What went and what came? Morbidity trends in general practice from the Netherlands

Figures & data

Figure 1.  Hyperthyroidism (prevalence, trend line).

Figure 2.  Hypothyroidism (prevalence, trend line).

Figure 3.  Depression (prevalence, trend line).

Figure 4.  Anxiety disorders (prevalence, trend line).

Figure 5.  Pinworms (prevalence, trend line).

Figure 6.  Duodenal ulcer (prevalence, trend line).

Figure 7.  Diabetes (prevalence, trend line).

Figure 1.  CMR population and Dutch population for men (CBS; Statistics Netherlands 2000) (percentages) according to age group (years).

Figure 2.  CMR population and Dutch population for women (CBS; Statistics Netherlands 2000) (percentages) according to age group (years).

Figure 3.  Trend in age distributions for men 1985–2005 (percentages).

Figure 4.  Trend in age distributions for women 1985–2005 (percentages).

Figure 5.  Trend for overall morbidity: incidence rates.

Figure 6.  Trend for overall morbidity: prevalence rates.

Figure 7.  Trend for chronic morbidity: incidence rates.

Table I.  Incidence rates, prevalence rates, and annual percentage change (APC).

	Incidence 2002–2006		Prevalence 2002–2006		APC (prevalence) 1986–2006
	male	female	male	female	male	female
Infectious diseases**
Erysipelas			3.6	3.3	1.7	0.5
Varicella			3.7	2.8	0.1	−0.9
Herpes labialis			2.1	4.0	−1.8	−4.2
Herpes zoster			3.5	4.1	0.0	0.3
Oral candidiasis			3.6	4.8	2.1	3.1
Genital candidiasis			3.3	2.5	0.8	6.7
Mycosis foot			12.0	14.1	−1.4	−0.3
Other mycosis			20.1	19.8	4.3	5.0
Pityriasis versicolour			2.4	2.4	1.8	0.9
Exanthema subitum			1.1	1.1	−2.1	−2.1
Malignancies*
Lung	0.8	0.3	2.0	0.7	−0.3	11.0
Breast	0.0	1.6	0.3	17.3	2.3	4.3
Colorectal	0.8	0.6	3.6	4.7	3.4	3.1
Melanoma	0.2	0.3	1.0	2.4	na	na
Bladder	0.4	0.1	3.6	0.5	4.1	0.0
Renal	0.3	0.2	1.6	1.2	7.7	5.9
Basalioma	2.3	2.1	3.3	2.6	na	na
Leukaemia	0.3	0.1	1.3	0.9	na	na
Lymphoma	0.2	0.2	0.9	1.5	4.0	6.8
Prostate	0.7	−	4.7	−	6.9	−
Cervical	−	0.1	−	1.6	−	7.9
Endometrial	−	0.3	−	2.1	−	1.9
Benign neoplasms
Fibroadenoma			0.0	2.4	na	−1.7
Skin tumours			14.0	21.0	2.9	2.6
Lipoma			3.6	3.5	2.2	3.3
Polyp colon	0.9	1.2	2.1	2.4	8.9	9.6
Struma*	0.0	0.8	0.2	8.1	0.0	0.8
Endocrinology/allergy
Seasonal rhinitis*	4.5	6.0	24.6	33.6	2.3	5.2
Hyperreactive rhinitis*	4.2	5.1	17.2	22.7	4.2	5.8
Asthma*	3.1	2.8	33.2	37.7	5.8	6.8
Hyperthyroidism*	0.2	0.6	0.8	5.1	−1.6	0.4
Hypothyroidism*	0.4	1.8	2.8	19.5	15.5	12.0
Diabetes I*	0.2	0.2	4.0	5.5	0.7	−0.5
Diabetes II*	3.6	3.3	38.6	35.6	6.4	4.8
Gout*	3.5	1.3	15.3	4.3	6.2	5.2
Obesity (BMI >30 kg/m^2)*	3.0	4.0	50.8	77.0	4.0	2.2
Urticaria	4.5	7.5	4.8	8.7	1.5	2.2
