Trends in depressive symptoms in Germany's adult population 2008-2023

The present study examines trends in the prevalence of depressive symptoms among adults in Germany between 2008 and 2023 within the framework of mental health surveillance.

We used survey data from seven observation periods from a total of N = 74,096 randomly sampled participants aged 18-79 living in Germany. Symptoms of depression were measured using the Patient Health Questionnaire-8. Time series consisting of prevalence estimates were calculated, also for subgroups by sex, age and education. Developments in the more severe symptom range and in individual symptoms were also examined. Joinpoint regression and logistic regressions including linear splines were used to assess trends.

Depressive symptom prevalence rose 2008-2023, with stagnation 2008-2020 followed by an increasing trend 2020-2023. While 7.5% of adults were at or above screening cutoff in 2020, 14.8% were affected in 2023. This development was found across subgroups. Both moderate and more severe symptoms increased, with a particular rise in severe symptoms among males. A clearly increasing trajectory was found across symptoms, although developments in low self-worth/guilt were less clear. Depressive symptoms were generally more prevalent among females than males, the youngest than the eldest adults and those with lower educational attainment. Young females and males with low educational attainment were particularly affected in the final observation period.

The observed increases in depressive symptoms among adults in Germany in times of multiple collective crises call for efforts to promote and protect mental health as well as for continued observation.