EMPLOYER BURDEN OF MILD, MODERATE, AND SEVERE MAJOR DEPRESSIVE DISORDER: MENTAL HEALTH SERVICES UTILIZATION AND COSTS, AND WORK PERFORMANCE
EMPLOYER BURDEN OF MILD, MODERATE, AND SEVERE MAJOR DEPRESSIVE DISORDER: MENTAL HEALTH SERVICES UTILIZATION AND COSTS, AND WORK PERFORMANCE
复制标题
DOI：
10.1002/da.20580
复制
发表时间：
2010-01-01
影响因子：
7.4
通讯作者：
Greenberg, Paul E.
中科院分区：
文献类型：
--
作者：
Birnbaum, Howard G.;Kessler, Ronald C.;Greenberg, Paul E.
背景：按疾病严重程度划分的重性抑郁障碍（MDD）患者的治疗利用情况/费用以及工作表现尚未得到充分记录。
方法：利用美国全国共病调查重复研究（2001 - 2002年）的数据，使用标准自评量表[抑郁症状快速自评量表（QIDS - SR）]将美国劳动力受访者（n = 4465）按临床严重程度（无临床抑郁、轻度、中度、重度）进行分类。结果包括12个月内医疗服务/药物使用/费用的患病率以及工作场所表现。治疗费用（从雇主角度）是通过将利用指标乘以索赔数据中MDD患者使用类似服务的单位成本来估算的。对三个严重程度组进行描述性分析得出卡方结果。
结果：在539名患有MDD的美国劳动力受访者样本中，13.8%被归类为轻度，38.5%为中度，47.7%为重度病例。包括抗抑郁药在内的心理健康服务使用情况随严重程度显著增加，重度病例的平均治疗费用在心理健康服务方面（697美元对388美元，卡方 = 4.4，P = 0.019）以及抗抑郁药方面（256美元对88美元，卡方 = 9.0，P = 0.001）都大大高于轻度病例。失业/残疾的患病率随MDD严重程度显著增加（卡方 = 11.7，P = 0.003）（轻度、中度和重度病例分别为15.7%、23.3%和31.3%）。重度和中度抑郁的工人比非抑郁工人缺勤更多；每月相当于工资损失的工作绩效为199美元（重度抑郁）和188美元（中度抑郁），显著高于非抑郁工人（卡方 = 10.3，P……（此处原文似乎不完整）
Background: Treatment utilization/costs and work performance for persons with major depressive disorder (MDD) by severity of illness is not well documented. Methods: Using National Comorbidity Survey-Replication (2001-2002) data, US workforce respondents (n = 4,465) were classified by clinical severity (not clinically depressed, mild, moderate, severe) using a standard self-rating scale [Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR)]. Outcomes included 12-month prevalence of medical services/medications use/costs and workplace performance. Treatment costs (employer's perspective) were estimated by weighing utilization measures by unit costs obtained for similar services used by MDD patients in claims data. Descriptive analysis across three severity groups generated chi(2) results. Results: Using a sample of 539 US workforce respondents with MDD, 13.8% were classified mild, 38.5% moderate, and 47.7% severe cases. Mental health services usage, including antidepressants, increased significantly with severity, with average treatment costs substantially higher for severe than for mild cases both regarding mental health services ($697 vs. $388, chi(2) =4.4, P=.019) and antidepressants ($256 vs. $88, chi(2)=9.0, p=.001). Prevalence rates of unemployment/disability increased significantly (chi(2) = 11.7, P=.003) with MDD severity (15.7, 23.3, and 31.3% for mild, moderate, and severe cases). Severely and moderately depressed workers missed more work than nondepressed workers; the monthly salary-equivalent lost performance of $199 (severely depressed) and $188 (moderately depressed) was significantly higher than for nondepressed workers (chi(2) = 10.3, P