Costs Of Mental Disorders Research Articles

The cost of mental disorders in Denmark: a register-based study

The aim of the study was to undertake a detailed analysis of healthcare cost, public transfer payments, and income loss associated with a broad range of mental disorders in Denmark. Based on all persons living in Denmark, we identified those with a hospital diagnosis of one of 18 types of mental disorders and 10 age- and sex-matched controls per case. For each mental disorder, the outcomes were nationwide totals, cost per case, and cost per capita, investigated by sex, age strata, and the number of years after diagnosis. We found a substantial annual income loss of 5 billion Euros and excess healthcare cost of 1 billion Euros for persons with any mental disorder. Each mental disorder was associated with an income loss, excess healthcare cost, and excess public transfer payments compared to matched controls. An interactive data visualisation site with summary data is available at https://nbepi.com/cost.

The excess economic burden of mental disorders: findings from a cross-sectional prevalence survey in Austria

Information about the scope of mental disorders (MDs), resource use patterns in health and social care sectors and economic cost is crucial for adequate mental healthcare planning. This study provides the first representative estimates about the overall utilisation of resources by people with MDs and the excess healthcare and productivity loss costs associated with MDs in Austria. Data were collected in a cross-sectional survey conducted on a representative sample (n = 1008) between June 2015 and June 2016. Information on mental health diagnoses, 12-month health and social care use, medication use, comorbidities, informal care, early retirement, sick leave and unemployment was collected via face-to-face interviews. Generalised linear model was used to assess the excess cost of MDs. The healthcare cost was 37% higher (p = 0.06) and the total cost was twice as high (p < 0.001) for the respondents with MDs compared to those without MDs. Lost productivity cost was over 2.5-times higher (p < 0.001) for those with MDs. Participants with severe MDs had over 2.5-times higher health and social care cost (p < 0.001) and 9-times higher mental health services cost (p < 0.001), compared to those with non-severe MDs. The presence of two or more physical comorbidities was a statistically significant determinant of the total cost. Findings suggest that the overall excess economic burden on health and social care depends on the severity of MDs and the number of comorbidities. Both non-severe and severe MDs contribute to substantially higher loss productivity costs compared to no MDs. Future resource allocation and service planning should take this into consideration.

The cost of mental disorders: a systematic review.

To identify and synthesise the literature on the cost of mental disorders. Systematic literature searches were conducted in the databases PubMed, EMBASE, Web of Science, EconLit, NHS York Database and PsychInfo using key terms for cost and mental disorders. Searches were restricted to January 1980-May 2019. The inclusion criteria were: (1) cost-of-illness studies or cost-analyses; (2) diagnosis of at least one mental disorder; (3) study population based on the general population; (4) outcome in monetary units. The systematic review was preregistered on PROSPERO (ID: CRD42019127783). In total, 13 579 potential titles and abstracts were screened and 439 full-text articles were evaluated by two independent reviewers. Of these, 112 articles were included from the systematic searches and 31 additional articles from snowball searching, resulting in 143 included articles. Data were available from 48 countries and categorised according to nine mental disorder groups. The quality of the studies varied widely and there was a lack of studies from low- and middle-income countries and for certain types of mental disorders (e.g. intellectual disabilities and eating disorders). Our study showed that certain groups of mental disorders are more costly than others and that these rankings are relatively stable between countries. An interactive data visualisation site can be found here: https://nbepi.com/econ. This is the first study to provide a comprehensive overview of the cost of mental disorders worldwide.

An internet-based intervention for adjustment disorder (TAO): study protocol for a randomized controlled trial

BackgroundAdjustment Disorder (AjD) is a common and disabling mental health problem. The lack of research on this disorder has led to the absence of evidence-based interventions for its treatment. Moreover, because the available data indicate that a high percentage of people with mental illness are not treated, it is necessary to develop new ways to provide psychological assistance. The present study describes a Randomized Controlled Trial (RCT) aimed at assessing the effectiveness and acceptance of a linear internet-delivered cognitive-behavioral therapy (ICBT) intervention for AjD.MethodsA two-armed RCT was designed to compare an intervention group to a waiting list control group. Participants from the intervention group will receive TAO, an internet-based program for AjD composed of seven modules. TAO combines CBT and Positive Psychology strategies in order to provide patients with complete support, reducing their clinical symptoms and enhancing their capacity to overcome everyday adversity. Participants will also receive short weekly telephone support. Participants in the control group will be assessed before and after a seven-week waiting period, and then they will be offered the same intervention. Participants will be randomly assigned to one of the 2 groups. Measurements will be taken at five different moments: baseline, post-intervention, and three follow-up periods (3-, 6- and 12-month). BDI-II and BAI will be used as primary outcome measures. Secondary outcomes will be symptoms of AjD, posttraumatic growth, positive and negative affect, and quality of life.DiscussionThe development of ICBT programs like TAO responds to a need for evidence-based interventions that can reach most of the people who need them, reducing the burden and cost of mental disorders. More specifically, TAO targets AjD and will entail a step forward in the treatment of this prevalent but under-researched disorder. Finally, it should be noted that this is the first RCT focusing on an internet-based intervention for AjD in the Spanish population.Trial registrationClinicalTrial.gov: NCT02758418. Trial registration date 2 May 2016.

