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The Added Costs of Depression to Medical Care

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References

  1. Greenberg PE, Stiglin LE, Finkelstein SN, et al. The economic burden of depression in 1990. J Clin Psychiatry 1993; 54: 405–18

    PubMed  CAS  Google Scholar 

  2. Miller MW. Dark days: the staggering cost of depression. Wall Street Journal 1993 Dec 2; Sect. B: 1 (col. 3)

    Google Scholar 

  3. Kind P, Sorensen J. The costs of depression. Int Clin Psycho­pharmacol 1993; 7: 191–5

    Article  CAS  Google Scholar 

  4. Garrity TF, Klein RF. Emotional response and clinical severity as early determinants of six-month mortality after myocardial infarction. Heart Lung 1975; 4: 430–7

    Google Scholar 

  5. Carney RM, Rich MW, Freedland KE, et al. Major depressive disorder predicts cardiac events in patients with coronary artery disease. Psychosom Med 1988; 50: 627–33

    PubMed  CAS  Google Scholar 

  6. Dalack GW, Roose SP. Perspectives on the relationship between cardiovascular disease and affective disorder. J Clin Psychi atry 1990; 51 (7 Suppl.): 4–9

    Google Scholar 

  7. Katon W, Sullivan MD. Depression and chronic medical illness. J Clin Psychiatry 1990; 51 (6 Suppl.): 3–11

    PubMed  Google Scholar 

  8. Katon W, Kleinman A, Rosen G. Depression and somatization: a review, part I. Am J Med 1982; 72: 127–35

    Article  PubMed  CAS  Google Scholar 

  9. Katon W, Kleinman A, Rosen G. Depression and somatization: a review, part II. Am J Med 1982; 72: 241–7

    Article  PubMed  CAS  Google Scholar 

  10. Eisenberg L. Treating depression and anxiety in primary care: closing the gap between knowledge and practice. N Engl J Med 1992; 326: 1080–4

    Article  PubMed  CAS  Google Scholar 

  11. Perez-Stable FJ, Miranda J, Munoz RF, et al. Depression in medical outpatients: under-recognition and misdiagnosis. Arch Intern Med 1990; 15O: 1083–8

    Article  Google Scholar 

  12. Von Korff M, Ormel J, Katon W, et al. Disability and depression among high utilizers of health care. Arch Gen Psychiatry 1992; 49: 91–100

    Article  Google Scholar 

  13. Depression Guideline Panel. Depression in primary care. Vol. 1. Detection and diagnosis. Clinical practice guideline no. 5 [ACH PR Publication No. 93–0550, March 1993]. Rockville, MD: US Department of Health and Human Services, Public Health Service, Agency for Health Care Policy And Research, 1993

  14. Wells KB, Hays RD, Brunam A, et al. Detection of depressive disorder for patients receiving prepaid or fee-for-service care. JAMA 1989; 262: 3298–302

    Article  PubMed  CAS  Google Scholar 

  15. Gerber PD, Barrett J, Barrett J, et al. Recognition of depression by internists in primary care: a comparison of internist and ‘gold standard’ psychiatric assessments. J Gen Intern Med 1989; 4: 7–13

    Article  PubMed  CAS  Google Scholar 

  16. Shapiro S, German PS, Skinner A, et al. An experiment to change detection and management of mental morbidity in primary care. Med Care 1987; 25: 327–39

    Article  PubMed  CAS  Google Scholar 

  17. Block M, Schulberg HC, Coulehan JC, et al. Diagnosing depression among new patients in ambulatory training settings. J Am Board Fam Pract 1988; 1: 91–7

    PubMed  CAS  Google Scholar 

  18. Wells KB, Stewart A, Hays RD, et al. The functioning and wellbeing of depressed patients: results from the Medical Outcome Study. JAMA 1989; 262: 914–9

