Study Enumerates Personal, System-Wide Effects of Depression in the United States

Researchers evaluated differences in the burden of health outcomes between those with and without depression.

The following article is a part of conference coverage from Psych Congress 2020 Virtual Experience, held virtually from September 10 to 13, 2020. The team at Psychiatry Advisor will be reporting on the latest news and research conducted by leading experts in psychiatry. Check back for more from the Psych Congress 2020.


Study data presented at Psych Congress 2020, held virtually from September 10 to 13, 2020, highlight the clinical and economic burden of depression in the United States. Individuals with depression reported lower quality of life (QoL) and greater impairment of work and activity compared with the general population. Healthcare utilization was also significantly greater in individuals with depression vs those without depression.

Investigators extracted response data from the 2017 US National Health and Wellness Survey, which is a self-administered, internet-based health survey given to adults in the United States selected by a stratified random sampling procedure. Individuals who reported ever having received a clinical diagnosis of major depressive disorder (n=8853) were compared with individuals without depression (n=30,478). Individuals with depression were further stratified by depression severity, which was determined based on Patient Health Questionnaire-9 (PHQ-9) scores.

Overall, 1876 patients had no/minimal depression, 2801 had mild depression, 1938 had moderate depression, 1376 had moderately severe depression, and 862 had severe depression.  All respondents also completed the Medical Outcomes Study 36-Item Short Form Survey Instrument version 2 (SF-36v2), the EuroQol 5-Dimension Health Questionnaire (EQ-5D-5L), and the Work Productivity and Activity Impairment questionnaire. Multivariable logistic regression was performed to assess the impact of depression status and severity on questionnaire outcomes.

Respondents with depression were more often women, non-Hispanic White, and unemployed compared with respondents without depression. Individuals with depression also had a higher mean number of comorbidities. In regression models, respondents with depression had lower mental (38.8 vs 51.8) and physical (52.2 vs 52.8) functioning scores on the SF-36v2. The depression cohort also had lower QoL scores per the SF-36v2 (0.67 vs 0.78) and the EQ-5D (0.79 vs 0.89).

Overall impairment of work (22.1% vs 9.9%) and activity (24.9% vs 11.9%) was more frequently reported by individuals with depression compared with respondents without depression. Numbers of past-year provider visits (3.6 vs 2.4), past-year emergency department visits (0.14 vs 0.09), and past-year hospitalizations (0.08 vs 0.04) were greater in the depression cohort and these trends became more pronounced with increasing depression severity.

These results highlight the clinical and economic burden of depression on adults in the United States. Individuals with depression reported lower mental and physical functioning, poorer overall quality of life, and general impairment with work and other activities. Depression was also associated with greater healthcare utilization and healthcare costs. Efforts to identify and treat symptoms are essential for reducing the impact of depression.

Limitations of this study include the data coming from a self-reported patient survey, although this was addressed, in part, through the use of short recall periods to reduce bias. Also, results of the study may not be generalizable to all individuals with depression, and the use of an internet-based survey may have recruited a sampling of respondents more familiar with using digital technology.

Disclosure: This study was sponsored by Sage Therapeutics, Inc.  Please see the original reference for a full list of authors’ disclosures.

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Gupta S, Li V, Suthoff E, Arnaud A. Humanistic and economic burden of depression in the United States (US). Presented at: Psych Congress 2020 Virtual Experience; September 10-13, 2020. Poster 163.