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Health service use by adults with depression: community survey in five European countries

Evidence from the ODIN study

Division of Psychiatry, University of Liverpool, Liverpool, UK

Odd Steffen Dalgard, DrMed

Institute of General Practice and Community Medicine, University of Oslo, Oslo, Norway

Jose Luis Ayuso-Mateos, MD

Department of Psychiatry, Hospital Universitario de la Princesa, Autonomous University of Madrid, Spain

Patricia Casey, FRCPsych

Mater Misericordiae Hospital, University College Dublin, Ireland

Greg Wilkinson, FRCPsych

Division of Psychiatry, University of Liverpool, Liverpool UK

Ville Lehtinen, MD

National Research and Development Centre for Welfare and Health, Helsinki, Finland

Christopher Dowrick, FRCGP

Division of Primary Care, University of Liverpool, Liverpool, UK

Correspondence: Professor Christopher Dowrick, Division of Primary Care, Whelan Building, University of Liverpool, Liverpool L69 3GB, UK. E-mail: cfd{at}liv.ac.uk

Declaration of interest None.

Background Little is known about patterns of healthcare use by people with depression in Europe.

Aims To examine the use and cost of services by adults with depressive or adjustment disorders in five European countries, and predictive factors.

Method People aged 18-65 years with depressive or adjustment disorders (n=427) in Ireland, Finland, Norway, Spain and the UK provided information on predisposition (demographics, social support), enablement (country, urban/rural, social function) and need (symptom severity, perceived health status) for services. Outcome measures were self-reported use Client Services Receipt Interview and costs of general practice, generic, psychiatricor social services in the past 6 months.

Results Less frequent use was made of generic services in Norway and psychiatric services in the UK. Severity of depression, perceived health status, social functioning and level of social support were significant predictors of use; the number of people able to provide support was positively associated with greater health service use.

Conclusions Individual participant factors provided greater explanatory power than national differences in healthcare delivery. The association between social support and service use suggests that interventions may be needed for those who lack social support.

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