Serum lipid disorders*	2.6	2.9	41.7	39.5	8.5	8.3
Blood
Anaemia	1.3	7.6	1.4	8.0	−1.9	1.4
Psychiatry
Nervous symptoms	39.1	69.1	76.8	167.1	−2.1	−0.7
Depression*	4.9	7.4	16.2	28.3	7.7	9.4
Schizophrenia*	0.0	0.2	1.6	1.5	5.3	0.5
Other psychosis*	0.4	0.5	3.0	3.9	2.8	3.2
Anxiety disorders*	1.9	3.7	7.8	14.6	18.3	22.8
Personality disorders*	0.4	0.5	2.7	2.0	11.7	7.9
Alcohol addiction*	2.4	1.2	9.9	4.7	1.1	3.6
Drug addiction (excl. smoking)*	0.5	0.2	2.4	0.7	8.4	0.8
Dementia*	1.1	2.5	3.6	8.7	6.1	5.1
Irritable bowel	2.7	6.0	3.9	10.2	0.1	1.6
Sexual	2.3	0.9	3.2	1.3	9.8	0.0
Anorexia*	0.0	0.3	0.0	2.3	0.0	3.2
Enuresis*	1.1	0.7	3.5	1.8	2.1	2.3
Circulatory tract
Valvular*	1.1	1.2	9.6	10.5	7.8	5.5
Myocardial infarction*	3.0	1.8	26.1	13.4	0.6	2.4
Angina*	2.3	1.8	29.6	20.4	2.2	1.2
Heart failure*	2.0	2.1	10.9	12.4	0.8	0.2
Atrial fibrillation*	2.7	2.4	16.3	13.5	4.2	3.9
Other arrhythmias*	1.2	2.4	4.3	7.0	3.1	2.1
Hypertension*	8.5	7.8	79.9	95.7	4.0	1.9
Perniones*	0.6	1.4	1.7	12.1	−3.4	1.5
Claudicatio*	1.4	0.9	12.1	5.7	1.5	−0.2
Varicosis*	3.3	8.0	27.7	97.2	2.4	1.1
Haemorrhoids	6.5	9.6	8.0	11.0	−0.9	−0.3
Syncope			4.6	6.0	6.4	6.1
Nervous systems
Transient ischaemic attack (TIA)*	1.1	0.9	6.0	7.4	4.5	3.1
Stroke*	2.7	3.0	14.9	15.0	2.8	3.1
Parkinson*	0.3	0.3	1.4	1.8	−2.2	0.2
Epilepsy*	0.5	0.4	5.5	4.9	−0.5	−1.1
Migraine*	1.3	3.2	5.7	25.6	2.6	3.4
Carpal tunnel syndrome	1.3	4.5	1.5	4.6	na	na
Cervicobrachialgia	3.2	4.6	3.4	4.7	na	na
Ischialgia	1.4	1.9	1.6	2.1	−2.1	−2.5
Restless legs syndrome	0.7	1.2	0.8	1.4	13.2	7.5
Sense organs
Hordeolum			2.8	3.4	0.4	−0.5
Chalazion			1.4	1.6	4.1	1.4
Conjunctivitis			22.2	28.9	−0.2	−0.5
Blepharitis	3.2	2.8	2.2	3.5	−1.5	−1.3
Squint	0.6	0.7	0.8	1.8	−7.7	−0.3
Cataract	4.4	6.2	20.3	32.9	6.7	5.6
Glaucoma	0.6	0.5	7.4	6.9	4.4	5.8
Amblyopia	0.5	0.4	3.4	3.6	−2.1	0.6
External otitis	16.2	15.5	19.2	19.0	0.1	−0.6
Otitis media			26.0	24.4	1.0	1.4
Cerumen			46.7	43.4	0.4	−0.3
Deafness*	3.1	3.4	35.6	34.3	0.5	0.9
Glue ear			15.9	18.7	−1,6	−1,2
Dizziness			7.5	14.0	1.8	2.5
Tinnitus			1.7	1.4	9.2	3.4
Respiratory tract
Common cold			71.6	103.6	−4.0	−3.0
Flu			52.2	53.5	−0.7	−0.6
Tonsillitis			12.5	17.6	−2.0	−1.9
Sinusitis			11.9	20.7	−2.2	−1.2
Seasonal rhinitis*	4.5	6.0	24.6	33.6	2.3	5.2
Hyperreactive rhinitis*	4.2	5.1	17.2	22.7	4.2	5.8
Asthma*	3.1	2.8	33.2	37.7	5.8	6.8
Laryngitis subglottica			2.3	0.7	2.1	−0.3
Tracheitis/laryngitis			2.9	4.7	−1.2	−0.3
Pneumonia			12.7	12.9	3.4	5.0
Acute bronchitis			17.4	18.7	−0.8	−1.2
Wheezing			6.0	6.7	2.5	3.5
COPD*	1.9	1.2	28.5	20.1	−0.4	3.2
Tonsillar hypertrophy			3.2	2.1	1.1	1.6
Nasal polyps	0.9	0.7	2.2	1.5	12.2	6.8
Epistaxis			4.9	3.8	0.2	1.9