    Article  PubMed  CAS  Google Scholar 

  19. Kathol R, Katon Jr W, Smith GR, et al. Guidelines for the diagnosis and treatment of depression for primary care physicians. Psychosomatics 1994; 35: 1–12

    Article  PubMed  CAS  Google Scholar 

  20. Johnson J, Weissman MM, Klerman GL. Service utilization and social morbidity associated with depressive symptoms in the community. JAMA 1992; 267: 1478–83

    Article  PubMed  CAS  Google Scholar 

  21. Duggan CF, Lee AS, Murray RM. Do different types of hospitalized depressives have different long-term outcomes? Arch Gen Psychiatry 1991; 48: 308–12

    Article  PubMed  CAS  Google Scholar 

  22. Hoeper EW, Nycz GR, Regier DA, et al. Diagnosis of mental disorder in adults and increased use of health services in four outpatient settings. Am J Psychiatry 1980; 137: 207–10

    PubMed  CAS  Google Scholar 

  23. Fulop G, Strain JJ, Vital J, et al. Impact on psychiatric comorbidity on length of hospital stay for medical/surgical patients: a preliminary report. Am J Psychiatry 1987; 144: 878–82

    PubMed  CAS  Google Scholar 

  24. Lyons JS, Larson DB, Burns BJ, et al. Psychiatric comorbidities and patients with head and spinal cord trauma: effects on acute hospital care. Gen Hosp Psychiatry 1988; 10: 292–7

    Article  PubMed  CAS  Google Scholar 

  25. Thomas RI, Cameron DJ, Fahs MC. A prospective study of delirium and prolonged hospital stay. Arch Gen Psychiatry 1988; 45: 937–40

    Article  PubMed  CAS  Google Scholar 

  26. Saravay SM, Steinberg MD, Weinschel B, et al. Psychological comorbidity and length of stay in the general hospital. Am J Psychiatry 1991; 148: 324–9

    PubMed  CAS  Google Scholar 

  27. Levenson JL, Hamer R, Silverman JJ, et al. Psychopathology in medical inpatients and its relationship to length of hospital stay: a pilot study. Int J Psychiatry Med 1986–1987; 16: 231–6

    Article  PubMed  Google Scholar 

  28. Saravay SM, Steinberg DM, Goldman E. Psychosocial screening to predict length of stay in medical inpatients. Proceedings of the Academy of Psychosomatic Medicine; 1993 Nov 11–14: New Orleans. Chicago: Academy of Psychosomatic Medicine, 1993: 27

    Google Scholar 

  29. Surridge DH, Williams Erdahl DL, Lawson JS, et al. Psychiatric aspects of diabetes mellitus. Br J Psychiatry 1984; 145: 269–76

    Article  PubMed  CAS  Google Scholar 

  30. Turkington RW. Depression masquerading as diabetic nephropathy. JAMA 1980; 243: 1147–50

    Article  PubMed  CAS  Google Scholar 

  31. Derogatis LR, Morrow GR, Fetting J, et al. The prevalence of psychiatric disorders among cancer patients. JAMA 1983; 249: 751–7

    Article  PubMed  CAS  Google Scholar 

  32. Surman OS. Hemodialysis and renal transplantation. In: Cassem NH, editor. Handbook of general hospital psychiatry. St Louis: Mosby Year Book, 1991: 401–30

    Google Scholar 

  33. Katon W, Roy-Byrne PP. Antidepressants in the medically ill: diagnosis and treatment in primary care. Clin Chem 1988; 34: 829–36

    PubMed  CAS  Google Scholar 

  34. Robinson RG, Starr LB, Lyssey JR, et al. A two-year longitudinal study of post-stroke mood disorders: dynamic changes in associated variables over the first six months of follow-up. Stroke 1984; 15: 510–7

    Article  PubMed  CAS  Google Scholar 

  35. Starkstein SE, Robinson RG, Price TR. Comparison of cortical and subcortical lesions in the production of post-stroke mood disorders. Brain 1987; 110: 1045–59

