neurosiscohort studytroubles anxieuxtroubles affectifsnévrose dépressiveétude de cohorte
Type
Original article
Information
Psychiatry and Psychobiology , Volume 4 , Issue 5 , 1989 , pp. 299 - 306
Copyright
Copyright © European Psychiatric Association 1989

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