Richard Ssegonja1, Iman Alaie2, Anna Philipson3, Lars Hagberg3, Filipa Sampaio4, Margareta Möller3, Lars von Knorring5, Anna Sarkadi6, Sophie Langenskiöld7, Anne-Liis von Knorring2, Hannes Bohman2, Ulf Jonsson8, Inna Feldman4. 1. Department of Public Health and Caring Sciences, Child Health and Parenting (CHAP), Uppsala University, Uppsala, Sweden. Electronic address: richard.ssegonja@pubcare.uu.se. 2. Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden. 3. University Health Care Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden. 4. Department of Public Health and Caring Sciences, Child Health and Parenting (CHAP), Uppsala University, Uppsala, Sweden. 5. Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden. 6. Department of Public Health and Caring Sciences, Child Health and Parenting (CHAP), Uppsala University, Uppsala, Sweden; Murdoch Children's Research Institute, Melbourne, Australia. 7. Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Sweden; Department of Medical Sciences, Uppsala University, Uppsala, Sweden. 8. Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden; Center of Neurodevelopmental Disorders at Karolinska Institutet (KIND), Pediatric Neuropsychiatry Unit, Sweden; Centre for Psychiatry Research, Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden.
Abstract
BACKGROUND: Depression in adolescence is associated with increased healthcare consumption in adulthood, but prior research has not recognized the heterogeneity of depressive disorders. This paper investigated the additional healthcare usage and related costs in mid-adulthood for individuals with adolescent depression, and examined the mediating role of subsequent depression in early adulthood. METHODS: This study was based on the Uppsala Longitudinal Adolescent Depression Study, initiated in Sweden in the early 1990s. Depressive disorders were assessed in adolescence (age 16-17) and early adulthood (age 19-30). Healthcare usage and related costs in mid-adulthood (age 31-40) were estimated using nationwide population-based registries. Participants with specific subtypes of adolescent depression (n = 306) were compared with matched non-depressed peers (n = 213). RESULTS: Women with persistent depressive disorder (PDD) in adolescence utilized significantly more healthcare resources in mid-adulthood. The association was not limited to psychiatric care, and remained after adjustment for individual and parental characteristics. The total additional annual cost for a single age group of females with a history of PDD at a population level was estimated at 3.10 million USD. Depression recurrence in early adulthood mediated the added costs for psychiatric care, but not for somatic care. LIMITATIONS: Primary health care data were not available, presumably resulting in an underestimation of the true healthcare consumption. Estimates for males had limited precision due to a relatively small male proportion. CONCLUSIONS: On a population level, the additional healthcare costs incurred in mid-adulthood in females with a history of adolescent PDD are considerable. Early treatment and prevention should be prioritized.
BACKGROUND:Depression in adolescence is associated with increased healthcare consumption in adulthood, but prior research has not recognized the heterogeneity of depressive disorders. This paper investigated the additional healthcare usage and related costs in mid-adulthood for individuals with adolescent depression, and examined the mediating role of subsequent depression in early adulthood. METHODS: This study was based on the Uppsala Longitudinal Adolescent Depression Study, initiated in Sweden in the early 1990s. Depressive disorders were assessed in adolescence (age 16-17) and early adulthood (age 19-30). Healthcare usage and related costs in mid-adulthood (age 31-40) were estimated using nationwide population-based registries. Participants with specific subtypes of adolescent depression (n = 306) were compared with matched non-depressed peers (n = 213). RESULTS:Women with persistent depressive disorder (PDD) in adolescence utilized significantly more healthcare resources in mid-adulthood. The association was not limited to psychiatric care, and remained after adjustment for individual and parental characteristics. The total additional annual cost for a single age group of females with a history of PDD at a population level was estimated at 3.10 million USD. Depression recurrence in early adulthood mediated the added costs for psychiatric care, but not for somatic care. LIMITATIONS: Primary health care data were not available, presumably resulting in an underestimation of the true healthcare consumption. Estimates for males had limited precision due to a relatively small male proportion. CONCLUSIONS: On a population level, the additional healthcare costs incurred in mid-adulthood in females with a history of adolescent PDD are considerable. Early treatment and prevention should be prioritized.
Authors: Iman Alaie; Anna Philipson; Richard Ssegonja; William E Copeland; Mia Ramklint; Hannes Bohman; Ulf Jonsson Journal: Eur Child Adolesc Psychiatry Date: 2021-06-25 Impact factor: 4.785
Authors: Anna Philipson; Iman Alaie; Richard Ssegonja; Henrik Imberg; William Copeland; Margareta Möller; Lars Hagberg; Ulf Jonsson Journal: Epidemiol Psychiatr Sci Date: 2020-04-29 Impact factor: 6.892
Authors: Jennifer M Ryan; Michael Walsh; Mary Owens; Michael Byrne; Thilo Kroll; Owen Hensey; Claire Kerr; Meriel Norris; Aisling Walsh; Grace Lavelle; Jennifer Fortune Journal: J Clin Med Date: 2022-08-18 Impact factor: 4.964
Authors: Iman Alaie; Richard Ssegonja; Anna Philipson; Anne-Liis von Knorring; Margareta Möller; Lars von Knorring; Mia Ramklint; Hannes Bohman; Inna Feldman; Lars Hagberg; Ulf Jonsson Journal: Soc Psychiatry Psychiatr Epidemiol Date: 2021-03-14 Impact factor: 4.328