Physical and mental health are closely related. People with chronic physical health conditions, like diabetes (DM), coronary heart disease (CHD), and chronic pain are more likely to have depression than people with no physical ailments, and treating depression costs communities and societies an enormous amount of time, money, and effort.
Interventions designed to provide better access to mental health care at lower costs have been implemented globally with much success. However, what is less known is how comorbid conditions contribute to the global burden of depression and what can be done to minimize the impact of that dynamic on financial and medical resources.
In an effort to determine how comorbid conditions increase the rates of depression and the use of mental and physical health services, N. Bhattarai of the Department of Primary Care and Public Health Sciences at King’s College London recently led a population based study that examined four specific health conditions with depression. Bhattarai analyzed data from almost 300,000 individuals and looked at rates of depression alone and then in combination with DM, CHD, colorectal cancer, and/or stroke.
The results revealed that women were twice as likely as men to have depression without any other conditions. When diabetes was considered as the primary factor, 22% of women with DM had depression while only 13% of the men had depression. Participants with CHD had slightly higher depression rates, with 24% of the women and 15% of the men showing depressive symptoms. Further, women and men with strokes or with colorectal cancer had similar rates of depression respectively.
But when Bhattarai looked at participants that had CHD, diabetes, and stroke, the rates of depression doubled with 49% of women and 23% of men in this group having depression. The cost associated with these comorbidities was much higher than the increases in rates of depression. For instance, the price tag for health care services for individuals with all three comorbidities was five times that of individuals with depression alone.
The results of this study clearly show that people with physical health conditions are at risk for depression, but that depression alone places a strong demand on financial and medical services. Bhattarai added, “Depression in patients with major comorbidities deserves further policy attention not only for the patient health implications but also for the contribution it makes to resource use in primary care.”
Bhattarai, N., et al. (2013). Prevalence of depression and utilization of health care in single and multiple morbidity: A population-based cohort study. Psychological Medicine 43.7 (2013): 1423-31. ProQuest. Web.
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