The economic cost of treatment-resistant depression in patients referred to a specialist service

Rost, Felicitas, Koutoufa, Iakovina, Stephanou, Stephanie, Taylor, David, McCrone, Paul, Koeser, Leonardo, Knapp, Martin, Goldberg, David and Fonagy, Peter (2017) The economic cost of treatment-resistant depression in patients referred to a specialist service. Journal of Mental Health . ISSN 0963-8237

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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.

Item Type: Article
Uncontrolled Keywords: Treatment-Resistant Depression, Burden, Cost Economic Analysis
Subjects: Disabilities & Disorders (mental & physical) > Depression
Health and Medical Sciences > General Practice
Department/People: Adult and Forensic Services

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