Prevalence of comorbid depressive symptoms in rehabilitation: A cross-indication, nationwide observational study.

Objective: Patients in rehabilitation with comorbid depressive disorders display increased morbidity, mortality and inability to work. The aim of this study is to determine the prevalence of comorbid depressive symptoms in rehabilitation.

Methods: A total of 6,000 patients were contacted by post at the same time as receiving approval for their medical rehabilitation from German Federal Pension Insurance. Depressive symptoms were assessed using the Patient Health Questionnaire (PHQ-2). Results were compared with prevalences in the general population by analysing the German Health Interview and Examination Survey for Adults (DEGS).

Results: A total of 2,152 out of 5,891 patients participated in the study (response rate: 36.5%). The prevalence of self-reported depressive symptoms was 33.1% (women 34.1%, men 31.3%). In contrast, 7.8% of the German general population reported depressive symptoms (women 9.4%, men 6.2%). The highest prevalences were found in neurological (36.4%) and orthopaedic (35.6%) rehabilitation, the lowest in cancer rehabilitation (23.0%). Depressive symptoms were significantly associated with higher comorbidity and impairment due to pain, with lower social support and self-efficacy and with specific work-related problems.

Conclusion: A short routine screening yielded a positive test result for depressive symptoms in a third of rehabilitation patients, thus approximately four times higher than in the general population. This is valuable information in order to better adjust treatment to patient needs.