title: Relation between depressed mood, somatic comorbidities and health service utilisation in older adults: results from the KORA-Age study.
abstract: BACKGROUND
  prior literature suggests that comorbidity with depression significantly worsens the health state of people with chronic diseases.
  
  
  OBJECTIVE
  the present study examines whether depressed mood increased medical care use for patients with a comorbid physical disease.
  
  
  METHODS
  the study was a population-based study (KORA-Age), with 3,938 participants aged 64-94.
  
  
  METHODS
  we investigated differences in health services use in participants with and without depressed mood (Geriatric Depression Scale). A further adjustment for disease was done and differences were examined with the Mann-Whitney U test. The incidence rate ratios (IRRs) for doctors' appointments or the number of days in hospital were explored with (zero-inflated) negative binomial regression models.
  
  
  RESULTS
  there are increased self-neglecting behaviours and medical comorbidities in participants with depressed mood. Depressed mood increased participants' use of medical services (P < 0.0001). Among participants who visited the doctor during the last 3 months, those with depressed mood had more visits than those without depressed mood, irrespective of somatic comorbidities (P < 0.0001 and P < 0.05 for ill and healthy, respectively). Additionally, patients with coexisting depressed mood and physical disease visited the doctor's practice significantly more often. Having depressed mood significantly increases the likelihood for more doctor visits (IRR = 1.5, CI = 1.3-1.7) and longer hospital stays (IRR = 1.9, CI = 1.6-2.3). In participants with somatic comorbidities the risk is even greater (IRR = 1.6, CI = 1.3-2, for the number of doctors visits and IRR = 2, CI = 1.4-2.9, for the number of days in the hospital).
  
  
  CONCLUSIONS
  results suggest that patients with depressed mood had increased use of health-care services overall, particularly those with somatic comorbidities.
authors.affiliation: Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstr. 1, 85764 Neuherberg,  Germany.
authors.forename: Maria Elena
authors.initials: ME
authors.lastname: Lacruz
authors.forename: Rebecca Thwing
authors.initials: RT
authors.lastname: Emeny
authors.forename: Sibylle
authors.initials: S
authors.lastname: Haefner
authors.forename: Anja Kerstin
authors.initials: AK
authors.lastname: Zimmermann
authors.forename: Birgit
authors.initials: B
authors.lastname: Linkohr
authors.forename: Rolf
authors.initials: R
authors.lastname: Holle
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Ladwig
mesh_terms: D000339:Affect; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology*; D001071:Appointments and Schedules; D016009:Chi-Square Distribution; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D005260:Female; D005858:Germany / Q000453:epidemiology; D006296:Health Services / Q000706:statistics & numerical data*; D006304:Health Status; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009819:Office Visits / Q000706:statistics & numerical data; D012044:Regression Analysis; D013997:Time Factors