title: Excess cost of non-remission among outpatients with major depressive disorder.
abstract: BACKGROUND
  The purpose of this study was to assess the economic benefit of achieving remission among outpatients with major depressive disorder (MDD) who are currently employed in Korea.
  
  
  METHODS
  Cross-sectional observational study. A total of 337 outpatients with MDD with paid jobs were recruited from 14 psychiatric clinics in Korea and were then divided into three groups as follows: new visit group (n = 128), remitted group (n = 100) and non-remitted group (n = 109). The 17-item Hamilton Depression Rating Scale (HAM-D) was used to decide whether a patient should be assigned to the remitted or non-remitted group. Direct medical and non-medical costs were measured via interview with the subjects. The World Health Organization Health and Work Performance Questionnaire (HPQ) were applied in order to measure the lost productive time (LPT) and related productivity costs.
  
  
  RESULTS
  The three groups did not show a significant difference in direct medical cost. However, the difference between the remitted group and non-remitted group was statistically significant (25.49 ± 52.99 vs. 44.79 ± 126.55, χ (2) = 12.99, p = 0.0015). The remitted group demonstrated a significant improvement in productivity (particularly presenteeism) when compared with the new visit group (Z = -3.29, p = 0.001). Although the non-remitted group received treatment at psychiatric clinics similar to the remitted group, it lost 33 more working hours per month, which is compatible to $332 per month.
  
  
  CONCLUSIONS
  These results suggest the economic importance of achieving remission in treating depression.
authors.affiliation: Department of Psychiatry, Seoul Paik Hospital, Inje University School of Medicine, Seoul, Korea ; Stress Research Institute, Inje University, Seoul, Korea.
authors.forename: Jong-Min
authors.initials: JM
authors.lastname: Woo
authors.affiliation: Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea ; Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
authors.forename: Hong Jin
authors.initials: HJ
authors.lastname: Jeon
authors.affiliation: OR/EBM Team, Market Access Division, Pfizer Pharmaceuticals Korea Limited, Seoul, Korea.
authors.forename: Hyo-Jin
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Department of Psychiatry, Dongguk University College of Medicine, Gyeongju, Korea.
authors.forename: Kwang-Hun
authors.initials: KH
authors.lastname: Lee
authors.affiliation: Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Chang Uk
authors.initials: CU
authors.lastname: Lee
authors.affiliation: Department of Psychiatry, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Jai Sung
authors.initials: JS
authors.lastname: Noh
authors.affiliation: Department of Psychiatry, Eulji University School of Medicine, Daejeon, Korea.
authors.forename: Chang Hwa
authors.initials: CH
authors.lastname: Lee
authors.affiliation: Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
authors.forename: Jin Pyo
authors.initials: JP
authors.lastname: Hong
keywords: HPQ; Lost productive time; Major depressive disorder; Presenteeism; Remission