Health Resource Utilization and Comorbidities in Patients with Mental Disorders: Analysis Based on Health Insurance Claim Data

The number of patients with mental disorders is increasing all over the world and they have a high prevalence of physical complications. To analyze and compare the cost of mental disorders with the total medical costs such as mental disorders and physical disorders, we analyzed the cost that patients with mental disorders incurred. We investigated the distribution of medical costs and the characteristics of diseases by using the health insurance claims of people in City A, Japan from March 2013 to February 2014. The subjects had one or more of 4 mental disorders: schizophrenia, alcohol related disorders, bipolar disorder, and depressive episode. As a result, the total number of patients who met inclusion criteria per year was 7403 (6522 outpatients and 881 inpatients). It was revealed that the hospitalization rate of patients with mental disorders increased with age, and many inpatients stayed in hospital for a long time. Also, it was revealed that many patients with mental disorders were in complicated condition with more than one mental or physical disorders and incurred medical costs for these comorbidities. In conclusion, this analysis indicated that many patients with mental disorders switch from attending the outpatient department to hospitalization as they become older. Further, they incurred a lot of medical expenses for complication management. To improve their QOL, comprehensive assessment of their mental/ physical health, self-management education, coordination of services, and support for decision making regarding treatment are necessary.

The Mental Health of People with Disabilities

Disabled people are more likely to experience a lot, or a great deal, of worry than those who are not disabled. People with disabilities (e.g. physical impairments such as cerebral palsy, multiple sclerosis, spinal cord injury etc) are just as likely as the general population to experience mental health problems. They may be even more likely than the general population to need and use mental health services. Possible reasons for this may include – higher rates of poverty and unemployed amongst disabled people which are themselves associated with poor mental health; the greater risks of abuse experienced by disabled children and adults; and, some people with mental health support needs may be more likely to become physically disabled as a result of accidents or attempted suicide. There is also increasing acknowledgement that long-term mental health problems are correlated with conditions such as heart disease and diabetes. People with disabilities appear to be at greater risk of mental health problems than the general population and therefore make a disproportionate contribution to mental health morbidity internationally. The personal and social costs of mental disorders are considerable throughout the world. The mental health of populations has been recognized as an international priority (World Health Organisation 2005). An important part of addressing this will be attending to the needs of people with disabilities who are a disproportionately disadvantaged group. In the following sections we briefly examine what is currently known about the association between disability and mental health. It is suggested that people with physical impairments and mental health support needs tend to be overlooked by policy-makers and commissioners of services. Many people with disabilities report having difficulty accessing mental health services because of their physical impairments. Many also have difficulty accessing physical disability services because of the inadequate recognition of mental health needs with disability related services.

Costs of Mental Disorders in Poland and Their Complications

Costs of Mental Disorders in Poland and Their Complications

0157 The use of epidemiologic data to evaluate the economic burden of occupational risks: modelling the cost of diseases attributable to job strain in France

ObjectivesTo estimate the annual costs of coronary heart diseases (CHD) and mental disorders (MD) attributable to job strain exposure according to Karasek’s model in France for the year 2003 from...

Datapoints: U.S. out-of-pocket health care expenses for mental disorders, 1996-2011.

M disorders, characterized by sustained, abnormal changes in mood, thinking, or behavior associated with impaired functioning, contribute substantially to disability in developed countries. In 2004, approximately one in four U.S. adults reported having a mental disorder (1), and the annual economic cost in 2003 was about $300 billion (2). We tracked total per-capita and outof-pocket outpatient health care expenses for mental disorders in the privately insured population under age 65 from 1996 to 2011 using data from the Medical Expenditure Panel Survey, a nationally representative sample of the U.S. civilian noninstitutionalized population. Annual total health care expenses for mental disorders are defined as the sum of direct payments for outpatient services provided for mental disorder “events” (ICD-9 codes 290–319). Types of services include hospital outpatient care, emergency room services, and office-based services and prescriptions from medical providers. Expenses were converted to 2011 dollars. For 1996–2011, mean annual total per-capita expenses for mental disorders were $1,156 (95% confidence interval [CI]5$1,114–$1,198), with outof-pocket expenses of $338 (CI5$321– $355) accounting for 29.2% of the total. Despite some year-to-year variations, the per-capita amount showed an increasing trend from 1996 ($961, CI5 $850–$1,071) to 2009 ($1,323, CI5 $1,172–$1,474) (Figure 1). After 2009, a two-year continuous decrease was noted—to $1,119 (CI5$969–$1,269) in 2011. Annual out-of-pocket expenses first decreased from $377 (CI5$298– $456) in 1996 to $291 (CI5$234–$348) in 1999 and then increased to the baseline level in 2003. The amount then decreased continuously to $275 (CI5$244–$307) in 2011. Thus, the out-of-pocket proportion of the total steadily decreased from 39.2% in 1996 to 24.6% in 2011. Whereas the overall health care cost of mental disorders remains substantial, out-of-pocket expenses have decreased to some extent during the past decade.

