title: Depression and outpatient medical utilization: a naturalistic 10-year follow-up.
abstract: The current investigation described the relationship between depression and outpatient medical utilization in a sample of 424 treatment-seeking individuals diagnosed with a depressive disorder and a demographically matched community sample of 424 men and women. This relationship was assessed longitudinally from baseline (intake for the patient sample) to 1-, 4-, and 10-year follow-ups. Patients and community individuals demonstrated distinct patterns of depressive symptoms and outpatient medical utilization: patients declined in symptoms and medical utilization following treatment, although they continued to have higher levels of depressive symptoms and outpatient utilization than controls at each follow-up period. Community controls demonstrated no change from baseline in symptoms or utilization at any follow-up. Higher levels of depressive symptoms was associated with increased outpatient medical utilization over the 10 years, even when age, sex, marital status, medical comorbidity, and patient status were controlled. Results add further evidence for a relationship between symptoms of depression and outpatient utilization by documenting this relationship in a posttreatment sample. Furthermore, the findings underscore the need for long-term follow-ups in investigations of the association between treatment for depression and the outpatient medical utilization of depressed individuals.
authors.affiliation: Veterans Affairs Palo Alto Health Care System, CA, USA.
authors.forename: R
authors.initials: R
authors.lastname: Kimerling
authors.forename: P C
authors.initials: PC
authors.lastname: Ouimette
authors.forename: R C
authors.initials: RC
authors.lastname: Cronkite
authors.forename: R H
authors.initials: RH
authors.lastname: Moos
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data*; D002140:California; D016022:Case-Control Studies; D003863:Depression / Q000523:psychology / Q000628:therapy*; D003866:Depressive Disorder / Q000523:psychology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D012044:Regression Analysis; D012720:Severity of Illness Index; D016896:Treatment Outcome