Depression status, medical comorbidity and resource costs: evidence from an international study of major depression in primary care (LIDO)

Background: Despite the burden of depression, there remain few data on its economic consequences in an international context. Aims: To explore the relationship between depression status (with and without medical comorbidity), work loss and health care costs, using cross-sectional data from a multi-national study of depression in primary care. Method: Primary care attendees were screened for depression. Those meeting eligibility criteria were categorised according to DSM–IV criteria for major depressive disorder and comorbid status. Unit costs were attached to self-reported days absent from work and uptake of health care services. Results: Medical comorbidity was associated with a 17–46% increase in health care costs in five of the six sites, but a clear positive association between costs and clinical depression status was identified in only one site. Conclusions: The economic consequences of depression are influenced to a greater (and considerable) extent by the presence of medical comorbidity than by symptom severity alone.