title: Excess costs of social anxiety disorder in Germany.
abstract: Social anxiety disorder is one of the most frequent mental disorders. It is often associated with mental comorbidities and causes a high economic burden. The aim of our analysis was to estimate the excess costs of patients with social anxiety disorder compared to persons without anxiety disorder in Germany.
  
  
  
  Excess costs of social anxiety disorder were determined by comparing two data sets. Patient data came from the SOPHO-NET study A1 (n=495), whereas data of persons without anxiety disorder originated from a representative phone survey (n=3213) of the general German population. Missing data were handled by "Multiple Imputation by Chained Equations". Both data sets were matched using "Entropy Balancing". Excess costs were calculated from a societal perspective for the year 2014 using general linear regression with a gamma distribution and log-link function. Analyses considered direct costs (in- and outpatient treatment, rehabilitation, and professional and informal care) and indirect costs due to absenteeism from work.
  
  
  
  Total six-month excess costs amounted to 451€ (95% CI: 199€-703€). Excess costs were mainly caused by indirect excess costs due to absenteeism from work of 317€ (95% CI: 172€-461€), whereas direct excess costs amounted to 134€ (95% CI: 110€-159€).
  
  
  
  Costs for medication, unemployment and disability pension was not evaluated.
  
  
  
  Social anxiety disorder was associated with statistically significant excess costs, in particular due to indirect costs. As patients in general are often unaware of their disorder or its severity, awareness should be strengthened. Prevention and early treatment might reduce long-term indirect costs.
authors.affiliation: Department of Health Economics and Health Services Research, Hamburg Center for Health Economics (HCHE), University Medical Center Hamburg-Eppendorf, Germany. Electronic address: j.dams@uke.de.
authors.forename: Judith
authors.initials: J
authors.lastname: Dams
authors.affiliation: Department of Health Economics and Health Services Research, Hamburg Center for Health Economics (HCHE), University Medical Center Hamburg-Eppendorf, Germany.
authors.forename: Hans-Helmut
authors.initials: HH
authors.lastname: König
authors.affiliation: Department of Health Economics and Health Services Research, Hamburg Center for Health Economics (HCHE), University Medical Center Hamburg-Eppendorf, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Bleibler
authors.affiliation: Institute for Clinical Psychology and Psychotherapy, Technische Universität Dresden, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Hoyer
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Germany.
authors.forename: Jörg
authors.initials: J
authors.lastname: Wiltink
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Germany.
authors.forename: Manfred E
authors.initials: ME
authors.lastname: Beutel
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Medicine, Georg-August-University Goettingen, Germany; International Psychoanalytic University IPU Berlin, Germany.
authors.forename: Simone
authors.initials: S
authors.lastname: Salzer
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, LWL-University Clinic, Ruhr-University Bochum, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Herpertz
authors.affiliation: Department of Psychology and Psychotherapy, Faculty of Health, University Witten/Herdecke, Germany.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Willutzki
authors.affiliation: Institute of Psychosocial Medicine and Psychotherapy, University Hospital, Jena, Germany.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Strauß
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Medicine, Georg-August-University Goettingen, Germany.
authors.forename: Eric
authors.initials: E
authors.lastname: Leibing
authors.affiliation: Department of Psychosomatics and Psychotherapy, Justus-Liebig-University Giessen, Germany.
authors.forename: Falk
authors.initials: F
authors.lastname: Leichsenring
authors.affiliation: Department of Health Economics and Health Services Research, Hamburg Center for Health Economics (HCHE), University Medical Center Hamburg-Eppendorf, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Konnopka
mesh_terms: D000041:Absenteeism; D000328:Adult; D000553:Ambulatory Care / Q000191:economics; D017281:Cost of Illness; D005260:Female; D005858:Germany; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D000072861:Phobia, Social / Q000191:economics*
keywords: Cost-of-illness; Economic burden; Excess costs; Social anxiety disorder