{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T23:57:46Z","timestamp":1790639866106,"version":"4.1.0"},"reference-count":33,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gesundheitswesen"],"abstract":"<jats:title>Zusammenfassung<\/jats:title>\n                  <jats:p>Depressive St\u00f6rungen tragen wesentlich zur Krankheitslast in Deutschland bei\n                        und k\u00f6nnen mit schwerwiegenden gesundheitlichen Folgen assoziiert sein. Im\n                        regionalen Vergleich zeigen sich in Bayern unterschiedliche H\u00e4ufigkeiten\n                        depressiver St\u00f6rungen. Daher zielt die Analyse darauf ab, auf regionaler\n                        Ebene in Bayern Zusammenh\u00e4nge zwischen sozio\u00f6konomischen,\n                        siedlungsstrukturellen und umweltbezogenen Faktoren und der Rate depressiver\n                        St\u00f6rungen bei Erwachsenen zu untersuchen.<\/jats:p>\n                  <jats:p>Datengrundlage der Querschnittsstudie stellen die ambulanten Abrechnungsdaten\n                        der Kassen\u00e4rztlichen Vereinigung Bayerns (KVB) f\u00fcr depressive St\u00f6rungen\n                        (F32, F33) gesetzlich versicherter Patienten aus den Jahren 2018\u20132023 auf\n                        Ebene der 96 bayerischen Landkreise und kreisfreien St\u00e4dte dar. Als\n                        Pr\u00e4diktoren wurden der German Index of Socioeconomic Deprivation\n                        (sozio\u00f6konomischer Faktor), der siedlungsstrukturelle Kreistyp\n                        (siedlungsstruktureller Faktor) und der Anteil an Sport-, Freizeit- und\n                        Erholungsfl\u00e4chen sowie Gr\u00fcnanlagen (umweltbezogener Faktor) auf Kreisebene\n                        einbezogen. Zur Kontrolle potenzieller Confounder wurden demografische\n                        Merkmale ber\u00fccksichtigt. Die Analyse der Zusammenh\u00e4nge dieser Faktoren und\n                        der Rate depressiver St\u00f6rungen im Jahr 2023 erfolgte mittels multivariabler\n                        negativer Binomialregression sowohl in einem Gesamtmodell als auch in\n                        Modellen stratifiziert nach Geschlecht.<\/jats:p>\n                  <jats:p>In der multivariablen Analyse zeigte sich mit zunehmender sozio\u00f6konomischer\n                        Deprivation ein Anstieg der Rate depressiver St\u00f6rungen. Der st\u00e4rkste Effekt\n                        ergab sich in Quintil 5 (RR=1,17; 95%-KI=1,08\u20131,28) im Vergleich zum Quintil\n                        der niedrigsten Deprivation (Q1). Die Quintile 1\u20134 der umweltbezogenen\n                        Fl\u00e4che wiesen geringere Rate Ratios f\u00fcr depressive St\u00f6rungen im Vergleich zu\n                        Q5 (h\u00f6chster Fl\u00e4chenanteil) auf. F\u00fcr den siedlungsstrukturellen Kreistyp\n                        waren keine signifikanten Effekte feststellbar.<\/jats:p>\n                  <jats:p>Sozio\u00f6konomische und umweltbezogene Faktoren waren mit der in der ambulanten\n                        Versorgung dokumentierten Rate depressiver St\u00f6rungen auf regionaler Ebene in\n                        Bayern assoziiert. Zur Reduktion regionaler Ungleichheiten sollte ein\n                        besonderer Fokus auf sozio\u00f6konomisch deprivierte Kreise gelegt werden.\n                        Weiterf\u00fchrende kleinr\u00e4umige Analysen zu anderen umweltbezogenen Fl\u00e4chen\n                        sowie zu ihrer Beschaffenheit sind f\u00fcr zielgerichtete verh\u00e4ltnispr\u00e4ventive\n                        Ma\u00dfnahmen erforderlich.<\/jats:p>","DOI":"10.1055\/a-2940-0095","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T23:00:32Z","timestamp":1790636432000},"source":"Crossref","is-referenced-by-count":0,"title":["Regionale Verteilung depressiver St\u00f6rungen bei Erwachsenen in Bayern:\n                    Eine multivariable Analyse sozio\u00f6konomischer, siedlungsstruktureller und\n                    umweltbezogener Faktoren"],"prefix":"10.1055","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-8576-2188","authenticated-orcid":false,"given":"Laura","family":"Anderle","sequence":"additional","affiliation":[{"name":"Ludwig-Maximilians-Universit\u00e4t M\u00fcnchen, BY, Germany","place":["Munich"],"department":["Institut f\u00fcr Medizinische Informationsverarbeitung, Biometrie und\n                    Epidemiologie (IBE)"]},{"name":"Ludwig-Maximilians-Universit\u00e4t M\u00fcnchen, BY, Germany","place":["Munich"],"department":["Pettenkofer School of Public Health, M\u00fcnchen"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Brettner","sequence":"additional","affiliation":[{"name":"Bayerisches Landesamt f\u00fcr Gesundheit und\n                    Lebensmittelsicherheit Dienststelle Oberschlei\u00dfheim, BY, Germany","place":["Oberschlei\u00dfheim"],"department":["Gesundheitsberichterstattung"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Tauscher","sequence":"additional","affiliation":[{"name":"Kassen\u00e4rztliche Vereinigung Bayerns, BY, Germany","place":["M\u00fcnchen"],"department":["Kassen\u00e4rztliche Vereinigung Bayerns"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Geigl","sequence":"additional","affiliation":[{"name":"Landeszentrale f\u00fcr Gesundheit in Bayern e. V., BY, Germany","place":["M\u00fcnchen"],"department":["Projektentwicklung"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Blank-Matthes","sequence":"additional","affiliation":[{"name":"Bayerisches Landesamt f\u00fcr Gesundheit und\n                    Lebensmittelsicherheit Dienststelle Oberschlei\u00dfheim, BY, Germany","place":["Oberschlei\u00dfheim"],"department":["Gesundheitsberichterstattung"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"key":"ref3","doi-asserted-by":"publisher","first-page":"793","DOI":"10.1016\/j.eurpsy.2015.06.003","article-title":"Functional disability and quality of life decrements in mental disorders:\n                    Results from the Mental Health Module of the German Health Interview and\n                    Examination Survey for Adults (DEGS1-MH)","volume":"30","author":"S Mack","year":"2015","journal-title":"Eur Psychiatry"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"242","DOI":"10.1016\/j.jpsychires.2021.02.053","article-title":"Estimating the risk of suicide associated with mental disorders: A systematic\n                    review and meta-regression analysis","volume":"137","author":"M Moitra","year":"2021","journal-title":"J Psychiatr Res"},{"key":"ref5","volume-title":"Gesundheitsreport 2024: Analyse der Arbeitsunf\u00e4-higkeiten. 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