    Article  PubMed  Google Scholar 

  36. Robinson RG, Morris PLP, Federoff JP. Depression and cerebrovascular disease. J Clin Psychiatry 1990; 51 (7 Suppl.): 26–31

    PubMed  Google Scholar 

  37. Rovner BW, German PS, Brant LJ, et al. Depression and mortality in nursing homes. JAMA 1991; 265: 993–6

    Article  PubMed  CAS  Google Scholar 

  38. Frasure-Smith N, Lesperance F, Talajic M. Depression following myocardial infarction: impact on 6-month survival. JAMA 1993; 270: 1819–25

    Article  PubMed  CAS  Google Scholar 

  39. Ormel J, Van Den Brink W, Koeter MW, et al. Recognition, management and outcome of psychological disorders in primary care: a naturalistic follow-up study. Psychol Med 1990; 20: 909–23

    Article  PubMed  CAS  Google Scholar 

  40. Roose SP, Glassman AH, Giardina EGV, et al. Cardiovascular effects of imipramine and bupropion in depressed patients with congestive heart failure. J Clin Psychopharmacol 1987; 7: 247–51

    Article  PubMed  CAS  Google Scholar 

  41. Roose SP, Glassman AH, Giardina EGV, et al. Nortriptyline in depressed patients with left ventricular impairment. JAMA 1986; 256: 3253–7

    Article  PubMed  CAS  Google Scholar 

  42. Lipsey JR, Robinson RG, Pearlson GO, et al. Nortriptyline treatment of post-stroke depressions: a double blind study. Lancet 1984; 1: 297–300

    Article  PubMed  CAS  Google Scholar 

  43. Massie MJ, Holland JC. Depression and the cancer patient. J Clin Psychiatry 1990; 51 (7 Suppl.): 12–7

    PubMed  Google Scholar 

  44. Chaturvedi SK, Maguire P, Hopwood P. Antidepressant medications in cancer patients. Psycho-Oncol 1994; 3: 57–60

    Article  Google Scholar 

  45. Hales RE. The benefits of a psychiatric consultation-liaison service in a general hospital. Gen Hosp Psychiatry 1985; 7: 214–8

    Article  PubMed  CAS  Google Scholar 

  46. Levenson JL, Hamer RM, Rossiter LF. A randomized controlled study of psychiatric consultation guided by screening in general medical in patients. Am J Psychiatry 1992; 149: 631–7

    PubMed  CAS  Google Scholar 

  47. Levitan S, Kornfeld D. Clinical and cost benefits of liaison psychiatry. Am J Psychiatry 1981; 138: 790–3

    PubMed  CAS  Google Scholar 

  48. Lyons JS, Hammer JS, Strain JJ, et al. The timing of psychiatric consultation in the general hospital and length of hospital stay. Gen Hosp Psychiatry 1986; 8: 159–62

    Article  PubMed  CAS  Google Scholar 

  49. Strain JJ, Lyons JS, Hammer JS, et al. Cost offset from a psychiatric consultation-liaison intervention with elderly hip fracture patients. Am J Psychiatry 1991; 148: 1044–9

    PubMed  CAS  Google Scholar 

  50. Verbosky LA, Franco KN, Zrull JP. The relationship between depression and length of stay in the general hospital patient. J Clin Psychiatry 1993; 54: 177–81

    PubMed  CAS  Google Scholar 

  51. American Psychiatric Association. DSM-III-R: Diagnostic and statistical manual of mental disorders. 3rd rev. ed. Washington, DC: The American Psychiatric Association Press, 1987

    Google Scholar 

  52. Knaus WA, Draper EA, Wagner DP, et al. APACHE II: a severity of disease classification system. Crit Care Med 1985; 13: 818–29

    Article  PubMed  CAS  Google Scholar 

  53. Borus J, Olendzki MC, Kessler L. The ‘offset effect’ of mental health treatment on ambulatory medical care utilization and charges. Arch Gen Psychiatry 1985; 42: 573–80

