Krankheitsbedingte Fehlzeiten in der deutschen Wirtschaft im Jahr 2019

The German health interview and examination survey for adults (DEGS1) with the mental health module (DEGS1-MH) is the successor to the last survey of mental disorders in the general German population 15 years ago (GHS-MHS). This paper reports the basic findings on the 12-month prevalence of mental disorders, associated disabilities and self-reported healthcare utilization.

In Germany, the significant increase of healthcare provision and service use in recent decades has not resulted in a decreasing prevalence of mental disorders.Three explanations for this phenomenon are considered: 1) prevention and the healthcare system are insufficient and ineffective, 2) the success of the healthcare service is masked by growing morbidity due to increasing societal risks, and 3) a fundamental shift towards a psychological culture accounts for an increasing perception and treatment of mental disorders and their symptoms at the same time. In order to review these three theoretical approaches, results from population-based health surveys and healthcare research in Germany as well as the international debate are presented and discussed.The present results provide evidence for each of the three explanations: 1) problems with implementation of preventive actions and access to healthcare services are well documented, 2) influences of the multifaceted development of risk factors on the prevalence and disease burden of mental disorders cannot be ruled out, and 3) a growing mental health literacy implies that problems (in everyday life) are currently more often interpreted and treated psychologically.For the purpose of evaluating changes in the healthcare system, not only should the prevalence of mental disorders be considered, but also incidence (and their potential reduction by preventive measures) as well as indicators of need for treatment (i. e. functional impairment) and mortality (i. e. suicides and reduced life expectancy).

Employees are thought to lengthen their weekends by voluntary absenteeism, but the magnitude of such potentially reversible behaviour is not known. A follow up study based on employers' registers on the dates of work contracts and absences in 27 541 permanent full time municipal employees in five towns during 1993-7. The absence rate on each weekday separately for all sick leaves and for 1 day sick leaves was determined. 3.4% of the male employees and 5.0% of the female employees were on sick leave daily. The mean rate of sickness absence was lowest on Mondays, after which it increased towards Wednesday, and remained on the same level for the rest of the week. This pattern applied to both sexes, to each year of the follow up, and across towns, age groups, and income groups. For 1 day sick leaves, representing 4.5% of the total sickness absenteeism, the rates of sick leave for Mondays and Fridays were 1.4 and 1.9 times greater than those for other weekdays. However, these excess rates account for less than 1% of all days lost due to sickness absenteeism. Extended weekend absences were more common in men, in young employees, and in those in a low socioeconomic position, and they varied between towns. Extended weekends seem to contribute only marginally to the days lost due to sickness absenteeism.