title: Association of mental distress with health care utilization and costs: a 5-year observation in a general population.
abstract: OBJECTIVE
  Previous studies have associated mental distress and disorders with increased health care utilization and costs. However, most studies have selected subjects from treatment facilities or have applied retrospective designs.
  
  
  METHODS
  N = 3,300 subjects from the baseline cohort of the Study of Health in Pomerania were followed up 5 years later. Mental distress was assessed with the SF-12 Health Survey and the Composite Diagnostic Screener for mental disorders. Two-part econometric models were applied adjusting for medical confounders and baseline services use.
  
  
  RESULTS
  At 5-year follow-up somatization at baseline predicted an increase of inpatient (+39.9%) and outpatient costs (+11.9%). Depression predicted an increase of inpatient (+24.1%) and outpatient costs (+8.9%). Comorbidity of somatization and depression and somatization and anxiety predicted an increase in overall health care costs of > or =50%.
  
  
  CONCLUSIONS
  Simple and time-efficient screening procedures for mental disorders may help to identify subjects at risk for increased future health care utilization. Standardized therapeutic interventions should be evaluated in subjects at risk in primary care.
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Greifswald, Rostocker Chaussee 70, 18437, Stralsund, Germany. grabeh@uni-greifswald.de
authors.forename: Hans Jörgen
authors.initials: HJ
authors.lastname: Grabe
authors.forename: Sebastian E
authors.initials: SE
authors.lastname: Baumeister
authors.forename: Ulrich
authors.initials: U
authors.lastname: John
authors.forename: Harald J
authors.initials: HJ
authors.lastname: Freyberger
authors.forename: Henry
authors.initials: H
authors.lastname: Völzke
mesh_terms: D000328:Adult; D000368:Aged; D015897:Comorbidity; D003266:Continuity of Patient Care / Q000191:economics; D003866:Depressive Disorder / Q000191:economics / Q000453:epidemiology; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008403:Mass Screening / Q000379:methods; D001523:Mental Disorders / Q000191:economics* / Q000453:epidemiology*; D008875:Middle Aged; D017059:Models, Econometric; D010342:Patient Acceptance of Health Care; D011320:Primary Health Care / Q000191:economics / Q000379:methods / Q000706:statistics & numerical data*; D018570:Risk Assessment; D013001:Somatoform Disorders / Q000191:economics / Q000453:epidemiology; D011795:Surveys and Questionnaires