    Article  PubMed  CAS  Google Scholar 

  54. Keller MB, Lavori PW. The adequacy of treating depression. J Nerv Ment Dis 1988; 176: 471–4

    Article  PubMed  CAS  Google Scholar 

  55. Mintz J, Mintz LI, Phepps C. Treatments of mental disorders and the functional capacity to work. In: Liberman RP, editor. Handbook of psychiatric rehabilitation. New York: Macmillan Publishing Co., 1992: 290–316

    Google Scholar 

  56. Mintz J, Mintz LI, Arruda MJ, et al. Treatments of depression and the functional capacity to work. Arch Gen Psychiatry 1992; 49: 761–8

    Article  PubMed  CAS  Google Scholar 

  57. Nemeroff CB. Evolutionary trends in the pharmacotherapeutic management of depression. J Clin Psychiatry 1994; 55 Suppl. 12: 3–15

    PubMed  Google Scholar 

  58. DeVane CL. Pharmacokinetics of the newer antidepressants: clinical relevance. Am J Med 1994; 97 Suppl. 6A: 13–23

    Article  Google Scholar 

  59. Cooper GL. The safety of fluoxetine: an update. Br J Psychiatry 1988; 153 Suppl. 3: 77–86

    Google Scholar 

  60. Kilts CD. Recent pharmacologic advances in antidepressant therapy. Am J Med 1994; 97 Suppl. 6A: 3–12

    Article  Google Scholar 

  61. McCombs JS, Nichol MB, Stimmel GL, et al. The cost of an antidepressant drug therapy failure: a study of antidepressant use patterns in a Medicaid population. J Clin Psychiatry 1990; 51 (6 Suppl.): 60–9

    PubMed  Google Scholar 

  62. Cohn CK, Shrivasteva R, Mendels J, et al. Double-blind, multi­center comparison of sertraline and amitriptyline in elderly depressed patients. J Clin Psychiatry 1990; 51 (12 Suppl. B): 28–33

    PubMed  Google Scholar 

  63. Beasley CM, Sayler ME, Cunningham GE, et al. Fluoxetine in tricyclic refractory major depressive disorder. J Affect Disord 1990; 20: 193–200

    Article  PubMed  Google Scholar 

  64. Simon GE, Von Korff M, Wagner EH, et al. Patterns of antidepressant use in community practice. Gen Hosp Psychiatry 1993; 15: 399–408

    Article  PubMed  CAS  Google Scholar 

  65. Sclar DA, Robison LM, Skaer TL, et al. Antidepressant pharmacotherapy: economic outcomes in a health maintenance organization. Clin Therapeutics 1994; 16: 715–30

    CAS  Google Scholar 

  66. McFarland BH. Cost-effectiveness considerations for managed care systems: treating depression in primary care. Am J Med 1994; 97 (6A Suppl.): 47–57

    Article  Google Scholar 

  67. Tollefson GD, Souêtre E, Thomander L, et al. Comorbid anxious signs and symptoms in major depression: impact on functional work capacity and comparative treatment outcomes. Int Clin Psychopharmacol 1993; 8: 281–93

    Article  PubMed  CAS  Google Scholar 

  68. Matthews K, Eagles JM. Which antidepressant? Br J Gen Pract 1991; 41: 123–5

    PubMed  CAS  Google Scholar 

  69. Matthews K, Eagles JM. Toxicity of antidepressants. Br J Psychiatry 1989; 155: 420

    PubMed  CAS  Google Scholar 

  70. Wilens T, Biederman J, Baldessarini R, et al. Electrocardiographic effects of desipramine and 2-hydroxydesipramine in children, adolescents, and adults treated with desipramine. J Am Acad Child Adolesc Psychiatry 1993; 32: 798–804