The annual costs of cardiovascular diseases and mental disorders attributable to job strain in France.

BackgroundWork stress has become a major occupational risk factor in industrialized countries and an important economic issue. The objective was to estimate the annual costs of coronary heart diseases (CHD) and mental disorders (MD) attributable to job strain exposure according to Karasek’s model in France for the year 2003 from a societal perspective.MethodsWe produced attributable fraction estimates which were applied to the number of cases (morbidity and mortality) and the costs of CHD and MD. Relative risk estimates came from a systematic literature review of prospective studies. We conducted meta-analyses based on this selection of studies. Prevalence of exposure to job strain came from the national SUMER survey conducted in France in 2003. Costs included direct medical costs and indirect costs: production losses due to sick leaves and premature deaths.ResultsBetween 8.8 and 10.2% of CHD morbidity was attributable to job strain, and between 9.4 and 11.2% of CHD mortality was attributable to this exposure for men. Between 15.2 and 19.8% of MD was attributable to job strain for men, and between 14.3 and 27.1% for women. As a whole, between 450 000 and 590 000 cases of diseases and 910–1130 deaths were attributable to job strain for men. From 730 000 to 1 380 000 cases of diseases and from 150 to 280 deaths were attributable to job strain for women. The total number of sick leave days amounted from 5 to 6.6 million days for men, and from 8.5 to 16 million days for women. The total costs of CHD and MD attributable to job strain exposure ranged from 1.8 to 3 billion euros for the year 2003 (0.12-0.19% GDP). Medical costs accounted for 11% of the total costs, value of life costs accounted for 13-15% and sick leave costs for 74-77%. The cost of CHD was estimated at 113–133 million euros and the cost of MD was between 1.7 - 2.8 billion euros in 2003.ConclusionThis study on the economic burden of diseases attributable to job strain in France provides relevant insights for policy-makers when defining public health priorities for prevention policies.

Epidemiology meets health economy: occurrence and costs of mental disorders in old age - results from large population-based and primary-care based cohorts in Germany

Epidemiology meets health economy: occurrence and costs of mental disorders in old age - results from large population-based and primary-care based cohorts in Germany

Work characteristics, anxiety and depression

In addition to serious human suffering, mental disorders result in work impairment.1 2 The costs of mental disorders, particularly depression, to employers in terms of lost work days and reduced...

Healthcare costs of intellectual disability in the Netherlands: a cost-of-illness perspective.

Healthcare costs are continuously increasing, and impose a strong responsibility on governments for an adequate allocation of resources among healthcare provisions and patients. The aims of the present study were to describe the healthcare costs of intellectual disability (ID) and other mental disorders in the context of the total costs of all other diseases, and to determinate the future need of healthcare resources, especially for ID and mental disorders. The present authors performed a top-down cost-of-illness study comprising all healthcare costs of the Netherlands in 1994. Data on healthcare use were obtained for all 22 healthcare sectors, and used to ascribe costs to disease groups, age and sex. Costs of mental disorders are by far the largest in the Dutch healthcare system. Some 25.8% of total disease-specific costs could be ascribed to mental disorders: psychiatric conditions, 10.6%; ID, 9.0%; and dementia, 6.2%. There are large differences between age and sex groups. The costs of ID and schizophrenia are higher among men, and the costs of dementia and depression are higher among women. The age pattern shows two peaks: the first occurs at 25-35 years of age (ID and psychiatric conditions); and the second at 75-85 years of age (dementia). Time trends between 1988 and 1994 show an average annual growth rate of 5.2% for total healthcare costs: psychiatric conditions, 4.8%; ID, 5.4%; and dementia, 9.4%. Demographic projections suggest a less-than-average cost increase for ID and psychiatric disorders (with annual growth rates of 0.2% and 0.4%, respectively) compared to the costs of dementia and total healthcare (with annual growth rates of 1.6% and 0.9%, respectively). Intellectual disability and mental disorders represent a large part of healthcare use in the Netherlands. The costs will inevitably increase because of the ageing of the population and increasing life expectancy among people with disabilities. Non-specific cost containment measures may endanger the quality of care for vulnerable people at younger and older ages.

Cost of diseases in international perspective

This study compares the health care costs of The Netherlands with the United States and Sweden and estimates the impact of demographic change on costs. Total health care costs were allocated to disease, age, sex and specific subsectors. For The Netherlands 75% of the costs in 1988 were assigned to specific diseases. Costs of mental disorders and other chronic non-fatal diseases dominate, followed by cardiovascular diseases. The effect of age is strong from age 70 years onwards. The effect of sex, adjusting for age, is small, except for elderly women, who are more expensive. Both total and disease-specific costs are similar in The Netherlands and Sweden, but differ from those in the US. The available data suggest that the differences in medical practice and health care systems may explain a substantial part of the divergent results; demographic or epidemiologic aspects seem less important. Ageing induces, in the Dutch case, a modest 0.7% annual increase in costs. The contribution of other forces in the increase of costs is probably more important. A structural upward pressure on costs also prevails in The Netherlands and Sweden, but it is more prominent in the US, due to a large amount of expensive surgery and high administration costs.