McCrone, P;
Rost, F;
Koeser, L;
Koutoufa, I;
Stephanou, S;
Knapp, M;
Goldberg, D;
... Fonagy, P; + view all
(2017)
The economic cost of treatment-resistant depression in patients referred to a specialist service.
Journal of Mental Health
10.1080/09638237.2017.1417562.
(In press).
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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.
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