    Article  PubMed  CAS  Google Scholar 

  71. Tingelstad JB. The cardiotoxicity of the tricyclics. J Am Acad Child Adolesc Psychiatry 1991; 30: 845–6

    PubMed  CAS  Google Scholar 

  72. Frazer A, Conway P. Pharmacologic mechanisms of action of antidepressants. Psychiatric Clin North Am 1984; 7: 575–86

    CAS  Google Scholar 

  73. Cohen-Cole SA, Stoudemire A. Major depression and physical illness: special considerations in diagnosis and biologic treatment. Psychiatr Clin North Am 1987; 10: 1–17

    PubMed  CAS  Google Scholar 

  74. Diagnosis Related Groups Definitions Manual and Software. Murray, UT: 3M Health Information Systems, 1992

    Google Scholar 

  75. Dunner DL. Therapeutic considerations in treating depression in the elderly. J Clin Psychiatry 1994; 55 Suppl. 12: 48–58

    PubMed  Google Scholar 

  76. Hirschfeld RM. Guidelines for the long term treatment of depression. J Clin Psychiatry 1994; 55 Suppl. 12: 61–9

    PubMed  Google Scholar 

  77. Santiago JM. The costs of treating depression. J Clin Psychiatry 1993; 54: 425–6

    PubMed  CAS  Google Scholar 

  78. Stoudemire A, Moran MG, Fogel BS. Psychotropic drug use in the medically ill, part 1. Psychosomatics 1990; 31: 377–91

    Article  PubMed  CAS  Google Scholar 

  79. Stoudemire A, Moran MG, Fogel BS. Psychotropic drug use in the medically ill, part 2. Psychosomatics 1991; 32: 34–46

    Article  PubMed  CAS  Google Scholar 

  80. Katon W, Von Korff M, Lin E, et al. Adequacy and duration of antidepressant treatment in primary care. Med Care 1992; 30: 67–76

    Article  PubMed  CAS  Google Scholar 

  81. Koenig HG, Breitner JCA. Use of antidepressants in medically ill older patients. Psychosomatics 1990; 31: 22–32

    Article  PubMed  CAS  Google Scholar 

  82. Fava GA, Sonino N, Wise TN. Management of depression in medical patients. Psychother Psychosom 1988; 49: 81–102

    Article  PubMed  CAS  Google Scholar 

  83. Rodin G, Voshant K. Depression in the medically ill: an over­view. Am J Psychiatry 1986; 143: 695–705

    Google Scholar 

  84. Blumenfield M, Levy NB, Dubey A, et al. Safety and efficacy of fluoxetine in patients on dialysis. Proceedings of the Academy of Psychosomatic Medicine; 1993 Nov 11–14: New Orleans. Chicago: Academy of Psychosomatic Medicine, 1993: 3

    Google Scholar 

  85. Mitchell KE, Popkin MK, Callies AL. The outcome of depressed, medically ill patients treated with fluoxetine. Proceedings of the Academy of Psychosomatic Medicine; 1993 Nov 11–14: New Orleans. Chicago: Academy of Psychosomatic Medicine, 1993: 13–4

    Google Scholar 

  86. Maynard A. Cost management: the economist’s viewpoint. Br J Psychiatry 1993; 163 (20 Suppl.): 7–13

    Google Scholar 

  87. Preskorn SH, Fast GA. Therapeutic drug monitoring for antidepressants: efficacy, safety, and cost effectiveness. J Clin Psychiatry 1991; 52 (6 Suppl.): 23–33

    PubMed  Google Scholar 

  88. Preskorn SH, Dorey RC, Jerkovich GS. Therapeutic drug monitoring of tricyclic antidepressants. Clin Chern 1988; 34: 822–8

    CAS  Google Scholar 

  89. Simmons SA, Perry PJ, Rickert ED, et al. Cost-benefit analysis of prospective pharmacokinetic dosing of nortriptyline in depressed inpatients. J Affect Disord 1985; 8: 47–53

