Depression: cost-of-illness studies in the international literature, a review

Abstract

Background: Depression is one of the most ancient and common diseases of the human race and its burden on society is really impressive. This stems both from the epidemiological spread (lifetime prevalence rate, up to 30 years of age, was estimated as greater than 14.4% by Angst et al.) and from the economic burden on healthcare systems and society, but also as it pertains to patient well-being. Aims of the study: The scope of this review was to examine studies published in the international literature to describe and compare the social costs of depression in various countries. Methods: A bibliographic search was performed on international medical literature databases (Medline, Embase), where all studies published after 1970 were selected. Studies were carefully evaluated and only those that provided cost data were included in the comparative analysis; this latter phase was conducted using a newly developed evaluation chart. Results: 110 abstracts were firstly selected; 46 of them underwent a subsequent full paper reading, thus providing seven papers, which were the subject of the in-depth comparative analysis: three studies investigated the cost of depression in the USA, three studies in the UK and one study was related to Italy. All the studies examined highlight the relevant economic burden of depression; in 1990, including both direct and indirect costs, it accounted for US$ 43.7 billion in the US (US$ 65 billion, at 1998 prices) according to Greenberg and colleagues, whilst direct costs accounted for £417 million in the UK (or US$ 962.5 million, at 1998 prices), according to Kind and Sorensen. Within direct costs, the major cost driver was indeed hospitalization, which represented something in between 43 and 75% of the average per patient cost; conversely, drug cost accounted for only 2% to 11% in five out of seven studies. Discussion: Indeed, our review suggests that at the direct cost level, in both the United States and the United Kingdom, the burden of depression is remarkable, and this is confirmed by a recent report issued by the Pharmaceutical Research and Manufacturers Association (PhRMA) where prevalence and cost of disease were compared for several major chronic diseases, including Alzheimer, asthma, cancer, depression, osteoporosis, hypertension, schizophrenia and others: in this comparison, depression is one of the most significant diseases, ranked third by prevalence and sixth in terms of economic burden. Moreover, in terms of the average cost per patient, depression imposes a societal burden that is larger

Medical disorders affect health outcome and general functioning depending on comorbid major depression in the general population

“…Many previous studies have demonstrated that major depression significantly impairs health-related quality of life (HR-QoL), general functioning, and work productivity, and causes significant individual and economic burden with direct and indirect costs of illness [1][2][3][4][5]. Epidemiological studies show that depression is associated with substantial work impairment [5,6], and experimental studies indicate that adequate depression treatment can substantially reduce work impairment [7].…”

Medical disorders affect health outcome and general functioning depending on comorbid major depression in the general population

“…Many previous studies have demonstrated that major depression significantly impairs health-related quality of life (HR-QoL), general functioning, and work productivity, and causes significant individual and economic burden with direct and indirect costs of illness [1][2][3][4][5]. Epidemiological studies show that depression is associated with substantial work impairment [5,6], and experimental studies indicate that adequate depression treatment can substantially reduce work impairment [7].…”

Fatores associados à depressão em homens e mulheres presos

“…Regarding the association between drug crime and depression, it is not possible to reach a definitive conclusion, however ,our results lead to the hypothesis that women with depression are more vulnerable to being persuased and manipulated by partners, and have fewer psychological resources to obtain other types of work activity 32 . Thus, crime is an alternative to providing for their children 28 .…”

“…Thus, crime is an alternative to providing for their children 28 . The association between depression and reoffending only among women is not clear, but it is suggested that it can be understood in the context of vulnerability and poor social adaptation of those who engage in crime, especially those with depression 28,32 .…”

Real-World Treatment Costs and Care Utilization in Patients with Major Depressive Disorder With and Without Psychiatric Comorbidities in Specialist Mental Healthcare

“…They might have also learned how to better cope with a depressive episode because of prior experiences. Furthermore, age and hospitalizations were significant cost drivers in other cost-of-illness studies [ 26 , 29 , 43 ], with hospitalizations being a major cost component. In our study, hospitalizations were also a major cost driver, contributing to 50% of total costs, though only occurring in 12.7% of the episodes.…”

Medical disorders affect health outcome and general functioning depending on comorbid major depression in the general population

“…Many previous studies have demonstrated that major depression significantly impairs health-related quality of life (HR-QoL), general functioning, and work productivity, and causes significant individual and economic burden with direct and indirect costs of illness [1][2][3][4][5]. Epidemiological studies show that depression is associated with substantial work impairment [5,6], and experimental studies indicate that adequate depression treatment can substantially reduce work impairment [7].…”

Fatores associados à depressão em homens e mulheres presos

“…Regarding the association between drug crime and depression, it is not possible to reach a definitive conclusion, however ,our results lead to the hypothesis that women with depression are more vulnerable to being persuased and manipulated by partners, and have fewer psychological resources to obtain other types of work activity 32 . Thus, crime is an alternative to providing for their children 28 .…”

“…Thus, crime is an alternative to providing for their children 28 . The association between depression and reoffending only among women is not clear, but it is suggested that it can be understood in the context of vulnerability and poor social adaptation of those who engage in crime, especially those with depression 28,32 .…”

Real-World Treatment Costs and Care Utilization in Patients with Major Depressive Disorder With and Without Psychiatric Comorbidities in Specialist Mental Healthcare

“…They might have also learned how to better cope with a depressive episode because of prior experiences. Furthermore, age and hospitalizations were significant cost drivers in other cost-of-illness studies [ 26 , 29 , 43 ], with hospitalizations being a major cost component. In our study, hospitalizations were also a major cost driver, contributing to 50% of total costs, though only occurring in 12.7% of the episodes.…”

Medical disorders affect health outcome and general functioning depending on comorbid major depression in the general population

“…Many previous studies have demonstrated that major depression significantly impairs health-related quality of life (HR-QoL), general functioning, and work productivity, and causes significant individual and economic burden with direct and indirect costs of illness [1][2][3][4][5]. Epidemiological studies show that depression is associated with substantial work impairment [5,6], and experimental studies indicate that adequate depression treatment can substantially reduce work impairment [7].…”

Fatores associados à depressão em homens e mulheres presos

“…Regarding the association between drug crime and depression, it is not possible to reach a definitive conclusion, however ,our results lead to the hypothesis that women with depression are more vulnerable to being persuased and manipulated by partners, and have fewer psychological resources to obtain other types of work activity 32 . Thus, crime is an alternative to providing for their children 28 .…”

“…Thus, crime is an alternative to providing for their children 28 . The association between depression and reoffending only among women is not clear, but it is suggested that it can be understood in the context of vulnerability and poor social adaptation of those who engage in crime, especially those with depression 28,32 .…”

Real-World Treatment Costs and Care Utilization in Patients with Major Depressive Disorder With and Without Psychiatric Comorbidities in Specialist Mental Healthcare

“…They might have also learned how to better cope with a depressive episode because of prior experiences. Furthermore, age and hospitalizations were significant cost drivers in other cost-of-illness studies [ 26 , 29 , 43 ], with hospitalizations being a major cost component. In our study, hospitalizations were also a major cost driver, contributing to 50% of total costs, though only occurring in 12.7% of the episodes.…”