Humanistic and Economic Burden of Depression in the United States (US)

Objective: This study determined differences in outcomes among respondents with and without a depression diagnosis and across symptom severity in respondents with diagnosed depression.

Methods: Data for respondents 18-64 obtained from the self-administered 2017 US National Health and Wellness Survey were analyzed. Respondents with (n=8,853) and without (n=30,478) depression were compared. Respondents with depression were further examined across depression severity based on Patient Health Questionnaire-9 (n=1,876 non/minimal, n=2,801 mild, n=1,938 moderate, n=1,376 moderately severe, n=862 severe). Multivariable models assessed outcomes as a function of depression status and severity.

Results: Respondents with depression were more likely to be female, non-Hispanic White, unemployed, and have more comorbidities than respondents without depression. After adjustments, respondents with depression had lower mental (38.8 vs. 51.8), physical (52.2 vs. 52.8), SF-6D (0.67 vs. 0.78) and EQ-5D (0.79 vs 0.89) scores than respondents without depression (all p<0.001). Respondents with depression reported more absenteeism (4.8% vs. 1.8%), presenteeism (20.1% vs. 9.1%), and overall work impairment (22.1% vs. 9.9%) when employed than respondents without depression (all p<0.001). Respondents with depression reported greater activity impairment (24.9% vs. 11.9%), number of provider visits (3.6 vs. 2.4), emergency room visits (0.14 vs. 0.09) and hospitalizations (0.08 vs. 0.04) than respondents without depression (all p<0.001). As severity increased, quality of life (QoL) scores decreased and work impairment, activity impairment, provider visits, emergency room visits, and hospitalizations increased.

Conclusions: Respondents with depression reported lower QoL, greater work and activity impairment, and resource utilization than respondents without depression. The burden of depression increased with severity.