Treatment-resistant depression imposes high healthcare utilization

Patients suffering from treatment-resistant depression (TRD) have higher healthcare resource utilization (HRU) associated with psychiatric services, reports a recent study.

The study included 25,321 TRD patients who were matched with 50,638 non-TRD controls. All patients had their first hospital contact major depressive disorder (MDD) between 1996 and 2015. TRD was defined during the second shift in depression treatment. HRU was quantified using the Danish National Patient Register and the National Health Service Register.

Compared with controls, TRD patients saw a 138.4-percent higher risk of psychiatric hospitalization (95 percent confidence interval [CI], 128.3–149.0). Similarly, hospital bed days and emergency department visits were higher in the TRD group.

In terms of healthcare costs incurred, overall HRU expenditure was higher by 101.9 percent in TRD patients. Costs related to psychiatric services were higher by 55.2 percent in these patients, as opposed to non-TRD controls.

Similarly, costs for antipsychiatric medicines were up by 129.0 percent in TRD patients, while that for other psychiatric medicines increased by 25.2 percent. Costs for GP services were also up by 25.3 percent.

“Whereas the HRU and incurred costs increase with increasing depression severity in both TRD and non-TRD patients, the relative difference between TRD and non-TRD was largest for patients with mild depression and those diagnosed in the most recent years,” the researchers said.

“The specific causes of the increased acute hospitalizations and emergency department visits in TRD patients should be monitored in follow-up studies and investigated in more detail,” they added.