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Prevalence of depression and utilization of health care in single and multiple morbidity: a population-based cohort study

Published online by Cambridge University Press:  01 November 2012

N. Bhattarai ,
J. Charlton ,
C. Rudisill  and
M. C. Gulliford
N. Bhattarai*
Affiliation:
Department of Primary Care and Public Health Sciences, King's College London, UK
J. Charlton
Affiliation:
Department of Primary Care and Public Health Sciences, King's College London, UK
C. Rudisill
Affiliation:
Department of Social Policy, London School of Economics and Political Science, UK
M. C. Gulliford
Affiliation:
Department of Primary Care and Public Health Sciences, King's College London, UK
*
*Address for correspondence: N. Bhattarai, MPH, MSc, Division of Health and Social Care Research, King's College London, 7th Floor Capital House, 42 Weston Street, London SE1 3QD, UK. (Email: nawaraj.bhattarai@kcl.ac.uk)
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Abstract

Background

This study aimed to determine whether depression in patients with long-term conditions is associated with the number of morbidities or the type of co-morbidity.

Method

A cohort study of 299 912 participants aged 30–100 years. The prevalence of depression, rates of health-care utilization and costs were evaluated in relation to diagnoses of diabetes mellitus (DM), coronary heart disease (CHD), stroke and colorectal cancer.

Results

The age-standardized prevalence of depression was 7% in men and 14% in women with no morbidity. The frequency of depression increased in single morbidities including DM (men 13%, women 22%), CHD (men 15%, women 24%), stroke (men 14%, women 26%) or colorectal cancer (men 10%, women 21%). Participants with concurrent diabetes, CHD and stroke had a very high prevalence of depression (men 23%, women 49%). The relative rate of depression for one morbidity was 1.63 [95% confidence interval (CI) 1.59–1.66], two morbidities 1.96 (95% CI 1.89–2.03) and three morbidities 2.35 (95% CI 2.03–2.59). Compared to those with no morbidity, depression was associated with higher rates of health-care utilization and increased costs at any level of morbidity. In women aged 55 to 64 years without morbidity, the mean annual health-care cost was £513 without depression and £1074 with depression; when three morbidities were present, the cost was £1495 without depression and £2878 with depression.

Conclusions

Depression prevalence and health-care costs are more strongly associated with the number of morbidities than the nature of the co-morbid diagnosis.

Keywords

Colorectal cancerco-morbiditycoronary heart diseasedepressiondiabetes mellitusmulti-morbidityprimary carestroke
Type
Original Articles
Information
Psychological Medicine , Volume 43 , Issue 7 , July 2013 , pp. 1423 - 1431
Copyright
Copyright © Cambridge University Press 2012 

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