<p>Health-related quality of life outcomes, economic burden, and associated costs among diagnosed and undiagnosed depression patients in Japan</p>

Abstract

PurposeDepression is associated with substantial health and economic burden. This study examined the impact of diagnosed and undiagnosed depression on health-related outcomes and costs among Japanese adults.MethodsA retrospective, observational study was conducted using 2012–2014 Japan National Health and Wellness Survey (N=83,504) data. Differences between respondents diagnosed with depression (n=2,843) and undiagnosed with depression (weighted n=2,717) and controls without depression (weighted n=2,801) in health-related quality of life, impairment to work productivity and daily activities (Work Productivity and Activity Impairment Questionnaire), health care resource utilization, and annual costs were evaluated. Propensity score weighting and weighted generalized linear models were used to compare groups on the outcome variables, after adjusting for covariates.ResultsOverall, respondents with undiagnosed depression had significantly better outcomes than those diagnosed with depression, but significantly worse outcomes than controls (for all, P<0.001). The mean Mental Component Summary scores were lower in the diagnosed group when compared with undiagnosed respondents and controls (33.2 vs 34.5 vs 48.6). Similar findings were obtained for mean Physical Component Summary (49.2 vs 49.5 vs 52.8) and health state utility scores (0.61 vs 0.62 vs 0.76). Additionally, the diagnosed group reported greater absenteeism (13.1 vs 6.6 vs 2.5%), presenteeism (41.4 vs 38.1 vs 18.8%), overall work productivity impairment (47.2 vs 41.1 vs 20.2%), and activity impairment (48.4 vs 43.3 vs 21.1%) than the undiagnosed and control groups, respectively. Consistently, patients with diagnosed depression had higher annual per patient direct (1.6-fold) and indirect costs (1.1-fold) than those in the undiagnosed depression group.ConclusionDiagnosed depression was associated with lower health-related quality of life and greater impairment in work productivity and daily activities, higher health care resource utilization, and higher costs, compared with undiagnosed respondents and controls. These study findings suggest a need for greater awareness of depression symptoms among Japanese adults, which is needed to facilitate proper diagnosis and treatment.

Healthcare use and costs in adult cancer patients with anxiety and depression

“…However, undiagnosed depression has previously been associated with increased healthcare costs in a community sample (Williams, Chung, & Muennig, 2017). Similar results were also found in a large nationally representative sample of health patients in Japan (Yamabe, Liebert, Flores, & Pashos, 2019). In this latter study, undiagnosed depression was associated with greater number of ER visits, greater number of hospitalizations, more healthcare provider visits, higher direct and indirect costs, and higher hospital and ER costs compared to those who were not depressed.…”

Humanistic and economic burden associated with depression in the United States: a cross-sectional survey analysis

“…The current study also demonstrated that respondents with depression diagnosis reported greater work productivity losses when employed than respondents without depression diagnosis. These results are in agreement with previously published data that demonstrated higher presenteeism, absenteeism, overall work impairment, and activity impairment in those with depression versus those without depression [31,34,35]. We also observed higher presenteeism than absenteeism in the current study, which is consistent with previous research [31], where presenteeism could be identified as the primary contributor to work productivity loss.…”

“…Consistent with previously published studies, respondents with depression diagnosis had poorer HRQoL (with lower scores on MCS, PCS, SF-6D, and EQ-5D scores) compared to those without depression diagnosis [ 7 , 31 , 32 ]. In the STAR*D study approximately 50% of the patients with depression reported experiencing “severely impaired” QoL even after antidepressant treatment [ 9 ].…”

Effect of a brief cognitive behavioral program on depressive symptoms among newly licensed registered nurses: An observational study

“…Sessions were limited to 1 hour each, once a week, with a maximum of ten subjects. The following content was covered: (1) understanding motives for change and stress/stressor, (2) understanding the ABC model and cognitive therapy, (3) training in cognitive restructuring to change their relationship with negative automatic thoughts, and (4) training to improve coping skills and to identify areas for possible behavioral change. The CBP was first delivered 3 months after starting work in the first year (August/September; S1 Fig).…”

“…A deterioration in subjective well-being, or more specifically the onset of depressive symptoms, is a worldwide challenge in many workplaces. Such conditions are not only very common [1] but also have significant economic, productivity, and quality of life implications, especially if workers develop depression [2].…”