The economic cost of treatment-resistant depression in patients referred to a specialist service. (2nd November 2018)

• Record Type: Journal Article
• Authors: McCrone, Paul; Rost, Felicitas; Koeser, Leonardo; Koutoufa, Iakovina; Stephanou, Stephanie; Knapp, Martin; Goldberg, David; Taylor, David; Fonagy, Peter
• Is Part Of: Journal of mental health. Volume 27:Number 6(2018)
• Page Start: 567
• Page End: 573
• Publication Date: 2018-11-02
• Subjects: Treatment-resistant depression -- cost economic analysis -- burden; Mental health -- Periodicals; Mental health services -- Periodicals; 362.2
• DOI: 10.1080/09638237.2017.1417562
• Languages: English
• ISSNs: 0963-8237

Abstract

Abstract: Background : Patients with treatment-resistant depression (TRD) suffer very significant morbidity and are at a disadvantage concerning optimal clinical management. There are high associated societal costs. Aims : A detailed analysis of health economic costs in the United Kingdom in a group manifesting a severe form of TRD in the 12 months before their participation in a major randomized controlled treatment trial. Methods : The sample consisted of 118 participants from the Tavistock Adult Depression Study. Recruitment was from primary care on the basis of current major depression disorder of at least 2 years' duration and two failed treatment attempts. Service utilization was assessed based on self-report and general practitioner (GP) medical records. Generalized linear models were used to identify predictors of cost. Results : All participants used GP services. Use of other doctors and practice nurses was also high. The mean total societal cost was £22 124, 80% of which was due to lost work and care required of families. Level of general functioning was found to be the most consistent predictor of costs. Conclusions : Severe forms of TRD are associated with high costs in which unpaid care and lost work predominate. Treatments that improve functioning may reduce the large degree of burden.