# From feeling depressed to getting diagnosed: Determinants of a diagnosis of depression after experiencing symptoms

## TL;DR

This study explores what factors lead people with depression symptoms to eventually receive a formal diagnosis.

## Contribution

The study distinguishes between risk factors for symptoms and factors influencing diagnosis, emphasizing the chronological process.

## Key findings

- Depression symptoms are linked to chronic conditions, unemployment, and personality traits like higher neuroticism.
- Female gender, older age, and unemployment also increase the likelihood of receiving a diagnosis.
- Access to healthcare providers did not influence diagnosis rates.

## Abstract

Receiving a formal diagnosis for a depressive disorder is a prerequisite for getting treatment, yet the illness inherently complicates care-seeking. Thus, understanding the process from depression symptoms to diagnosis is crucial.

This study aims to disentangle (1) risk factors for depression symptoms from (2) facilitators and barriers to receiving a diagnosis after experiencing depression symptoms.

We used data from the German Socio-Economic Panel. Within a sample of 40,238 individuals, we investigated factors predicting depression symptoms, assessed with the SF-12 Mental Component Summary score. Additionally, within a subsample of 3,444 individuals with depression symptoms, we analyzed factors associated with receiving a first-ever diagnosis in the subsequent year. These factors included health status, demographics, socioeconomic characteristics, personality traits, and health infrastructure.

Depression symptoms were associated with chronic physical conditions, female gender, middle age, living alone, fewer close friends, being unemployed or not working, lower income, lower agreeableness, conscientiousness, or extraversion, and higher neuroticism. Additionally, poorer overall mental and physical health, female gender, older age, unemployment, and neuroticism were positively associated with receiving a formal diagnosis. Access to general practitioners and psychotherapists was not associated with receiving a formal diagnosis.

Our results replicated previous research on risk factors for depression symptoms. Moreover, some risk factors for experiencing symptoms (female gender, middle age, unemployment, and higher neuroticism) subsequently also facilitated receiving a formal depression diagnosis. Thus, this study underscores the importance of considering the chronological sequence in the process from depression symptoms to diagnosis.