Depression status, medical comorbidity and resource costs. Evidence from an international study of major depression in primary care (LIDO).
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.
Chisholm
Daniel
D
Health Services Research Department, King's College of Medicine and Institute of Psychiatry, London, UK. chisholmd@who.int
Diehr
Paula
P
Knapp
Martin
M
Patrick
Donald
D
Treglia
Michael
M
Simon
Gregory
G
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