Digestive tract
Reflux oesophagitis*	1.8	1.7	6.5	5.6	14.1	12.2
Duodenal ulcer*	0.5	0.2	2.9	1.2	−3.7	−4.3
Dyspepsia 1	13.2	17.7	21.4	25.9	1.7	3.8
Inguinal herniation	3.7	0.5	5.0	1.1	−1.4	−0.4
Appendicitis			1.2	0.9	1.3	3.8
Diverticulosis*	1.1	1.8	4.3	7.5	5.5	3.2
Crohn/ulcerosa*	0.2	0.1	2.9	2.1	6.8	2.4
Proctitis*	0.4	0.2	1.0	1.0	3.8	0.4
Gallbladder stones	0.8	2.7	1.3	5.0	2.1	0.8
Gastroenteritis			23.1	25.9	−1.4	−0.8
Obstipation	7.4	14.4	8.4	17.2	2.1	4.1
Anal fissure			3.3	5.0	0.2	0.6
Urogenital tract
Pyelonephritis			0.6	2.0	1.6	−2.1
Urinary stones	2.7	1.3	5.5	2.4	1.7	−0.4
Cystitis			11.0	81.7	1.9	1.3
Prostatism*	4.3	−	26.3	−	5.5	−
Phimosis			2.9	−	1.0	−
Balanitis			2.7	−	−2.1	−
Prolapse*	−	2.5	−	18.3	−	0.5
Dysmenorrhoea	−	3.2	−	8.9	−	−2.6
Menometrorrhagia	−	4.9	−	9.3	−	2.0
Climacteria*	−	6.5	−	24.8	−	5.3
Infertility	2.4	2.9	2.5	7.2	3.8	1.3
Vaginitis			−	48.5	−	−0.6
Incontinence urinal*	1.1	7.5	4.0	40.4	5.3	5.8
Skin diseases
Furunculosis			1.4	1.3	−5.2	−4.3
Paronychia			3.6	3.1	−0.8	−1.3
Hidradenitis	0.5	1.8	0.6	2.4	0.3	0.5
Cellulitis			10.0	10.0	−3.2	−2.8
Abscess			3.1	3.4	0.7	2.8
Impetigo			14.7	14.8	8.4	11.3
Molluscs			4.2	4.2	2.5	3.9
Warts			20.7	27.9	2.1	2.5
Folliculitis			4.5	7.1	1.3	0.4
Seborrhoea	5.0	6.5	12.8	13.0	5.5	5.7
Eczema*	6.5	5.7	23.8	25.7	0.1	−1.8
Contact dermatitis	1.5	3.5	2.2	5.8	−2.7	−4.1
Diaper rash			1.3	2.4	−3.9	−0.7
Psoriasis*	1.3	1.6	15.5	16.4	1.7	2.4
Clavus			3.4	4.5	−0.8	−1.5
Acne vulgaris*	2.4	4.1	5.4	13.7	−4.7	−1.7
Unguis incarnatus			6.1	7.5	−0.4	1.5
Diseases, hair	0.8	2.1	1.4	3.7	−0.6	0.8
Hyperhidrosis			1.3	1.7	−6.3	−5.4
Chronic ulcer	1.7	2.5	2.2	2.8	0.2	0.7
Pityriasis rosea			1.1	1.6	−2.8	−3.0
Naevus			7.8	16.7	na	na
Atheroma			11.2	10.4	−0.4	0.7
Pruritus			1.9	2.5	−2.7	−1.9
Seborrhoeic warts			8.2	9.9	6.8	6.0
Musculoskeletal tract
Rheumatoid arthritis*	0.2	0.4	3.4	4.9	na	na
Bechterew*	0.2	0.1	1.5	1.9	na	na
Osteoarthritis knee*	2.4	4.3	20.9	39.4	5.6	2.4
Osteoarthritis hip*	1.3	2.0	13.2	22.8	4.2	2.1
Osteoarthritis vert. column	2.4	2.8	21.3	24.9	1.0	0.5
Other osteoarthritis*	2.8	5.1	11.6	26.1	6.2	5.6
Muscle pain			48.1	70.5	−1.4	−0.9
Low back pain			64.9	46.1	−2.0	−1.3
Shoulder pain			21.9	26.4	0.9	0.9
Meniscal lesion			2.7	1.6	0.3	4.2
Herniated nucleus pulposus (HNP)	2.9	1.9	3.9	2.6	1.8	2.6
Hallux valgus	0.6	2.5	1.6	6.7	3.9	−0.6
Chondropathia patellae	2.6	4.1	3.3	6.0	−2.5	−1.7
Polymyalgia*	0.2	0.7	0.5	2.2	3.4	2.1
Osteoporosis*	0.2	1.5	1.8	9.9	4.3	6.0
Scoliosis, etc.*	0.4	0.5	1.5	4.2	−7.0	−3.9
Bursitis			8.0	7.4	1.3	4.8
Epicondylitis			7.2	7.9	0.4	1.2
Ganglion			2.2	4.0	0.2	−0.9
Coup de fouet			2.6	2.0	−0.3	0.4
Arthralgia			2.5	4.3	7.8	7.7

