title: Depression status, medical comorbidity and resource costs. Evidence from an international study of major depression in primary care (LIDO).
abstract: BACKGROUND
  Despite the burden of depression, there remain few data on its economic consequences in an international context.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  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.
authors.affiliation: Health Services Research Department, King's College of Medicine and Institute of Psychiatry, London, UK. chisholmd@who.int
authors.forename: Daniel
authors.initials: D
authors.lastname: Chisholm
authors.forename: Paula
authors.initials: P
authors.lastname: Diehr
authors.forename: Martin
authors.initials: M
authors.lastname: Knapp
authors.forename: Donald
authors.initials: D
authors.lastname: Patrick
authors.forename: Michael
authors.initials: M
authors.lastname: Treglia
authors.forename: Gregory
authors.initials: G
authors.lastname: Simon
mesh_terms: D000041:Absenteeism; D000328:Adult; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000191:economics* / Q000453:epidemiology / Q000523:psychology; D004651:Employment; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008393:Marriage; D008605:Mental Health Services; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology; D011320:Primary Health Care; D012044:Regression Analysis