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. 2021 Jan 18:17:111-123.
doi: 10.2147/NDT.S229530. eCollection 2021.

The Health-Related Quality of Life, Work Productivity, Healthcare Resource Utilization, and Economic Burden Associated with Levels of Suicidal Ideation Among Patients Self-Reporting Moderately Severe or Severe Major Depressive Disorder in a National Survey

Carmela Benson  1 , David Singer  2 , Colleen M Carpinella  3 , May Shawi  4 , Larry Alphs  4
Affiliations

The Health-Related Quality of Life, Work Productivity, Healthcare Resource Utilization, and Economic Burden Associated with Levels of Suicidal Ideation Among Patients Self-Reporting Moderately Severe or Severe Major Depressive Disorder in a National Survey

Carmela Benson et al. Neuropsychiatr Dis Treat. .

Abstract

Background: Suicidal ideation (SI) is a cardinal aspect of major depressive disorder (MDD); however, patient-reported outcomes data from large-scale surveys are limited concerning SI in the context of MDD. This study aims to understand the association between varying levels of SI and health-related quality of life (HRQoL), work productivity, healthcare resource utilization (HRU), and associated costs in patients with moderately severe/severe MDD.

Methods: This was a retrospective, cross-sectional analysis of 2013 national survey data. Patients who self-reported moderately severe or severe MDD and completed the Short Form Survey Version 2 (SF-36v2), Work Productivity Loss and Activity Impairment questionnaire (WPAI), and questions related to HRU were analyzed. Direct and indirect costs were calculated. Patients were categorized and analyzed by the level of SI (no SI, low, moderate, and high) based on their response to Item 9 of the Patient Health Questionnaire-9.

Results: Among 75,000 respondents, 15.3% self-reported receiving a physician diagnosis of moderately severe or severe MDD and 2.8% of the total sample endorsed some level of SI. Patients with high SI showed a higher burden than patients with no SI, reporting lower mean SF-36v2 mental component summary scores (p<0.001), higher work productivity loss (p=0.039), and higher numbers of per patient per month hospitalizations (p=0.002) and emergency room visits (p=0.011). High SI was associated with greater per patient per month direct costs ($1220 vs $796; p=0.002) and indirect costs ($1449 vs $1058; p=0.001) compared with no SI. When patients with low or moderate SI were compared with patients with no SI, the results were mixed.

Conclusion: Higher levels of SI were associated with lower HRQoL, greater HRU, and more work impairment resulting in higher direct and indirect costs compared with patients with MDD but no SI. These results highlight the need to implement effective treatment models and interventions in the employed population.

Keywords: economic burden; health-related quality of life; major depression; suicidal ideation.

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Conflict of interest statement

Carmela Benson is a full-time employee of Janssen Scientific Affairs, LLC. May Shawi and Larry Alphs were full-time employees of Janssen Scientific Affairs, LLC at the time of the study. David Singer was a post-doctoral fellow with Thomas Jefferson University and reports a grant from Janssen Scientific Affairs, LLC at the time of the study. Colleen M. Carpinella was an employee of Kantar Health, which conducted this study with funding from Janssen Scientific Affairs, LLC, at the time of the study. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Analysis sample definition.
Figure 2
Figure 2
Direct per patient per month costs by level of suicidal ideation and type of healthcare resource utilization among patients with moderately severe or severe MDD.
See this image and copyright information in PMC

References

    1. National Institute of Mental Health. Depression; 2020. Available from: https://www.nimh.nih.gov/health/topics/depression/index.shtml. Accessed October 22, 2020.
    1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-5. Washington, DC: American Psychiatric Association; 2013.
    1. G.B.D. Disease Injury Incidence Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392(10159):1789–1858. doi: 10.1016/S0140-6736(18)32279-7 - DOI - PMC - PubMed
    1. World Health Organization. Depression and Other Common Mental Disorders: Global Health Estimates. Geneva, Switzerland: WHO Document Production Services; 2017.
    1. Mitchell PM, Al-Janabi H, Richardson J, Iezzi A, Coast J. The relative impacts of disease on health status and capability wellbeing: a multi-country study. PLoS One. 2015;10(12):e0143590. doi: 10.1371/journal.pone.0143590 - DOI - PMC - PubMed

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