Health service use by adults with depression: community survey in five European countries. Evidence from the ODIN study.
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.
McCracken
Cherie
C
Division of Psychiatry, University of Liverpool, Liverpool, UK.
Dalgard
Odd Steffen
OS
Ayuso-Mateos
Jose Luis
JL
Casey
Patricia
P
Wilkinson
Greg
G
Lehtinen
Ville
V
Dowrick
Christopher
C
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
D011619:Psychotropic Drugs