The state of care and its utilization

The state of care and utilization of services were depicted using outpatient treatments in which a diagnosis of depression was coded, inpatient treatments with mental health diagnoses, as well as specific drug prescriptions. In outpatient care, treatments were differentiated according to the following specialties:

Furthermore, the extent to which services were utilized in line with the psychotherapy guideline was investigated (etable 1). These services were identified using the specific codes of the uniform evaluation scale (Einheitlicher Bewertungsmaßstab, EBM). A distinction was made between the following services:

EBM, German Uniform Evaluation Standard (Einheitlicher Bewertungsmaßstab); STT, short-term therapy; LTT, long-term therapy, Ps, participants

In order to depict inpatient care, all hospitalizations involving depression as the principal discharge diagnosis, as well as additionally with a diagnosis in the F chapter, were investigated. With regard to the provision of drugs, prescriptions in the active substance classes of antidepressants (N06A) were considered according to the Anatomical Therapeutic Chemical (ATC) classification, as well as supplementary lithium (N05AN), antipsychotics (N05A), and benzodiazepines (N05BA), since these are sometimes used for certain forms of depression (19).