*Chronic condition.

**For diseases with a limited duration incidence figures (not shown) and prevalence figures do not differ.

Table II.  Seasonal trends for respiratory infections (period 2001–2006): percentage spread over the year.

Respiratory tract	January–March	April–June	July–September	October–November
Common cold	34	26	16	24
Flu	35	33	13	19
Tonsillitis	25	30	2	23
Sinusitis	33	32	14	21
Seasonal rhinitis*	2	57	40	1
Hyperreactive rhinitis*	24	34	17	25
Asthma*	29	25	19	26
Laryngitis subglottica	25	27	13	35
Tracheitis/laryngitis	24	30	22	24
Pneumonia	37	29	14	20
Acute bronchitis	38	26	12	23
Wheezing	34	26	15	25
COPD*	29	26	15	30
Tonsillar hypertrophy	31	28	24	17
Nasal polyps	35	16	15	34
Epistaxis	32	28	21	19

*Chronic condition.

Table III.  Influence of socio-economic status (SES): prevalence rates for SES (patients/1000/year).

	Low	Middle	High
Rheumatoid arthritis*	0.9	0.4	0.2
Osteoarthritis knee*	4.5	3.5	1.8
Osteoarthritis hip*	1.7	1.7	1.7
Osteoarthritis vert. column	3.4	2.4	2.0
Other osteoarthritis*	4.7	4.0	3.5
Muscle pain	73.0	46.7	43.5
Low back pain	59.6	43.1	34.3
Shoulder pain	28.7	23.8	18.0
Meniscal lesion	2.4	2.3	1.9
HNP	2.6	2.3	2.4
Hallux valgus	1.3	1.6	1.6
Chondropathia patellae	3.7	3.7	3.0
Polymyalgia*	0.5	0.5	0.2
Osteoporosis*	1.2	0.8	0.4
Scoliosis, etc.*	0.5	0.5	0.3
Bursitis	10.1	7.6	4.6
Epicondylitis	3.8	3.0	2.9
Ganglion	3.8	3.0	2.9
Coup de fouet	2.8	2.4	1.8
Arthralgia	4.4	2.9	2.6

*Chronic condition.