Mental health conditions among children and adolescents in Germany – An analysis of healthcare data

Background

Today, the focus of public attention is on youth mental health. Healthcare data enables long-term analysis to be conducted, which can be stratified by gender and age.

Methods

We used outpatient and inpatient billing data from North Rhine-Westphalia (NRW), which is located in western Germany. Outpatient data was provided by the Association of Statutory Health Insurance Physicians, while inpatient data was provided by IT.NRW. We analysed ICD-10 F diagnoses over a 10-year period from 2015 to 2024. The groups were stratified by gender and age (5–9, 10–14, and 15–19 years). The prevalence rates were analysed and the rankings were then assigned.

Results

Children aged 5 to 9 are most commonly treated on an outpatient basis for language and speech development disorders, Childhood-onset behavioral and emotional disorders and hyperkinetic disorders. In adolescents, speech disorders decline and are replaced by hyperkinetic disorders, severe stress and adjustment disorders. Gender-specific findings show that hyperkinetic disorders are most prevalent in boys. Girls have double the rate of severe stress and adjustment disorders, and also a higher rate for depressive episodes than boys. Inpatient diagnoses for the 15–19 age group are led by depressive episodes, followed by severe stress and adjustment disorders, alcohol-related issues, and recurrent depression. Eating disorders rose to fourth place for girls in 2021, while boys were more often hospitalised for mental and behavioural disorders due to psychoactive substance use.

Conclusions

The data identifies areas where targeted prevention is needed to protect long-term quality of life and career prospects.

Key messages

• Among adolescents, inpatient cases are dominated by depressive episodes and stress disorders, underscoring the importance of early, gender-sensitive interventions to protect long-term life outcomes.

• The 10-year analysis of healthcare data highlights the urgent need for demographic-specific prevention strategies.