000K utf8 1100 2025$c2025-11-25 1500 eng 2050 urn:nbn:de:gbv:27-dbt-68360-5 2051 10.1186/s12913-025-13714-5 3000 Wrede, Nicolas 3010 Alpers, Georg W. 3010 Bartholdy, Stephan 3010 Berger, Elisa-Maria 3010 Brakemeier, Eva-Lotta 3010 Christiansen, Hanna 3010 Equit, Monika 3010 Fehm, Lydia 3010 Forkmann, Thomas 3010 Fritz, Jessica 3010 Glombiewski, Julia 3010 Heider, Jens 3010 Helbig-Lang, Sylvia 3010 Hermann, Andrea 3010 Hermann, Christiane 3010 Hoyer, Jürgen 3010 In-Albon, Tina 3010 Itz, Marlena L. 3010 Kirsch, Anke 3010 Klucken, Tim 3010 Lincoln, Tania M. 3010 Lueken, Ulrike 3010 Lutz, Wolfgang 3010 Margraf, Jürgen 3010 Odyniec, Patrizia 3010 Pedersen, Anya 3010 Pittig, Andre 3010 Renneberg, Babette 3010 Riesel, Anja 3010 Risch, Anne Katrin 3010 Rubel, Julian 3010 Rudolph, Almut 3010 Schwartz, Brian 3010 Stark, Rudolf 3010 Teismann, Tobias 3010 Vehlen, Antonia 3010 Velten, Julia 3010 Werheid, Katja 3010 Willutzki, Ulrike 3010 Wilz, Gabriele 3010 Witthöft, Michael 3010 Woud, Marcella L. 4000 Quantifying age-related disparities in outpatient psychotherapy utilization: a representation quotient analysis of routine data from 29 university clinics in Germany [Wrede, Nicolas] 4060 14 Seiten 4209 Abstract Background Although mental disorders are highly prevalent among older adults, evidence suggests that they underutilize psychotherapy. However, formal estimates of their actual representation in routine clinical settings are scarce. This study applied a representation quotient approach to identify and quantify age-related disparities in outpatient psychotherapy utilization in Germany. Methods We analyzed data from 13,635 adult patients who initiated cognitive-behavioral therapy between 2018 and 2023 at 29 university outpatient clinics. Using a representation quotient approach, we compared the observed proportions of young-old adults (65–74 years) and old-old adults (≥75 years) with prevalence-stratified population age distributions. The robustness of the results was investigated by extensive sensitivity analyses, including alternative prevalence assumptions and adjustments for long-term care needs. Results Even under conservative assumptions, young-old adults only accounted for about 25% and old-old adults for about 13% of their expected proportion. In contrast, young working-age adults (18–34 years) were particularly overrepresented in the sample. Underrepresentation of older adults was most pronounced among patients with post-traumatic stress disorder, eating disorders, and dysthymia, less pronounced among patients with generalized anxiety disorder, and not significant among patients with pain disorders. Conclusion This study demonstrates the utility of representation quotients for systematically identifying and quantifying age-related disparities in psychotherapy utilization based on routine care data. Our analyses of large-scale data from university outpatient clinics in Germany revealed a marked underrepresentation of older adults in this setting. These findings highlight the need to improve access to, and utilization of, psychotherapeutic services for older adults. 4950 https://doi.org/10.1186/s12913-025-13714-5$xR$3Volltext$534 4950 https://nbn-resolving.org/urn:nbn:de:gbv:27-dbt-68360-5$xR$3Volltext$534 4961 https://www.db-thueringen.de/receive/dbt_mods_00068360 5051 150 5550 Access barriers 5550 Age disparities 5550 Mental health services 5550 Older adults 5550 Psychotherapy utilization 5550 Representation quotient