Association of mental distress with health care utilization and costs: a 5-year observation in a general population

Soc Psychiatry Psychiatr Epidemiol. 2009 Oct;44(10):835-44. doi: 10.1007/s00127-009-0005-9. Epub 2009 Feb 27.


Objective: Previous studies have associated mental distress and disorders with increased health care utilization and costs. However, most studies have selected subjects from treatment facilities or have applied retrospective designs.

Methods: N = 3,300 subjects from the baseline cohort of the Study of Health in Pomerania were followed up 5 years later. Mental distress was assessed with the SF-12 Health Survey and the Composite Diagnostic Screener for mental disorders. Two-part econometric models were applied adjusting for medical confounders and baseline services use.

Results: At 5-year follow-up somatization at baseline predicted an increase of inpatient (+39.9%) and outpatient costs (+11.9%). Depression predicted an increase of inpatient (+24.1%) and outpatient costs (+8.9%). Comorbidity of somatization and depression and somatization and anxiety predicted an increase in overall health care costs of > or =50%.

Conclusion: Simple and time-efficient screening procedures for mental disorders may help to identify subjects at risk for increased future health care utilization. Standardized therapeutic interventions should be evaluated in subjects at risk in primary care.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Comorbidity
  • Continuity of Patient Care / economics
  • Depressive Disorder / economics
  • Depressive Disorder / epidemiology
  • Female
  • Health Care Costs / statistics & numerical data*
  • Health Status
  • Health Surveys
  • Humans
  • Longitudinal Studies
  • Male
  • Mass Screening / methods
  • Mental Disorders / economics*
  • Mental Disorders / epidemiology*
  • Middle Aged
  • Models, Econometric
  • Patient Acceptance of Health Care
  • Primary Health Care / economics
  • Primary Health Care / methods
  • Primary Health Care / statistics & numerical data*
  • Risk Assessment
  • Somatoform Disorders / economics
  • Somatoform Disorders / epidemiology
  • Surveys and Questionnaires