    Article  PubMed  CAS  Google Scholar 

  90. Jurman RJ, Davis JM. Comparisons of the costs of psychotropic medications: an update. Psychiatr Med 1991; 9: 349–59

    PubMed  CAS  Google Scholar 

  91. Thase ME. Relapse and recurrence in unipolar major depression: short-term and long-term approaches. J Clin Psychiatry 1990; 51: 51–7

    PubMed  Google Scholar 

  92. Frank E, Kupfer DJ, Perel JM, et al. Three-year outcomes for maintenance therapies in recurrent depression. Arch Gen Psychiatry 1990; 47: 1093–100

    Article  PubMed  CAS  Google Scholar 

  93. Shea MT, Elkin I, Imber SD, et al. Course of depressive symptoms over follow-up: findings from the National Institute of Mental Health Treatment of Depression Collaborative Research Program. Arch Gen Psychiatry 1992; 49: 782–7

    Article  PubMed  CAS  Google Scholar 

  94. Kupfer DJ, Frank E, Perel JM, et al. Five-year outcome for maintenance therapies in recurrent depression. Arch Gen Psychiatry 1992; 49: 769–73

    Article  PubMed  CAS  Google Scholar 

  95. Glassman AH. Cigarette smoking: implications for psychiatric illness. Am J Psychiatry 1993; 150: 546–53

    PubMed  CAS  Google Scholar 

  96. Kendler KS, Neale MC, MacLean CI, et al. Smoking and major depression: a causal analysis. Arch Gen Psychiatry 1993; 50: 36–43

    Article  PubMed  CAS  Google Scholar 

  97. Tamburrino MB, Lynch DJ, Nagel RW, et al. Screening women in family practice settings: association between depression and smoking cigarettes. Fam Pract Res J 1994; 14: 333–7

    PubMed  CAS  Google Scholar 

  98. Glassman AH, Helzer JE, Covey LS, et al. Smoking, smoking cessation and major depression. JAMA 1990; 264: 1546–9

    Article  PubMed  CAS  Google Scholar 

  99. Von Korff M, Katon W, Lin E, et al. Evaluation of cost and cost offset of collaborative management of depressed patients in primary care [abstract]. The Eighth Annual NIMH International Research Conference on Mental Health Problems in the General Health Care Sector; 1994 Sep 7–9: McLean, VA. Rockville, MD: Services Research Branch, NIMH, 1994: 84–5

    Google Scholar 

  100. Sturm K, Wells KB. How can care for depression be improved cost-effectively? [abstract]. The Eighth Annual NIMH International Research Conference on Mental Health Problems in the General Health Care Sector; 1994 Sep 7–9: McLean, VA. Rockville, MD: Services Research Branch, NIMH, 1994: 77

    Google Scholar 

  101. Starfield B. Primary care and mental health services [abstract]. The Eighth Annual NIMH International Research Conference on Mental Health Problems in the General Health Care Sector; 1994 Sep 7–9: McLean, VA. Rockville, MD: Services Research Branch, NIMH, 1994: 75–6

    Google Scholar 

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Authors and Affiliations

  1. The Cleveland Clinic Foundation, Department of Psychiatry and Psychology, 9500 Euclid Avenue, Desk p68, Cleveland, Ohio, OH 44195-5001, USA

    Kathleen Franco & David Bronson

  2. Medical College of Ohio, Department of Psychiatry, Toledo, Ohio, USA

    Marijo Tamburino, Nancy Campbell, Joel Zrull & Cynthia Evans

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  1. Kathleen Franco
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  2. Marijo Tamburino
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  4. Joel Zrull
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  6. David Bronson
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Franco, K., Tamburino, M., Campbell, N. et al. The Added Costs of Depression to Medical Care. Pharmacoeconomics 7, 284–291 (1995). https://doi.org/10.2165/00019053-199507040-00003

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