title: Comorbid depression and increased health care utilisation in individuals with diabetes.
abstract: OBJECTIVE
  The objective of this study was to examine the extent of health care utilisation (excluding costs) of diabetic patients with and without depressive symptoms attending a specialist clinic in Singapore.
  
  
  METHODS
  A total of 537 Asian outpatients (aged 21 years and above) who were attending a Diabetes Centre were recruited on a consecutive basis between August 2006 and February 2007. Sociodemographic data, clinical and health care utilisation data were collected from the participants. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale.
  
  
  RESULTS
  Individuals with depressive symptoms, on average, had more hospitalizations and hospitalization days. Those with depression reported losing significantly more working days as compared to the nondepressed individuals (1.9 vs. 1.4, P=.001).
  
  
  CONCLUSIONS
  Our findings in this population suggest that the presence of depressive symptoms has an independent effect on the greater utilization of medical services.
authors.affiliation: Institute of Mental Health, Singapore 539747, Singapore. mythily@imh.com.sg
authors.forename: Mythily
authors.initials: M
authors.lastname: Subramaniam
authors.forename: Chee Fang
authors.initials: CF
authors.lastname: Sum
authors.forename: Elaine
authors.initials: E
authors.lastname: Pek
authors.forename: Dorit
authors.initials: D
authors.lastname: Stahl
authors.forename: Swapna
authors.initials: S
authors.lastname: Verma
authors.forename: Pei Hsiang
authors.initials: PH
authors.lastname: Liow
authors.forename: Hong Choon
authors.initials: HC
authors.lastname: Chua
authors.forename: Edimansyah
authors.initials: E
authors.lastname: Abdin
authors.forename: Siow Ann
authors.initials: SA
authors.lastname: Chong
mesh_terms: D000328:Adult; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology* / Q000628:therapy*; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000628:therapy*; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D015995:Prevalence; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D055815:Young Adult