Current issues in the economics of depression management.

In this paper, we present a systematic review of the literature on current issues in the economics of depression management, focusing on studies within three distinct areas of interest: 1) the clinical and economic outcomes of alternative patterns of antidepressant use; 2) the impact of depression and antidepressant therapy on the costs of general medical-care services; and 3) the effects of depression and associated benefits of antidepressant therapy on worker productivity. Our review suggests that 1) patterns of antidepressant use are important predictors of symptom improvement, relapse/recurrence, and costs of care, and that use patterns vary according to the antidepressant received as initial therapy; 2) patients with depression have higher costs of general medical-care services compared with their nondepressed peers, and that treatment of depression may reduce these costs; and 3) depression can result in productivity losses via increased rates of absenteeism and short-term disability as well as via impaired on-the-job performance.