Author(s): Bhattarai N, Charlton J, Rudisill C, Gulliford MC
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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.
This article was published in Psychol Med
and referenced in Epidemiology: Open Access