Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-22T12:13:10.408Z Has data issue: false hasContentIssue false
  • English
  • Français

Prevalence of depression and utilization of health care in single and multiple morbidity: a population-based cohort study

Published online by Cambridge University Press:  01 November 2012

N. Bhattarai ,
J. Charlton ,
C. Rudisill  and
M. C. Gulliford
N. Bhattarai*
Affiliation:
Department of Primary Care and Public Health Sciences, King's College London, UK
J. Charlton
Affiliation:
Department of Primary Care and Public Health Sciences, King's College London, UK
C. Rudisill
Affiliation:
Department of Social Policy, London School of Economics and Political Science, UK
M. C. Gulliford
Affiliation:
Department of Primary Care and Public Health Sciences, King's College London, UK
*
*Address for correspondence: N. Bhattarai, MPH, MSc, Division of Health and Social Care Research, King's College London, 7th Floor Capital House, 42 Weston Street, London SE1 3QD, UK. (Email: [email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

This study aimed to determine whether depression in patients with long-term conditions is associated with the number of morbidities or the type of co-morbidity.

Method

A cohort study of 299 912 participants aged 30–100 years. The prevalence of depression, rates of health-care utilization and costs were evaluated in relation to diagnoses of diabetes mellitus (DM), coronary heart disease (CHD), stroke and colorectal cancer.

Results

The age-standardized prevalence of depression was 7% in men and 14% in women with no morbidity. The frequency of depression increased in single morbidities including DM (men 13%, women 22%), CHD (men 15%, women 24%), stroke (men 14%, women 26%) or colorectal cancer (men 10%, women 21%). Participants with concurrent diabetes, CHD and stroke had a very high prevalence of depression (men 23%, women 49%). The relative rate of depression for one morbidity was 1.63 [95% confidence interval (CI) 1.59–1.66], two morbidities 1.96 (95% CI 1.89–2.03) and three morbidities 2.35 (95% CI 2.03–2.59). Compared to those with no morbidity, depression was associated with higher rates of health-care utilization and increased costs at any level of morbidity. In women aged 55 to 64 years without morbidity, the mean annual health-care cost was £513 without depression and £1074 with depression; when three morbidities were present, the cost was £1495 without depression and £2878 with depression.

Conclusions

Depression prevalence and health-care costs are more strongly associated with the number of morbidities than the nature of the co-morbid diagnosis.

