© 2003 The Royal College of Psychiatrists
Depression status, medical comorbidity and resource costs
Evidence from an international study of major depression in primary care (LIDO)
,
Health Services Research Department, King's College of Medicine and Institute of Psychiatry, London, UK
University of Washington, Seattle, Washington, USA
Health Services Research Department, King's College of Medicine and Institute of Psychiatry, London, UK
University of Washington, Seattle, Washington, USA
Pfizer, Groton, Connecticut (formerly Eli Lilly and Company, Indianapolis, Indiana),USA
Center for Health Studies, Group Health Cooperative of Puget Sound, Seattle, Washington, USA
the LIDO Group
Correspondence: Dr Dan Chisholm, Global Programme on Evidence for Health Policy, World Health Organization, Avenue Appia, 1211 Geneva 27, Switzerland. E-mail: chisholmd{at}who.int
Declaration of interest This research was funded by research contracts from Eli Lilly and Company to Health Research Associates, Inc.
See editorial, pp. 92–94, this issue.
This report does not necessarily represent the decisions or stated policy
of the World Health Organization.
Background Despite the burden of depression, there remain few data on its economic consequences in an international context.
Aims To explore the relationship between depression status (with and without medical comorbidity), work loss and health care costs, using cross-sectional data from a multi-national study of depression in primary care.
Method Primary care attendees were screened for depression. Those meeting eligibility criteria were categorised according to DSM–IV criteria for major depressive disorder and comorbid status. Unit costs were attached to self-reported days absent from work and uptake of health care services.
Results Medical comorbidity was associated with a 17–46% increase in health care costs in five of the six sites, but a clear positive association between costs and clinical depression status was identified in only one site.
Conclusions The economic consequences of depression are influenced to a greater (and considerable) extent by the presence of medical comorbidity than by symptom severity alone.
Related articles in BJP:
- Highlights of this issue
- ELIZABETH WALSH
BJP 2003 183: 89-a7.[Full Text] - Global burden of depression: the intersection of culture and medicine
- JAN SCOTT and BARBARA DICKEY
BJP 2003 183: 92-94.[Full Text]
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