Paul McCrone1, Felicitas Rost2, Leonardo Koeser1, Iakovina Koutoufa3, Stephanie Stephanou4, Martin Knapp5, David Goldberg6, David Taylor4, Peter Fonagy3. 1. a Health Services and Population Research Department , King's Health Economics, Institute of Psychiatry, Psychology and Neuroscience, King's College London , London , UK. 2. b Portman Clinic, Tavistock and Portman NHS Foundation Trust , London , UK. 3. c Research Department of Clinical , Educational and Health Psychology, University College London , London , UK. 4. d Tavistock Clinic, Tavistock and Portman NHS Foundation Trust , London , UK. 5. e Personal Social Services Research Unit, London School of Economics and Political Science , London , UK , and. 6. f Institute of Psychiatry, Psychology and Neuroscience, King's College London , London , UK.
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.
RCT Entities:
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.
Authors: Daryl Wayne Niedermoser; Nadeem Kalak; Anna Kiyhankhadiv; Serge Brand; Corinna Walter; Nina Schweinfurth; Undine E Lang Journal: Front Psychiatry Date: 2020-03-17 Impact factor: 4.157
Authors: Daryl Wayne Niedermoser; Nadeem Kalak; Martin Meyer; Nina Schweinfurth; Marc Walter; Undine E Lang Journal: Int J Environ Res Public Health Date: 2021-02-17 Impact factor: 3.390
Authors: Rebecca Strawbridge; Paul McCrone; Andrea Ulrichsen; Roland Zahn; Jonas Eberhard; Danuta Wasserman; Paolo Brambilla; Giandomenico Schiena; Ulrich Hegerl; Judit Balazs; Jose Caldas de Almeida; Ana Antunes; Spyridon Baltzis; Vladimir Carli; Vinciane Quoidbach; Patrice Boyer; Allan H Young Journal: Eur Psychiatry Date: 2022-06-15 Impact factor: 7.156