Certain physical symptoms and stressful life situations can serve as early indicators of existing or emerging mental illness that may develop at a later stage. These findings can help initiate treatment earlier, improve disease progression, and reduce insurance risks. This conclusion comes from a study by Munich Re experts who analysed health data from more than 380,000 employed individuals aged 16 to 60 years, insured under the German statutory health system between 2013 and 2020. The aim was to identify warning signs for potential future mental disorders and assess the influence of physical diagnoses.

Mental illness is one of the most frequent causes of occupational disability worldwide, with significant economic consequences. Often, these conditions are diagnosed too late because many patients initially consult doctors for physical symptoms and do not report psychological distress. As a result, diagnoses often focus solely on physical complaints. Identifying risk indicators for mental illness at an earlier stage could enable earlier diagnosis and treatment. This would reduce the likelihood of chronic disease courses, improve recovery prospects for affected individuals, and lower insurance-related losses.

The connection between physical symptoms and mental disorders has been established in prior research. However, the temporal relationship between the onset of physical factors and subsequent mental illness has remained unclear. To address this gap, the Munich Re study analysed health insurance data from individuals without prior mental illness diagnoses. Researchers investigated which physical conditions during the three years preceding new cases of depression or anxiety were associated with increased risk.

The results revealed that 6.7% of the individuals examined developed new-onset depression and/or anxiety disorders between 2018 and 2020.

Hyperventilation, life-management difficulties, social or work-related problems, back pain, frequent doctor visits, and long periods of sickness absence were particularly strong predictors of later mental illness.

Especially in the age group of 46 to 60 years, the risk was significantly higher if they had experienced extended sickness leave during the previous three years.

The findings highlight that not only psychological but also physical and behavioural indicators should be viewed as warning signs of emerging mental illness.

In primary care settings, physicians can use these insights to identify potential psychological problems earlier and take appropriate action. For life and health insurers, these findings provide opportunities to identify risk factors more effectively and develop targeted prevention measures. By doing so, insurers can actively promote the health of their policyholders and help prevent long-term illness.

In the Life Science Report 2025, Munich Re outlines strategies for developing effective prevention measures. Insurers are advised not to focus solely on current health status and medical history, but also to consider lifestyle and broader determinants of health – such as age or environmental factors. Since the majority of policyholders are healthy, primary prevention strategies should take priority. These are interventions aimed at preventing disease or impairment before it occurs. By developing tailored risk profiles, insurers can create personalised prevention programs that improve health literacy and mitigate specific risk factors — ultimately achieving better prevention outcomes.