Introduction: Affective disorders profoundly affect individuals’ emotional well-being and quality of life. This
study investigates the epidemiology of affective disorders in Germany from 2011 to 2021, focusing on incidence
rates, age- and sex-standardized rates, and developmental trends.
Methods: Using nationwide data of ICD-10 diagnosis codes from 2011 to 2021, this cross-sectional study analyzed
inpatient cases of affective disorders in individuals aged 20 years or older. Age- and sex-standardized incidence
rates were calculated based on the population size of each birth cohort in the 16 German federal states. Incidence
rate ratios (IRRs) for 2011 to 2021 and 2019 to 2021 were compared with a two-sample z-test.
Results: Between 2011 and 2021, F30 (manic episode) showed a decline of 42.8 % to an incidence of 4.9 per
100,000 inhabitants, even though not statistically significant (p = 0.322). F31 (bipolar affective disorder)
remained relatively stable with a reduction of 15.3 % to an incidence of 13.6 per 100,000 inhabitants in 2021 (p
= 0.653). F32 (depressive episode) decreased statistically significant by 25.7 % to an incidence of 64.1 per
100,000 inhabitants (p = 0.072). F33 (recurrent depressive disorder) slightly increased by 18.3 % to an incidence
of 94.6 per 100,000 inhabitants (p = 0.267). No statistically significant differences were found when comparing
the COVID-19 pandemic year 2021 to 2019 incidences (p ≥ 0.529).
Conclusion: The study provides valuable insights into the changing landscape of affective disorders in Germany
over the past decade. The observed decline in incidence rates underscores the importance of continued efforts to
promote mental health awareness and access to care.