Keywords

Colorectal cancerco-morbiditycoronary heart diseasedepressiondiabetes mellitusmulti-morbidityprimary carestroke
Type
Original Articles
Information
Psychological Medicine , Volume 43 , Issue 7 , July 2013 , pp. 1423 - 1431
Copyright
Copyright © Cambridge University Press 2012 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ali, S, Stone, MA, Peters, JL, Davies, MJ, Khunti, K (2006). The prevalence of co-morbid depression in adults with Type 2 diabetes: a systematic review and meta-analysis. Diabetic Medicine 23 1165–1173CrossRefGoogle ScholarPubMed
Anderson, RJ, Freedland, KE, Clouse, RE, Lustman, PJ (2001). The prevalence of comorbid depression in adults with diabetes. Diabetes Care 24 1069–1078CrossRefGoogle ScholarPubMed
Bhattarai, N, Charlton, J, Rudisill, C, Gulliford, MC (2012). Coding, recording and incidence of different forms of coronary heart disease in primary care. PLoS One 7 e29776CrossRefGoogle ScholarPubMed
Ciechanowski, PS, Katon, WJ, Russo, JE (2000). Depression and diabetes: impact of depressive symptoms on adherence, function, and costs. Archives of Internal Medicine 160 3278–3285CrossRefGoogle ScholarPubMed
Cuijpers, P, Smit, F (2002). Excess mortality in depression: a meta-analysis of community studies. Journal of Affective Disorders 72 227–236CrossRefGoogle ScholarPubMed
Curtis, L (ed.) (2010). Unit Costs of Health and Social Care. Personal Social Service Research Unit (PSSRU), University of Kent Canterbury, UKGoogle Scholar
Duan, N, Manning, WG Jr., Morris, CN, Newhouse, JP (1983). A comparison of alternative models for the demand for medical care. Journal of Business and Economic Statistics 1 115–126Google Scholar
Dunn, G, Mirandola, M, Amaddeo, F, Tansella, M (2003). Describing, explaining or predicting mental health care costs: a guide to regression models. British Journal of Psychiatry 183 398–404CrossRefGoogle ScholarPubMed
Egede, LE (2005). Effect of comorbid chronic diseases on prevalence and odds of depression in adults with diabetes. Psychosomatic Medicine 67 46–51CrossRefGoogle ScholarPubMed
Egede, LE (2007). Major depression in individuals with chronic medical disorders: prevalence, correlates and association with health resource utilization, lost productivity and functional disability. General Hospital Psychiatry 29 409–416CrossRefGoogle ScholarPubMed
Gulliford, MC, Charlton, J, Ashworth, M, Rudd, AG, Toschke, AM; eCRT Research Team (2009). Selection of medical diagnostic codes for analysis of electronic patient records. Application to stroke in a primary care database. PLoS One 4 e7168CrossRefGoogle Scholar
Hackett, ML, Yapa, C, Parag, V, Anderson, CS (2005). Frequency of depression after stroke. Stroke 36 1330–1340CrossRefGoogle ScholarPubMed
Härter, M, Baumeister, H, Reuter, K, Jacobi, F, Höfler, M, Bengel, J, Wittchen, HU (2007). Increased 12-month prevalence rates of mental disorders in patients with chronic somatic diseases. Psychotherapy and Psychosomatics 76 354–360CrossRefGoogle ScholarPubMed
Herrett, E, Thomas, SL, Schoonen, WM, Smeeth, L, Hall, AJ (2010). Validation and validity of diagnoses in the General Practice Research Database: a systematic review. British Journal of Clinical Pharmacology 69 4–14CrossRefGoogle ScholarPubMed
Hoffman, C, Rice, D, Sung, H-Y (1996). Persons with chronic conditions. Journal of the American Medical Association 276 1473–1479CrossRefGoogle ScholarPubMed
Kisley, S, Gater, R, Goldberg, DP (1995). Results from the Manchester Centre. In Mental Illness in General Health Care: An International Study (ed. Ustun, T. B. and Sartorius, N.175–191Wiley ChichesterGoogle Scholar
Knapp, M (2003). Hidden costs of mental illness. British Journal of Psychiatry 183 477–478CrossRefGoogle ScholarPubMed
McCrone, P, Dhanasiri, S, Patel, A, Knapp, M, Lawton-Smith, S (2008). Paying the Price. The Cost of Mental Health Care in England to 2026. King's Fund LondonGoogle Scholar
McDermut, W, Mattia, J, Zimmerman, M (2001). Comorbidity burden and its impact on psychosocial morbidity in depressed outpatients. Journal of Affective Disorders 65 289–295CrossRefGoogle ScholarPubMed
NCCMH (2010). Depression: The Treatment and Management of Depression in Adults. National Clinical Guideline Practice 90. National Collaborating Centre for Mental Health. he British Psychological Society and The Royal College of Psychiatrists LondonGoogle Scholar
NICE (2009). Depression in Adults with a Chronic Physical Health Problem: Treatment and Management. National Institute of Health and Clinical Excellence LondonGoogle Scholar
Seeman, TE, Guralnik, JM, Kaplan, GA, Knudsen, L, Cohen, R (1989). The health consequences of multiple morbidity in the elderly. Journal of Aging and Health 1 50–66CrossRefGoogle ScholarPubMed
Simon, GE, Vonkorff, M, Barlow, W (1995). Health care costs of primary care patients with recognized depression. Archives of General Psychiatry 52 850–856CrossRefGoogle ScholarPubMed
Spijkerman, T, de Jonge, P, van den Brink, RHS, Jansen, JHC, May, JF, Crijns, HJGM, Ormel, J (2005). Depression following myocardial infarction: first-ever versus ongoing and recurrent episodes. General Hospital Psychiatry 27 411–417CrossRefGoogle ScholarPubMed
Sullivan, M, Simon, G, Spertus, J, Russo, J (2002). Depression-related costs in heart failure care. Archives of Internal Medicine 162 1860–1866CrossRefGoogle ScholarPubMed
Uijen, AA, van de Lisdonk, EH (2008). Multimorbidity in primary care: prevalence and trend over the last 20 years. European Journal of General Practice 14 28–32CrossRefGoogle ScholarPubMed
Üstün, TB, Ayuso-Mateos, JL, Chatterji, S, Mathers, C, Murray, CJL (2004). Global burden of depressive disorders in the year 2000. British Journal of Psychiatry 184 386–392CrossRefGoogle ScholarPubMed
Westert, GP, Satariano, WA, Schellevis, FG, van den Bos, GA (2001). Patterns of comorbidity and the use of health services in the Dutch population. European Journal of Public Health 11 365–372CrossRefGoogle ScholarPubMed