title: Health service use by adults with depression: community survey in five European countries. Evidence from the ODIN study.
abstract: BACKGROUND
  Little is known about patterns of healthcare use by people with depression in Europe.
  
  
  OBJECTIVE
  To examine the use and cost of services by adults with depressive or adjustment disorders in five European countries, and predictive factors.
  
  
  METHODS
  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, psychiatric or 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.
authors.affiliation: Division of Psychiatry, University of Liverpool, Liverpool, UK.
authors.forename: Cherie
authors.initials: C
authors.lastname: McCracken
authors.forename: Odd Steffen
authors.initials: OS
authors.lastname: Dalgard
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: Ayuso-Mateos
authors.forename: Patricia
authors.initials: P
authors.lastname: Casey
authors.forename: Greg
authors.initials: G
authors.lastname: Wilkinson
authors.forename: Ville
authors.initials: V
authors.lastname: Lehtinen
authors.forename: Christopher
authors.initials: C
authors.lastname: Dowrick
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003866:Depressive Disorder / Q000191:economics / Q000453:epidemiology / Q000523:psychology*; D005060:Europe / Q000453:epidemiology; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008605:Mental Health Services; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D011159:Population Surveillance / Q000379:methods; D011320:Primary Health Care; D011619:Psychotropic Drugs / Q000191:economics / Q000627:therapeutic use; D012720:Severity of Illness Index; D012944:Social Support; D012947:Social Work; D012959:Socioeconomic Factors
chemical_list: D011619:Psychotropic Drugs