Comparing patients with depressive complaints and patients with chronic medical conditions on their functioning and medical consumption

J Ment Health Policy Econ. 2001 Jun 1;4(2):91-100.


BACKGROUND: Several studies have found that depressive complaints are associated with limitations in functioning that are at least comparable with those of chronic medical conditions, such as diabetes or lung diseases. However, the consequences of these associations for the utilization of general health care services are not known, certainly not for health care settings outside the United States. AIMS OF THE STUDY: To investigate the association of depressive complaints with functioning and health care utilization, comparing this with the association of chronic medical conditions with functioning and health care utilization. METHODS: In a community-based sample of Dutch adults (N=9428), chronic conditions (21 types) and depressive complaints were assessed by self-report. Only active conditions and depressive complaints, for which treatment was taking place, were selected for the analyses. Health status and disabilities were also assessed by self-report. Information on the utilization of health care services was based on self-report as well as on data extracted from a claims database. This database also provided information on the use of psychoactive medications. The associations between chronic conditions, depressive complaints and dependent variables were determined by analysis of variance or regression analysis, adjusting for possibly confounding factors (gender, age, living conditions). RESULTS: Depressive complaints, more than any chronic condition (except back problems), were associated with fatigue, poor subjective health and days spent in bed. Those having depressive complaints visited their general practitioner (GP) more often than the others. They also contacted a medical specialist more often than other patient categories, apart from patients with heart diseases. The combination of depressive complaints and chronic medical conditions was not associated with increased utilization or lower functioning. CONCLUSION: Depressive complaints are not only connected to functioning, but also to the utilization of general health care services. The strength of these associations is comparable with that of chronic medical conditions. This study stresses the pertinence of (research on) the management and treatment of patients with depressive complaints in general health care settings.