title: The societal cost of depression: evidence from 10,000 Swedish patients in psychiatric care.
abstract: OBJECTIVE
  Depression cost studies have mainly taken a primary care perspective and should be completed with cost estimates from psychiatric care. The objectives of this study were to estimate the societal per-patient cost of depression in specialized psychiatric care in Sweden, and to relate costs to disease severity, depressive episodes, hospitalization, and patient functioning.
  
  
  METHODS
  Retrospective resource use data in inpatient and outpatient care for 2006-2008, as well as ICD-10 diagnoses and Global Assessment of Functioning (GAF), were obtained from the Northern Stockholm psychiatric clinic (covering half of Stockholm's population aged 18 years and above). As a complement, data from national registers on pharmaceuticals and sick leave were used in order to estimate the societal cost of depression.
  
  
  RESULTS
  Based on 10,430 patients (63% women), the mean annual per-patient cost was €17,279 in 2008. The largest cost item was indirect costs due to productivity losses (88%), followed by outpatient care (6%). Patients with mild and severe depression had average costs of €14,200 and €21,500, respectively. Total costs were substantially higher during depressive episodes, among patients with co-morbid psychosis or anxiety, for hospitalized patients, and for patients with poor functioning.
  
  
  CONCLUSIONS
  Primary care costs and costs for reduced productivity at work were not included.
  
  
  CONCLUSIONS
  The main cost item among depression patients in psychiatric care was indirect costs. Costs were higher than previously reported for primary care, and strongly related to hospitalization, depressive episodes, and low functioning. This suggests that effective treatment that avoids depressive episodes and hospitalization may reduce society's costs for depression.
authors.affiliation: OptumInsight, Stockholm, Sweden. mattias.ekman@astrazeneca.com
authors.forename: M
authors.initials: M
authors.lastname: Ekman
authors.forename: O
authors.initials: O
authors.lastname: Granström
authors.forename: S
authors.initials: S
authors.lastname: Omérov
authors.forename: J
authors.initials: J
authors.lastname: Jacob
authors.forename: M
authors.initials: M
authors.lastname: Landén
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000191:economics; D015897:Comorbidity; D017281:Cost of Illness; D003865:Major Depressive Disorder / Q000191:economics*; D005260:Female; D017048:Health Care Costs; D006295:Health Resources / Q000191:economics; D006760:Hospitalization / Q000191:economics; D006801:Humans; D038801:International Classification of Diseases / Q000592:standards; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000191:economics; D012189:Retrospective Studies; D018582:Sick Leave / Q000191:economics; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult
keywords: Burden-of-illness; Cost; Depression; Resource use