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Cited by 1,280Mental Health Treatment and AccessHealth Systems, Economic Evaluations, Quality of LifeTreatment of Major Depression

The Economic Burden of Depression in the United States: How Did It Change Between 1990 and 2000?

Greenberg, Paul E., Kessler, Ronald C., Birnbaum, Howard G., Leong, Stephanie A., Lowe, Sarah W., Berglund, Patricia A., Corey-Lisle, Patricia K.·2003·The Journal of Clinical Psychiatry
DOI 10.4088/jcp.v64n1211
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Abstract

BACKGROUND: The economic burden of depression was estimated to be 43.7 billion dollars in 1990. A subsequent study reported a cost burden of 52.9 billion dollars using revised prevalence data and a refined workplace cost estimation approach. The objective of the current report is to provide a 10-year update of these estimates using the same methodological framework. METHOD: Using a human capital approach, we developed prevalence-based estimates of 3 major cost categories: (1) direct costs, (2) mortality costs arising from depression-related suicides, and (3) costs associated with depression in the workplace. Cost-of-illness estimates from 1990 were updated to reflect the experience in 2000 using current epidemiologic data and publicly available population, wage, and cost information. RESULTS: Whereas the treatment rate of depression increased by over 50%, its economic burden rose by only 7%, going from 77.4 billion dollars in 1990 (inflation-adjusted dollars) to 83.1 billion dollars in 2000. Of the 2000 total, 26.1 billion dollars (31%) were direct medical costs, 5.4 billion dollars (7%) were suicide-related mortality costs, and 51.5 billion dollars (62%) were workplace costs. CONCLUSION: The economic burden of depression remained relatively stable between 1990 and 2000, despite a dramatic increase in the proportion of depression sufferers who received treatment. Future research will incorporate additional costs associated with depression sufferers, including the excess costs of their coexisting psychiatric and medical conditions and attention to the role of painful conditions as a driver of these costs.

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  • Major depressive disorder is associated with among the highest number of days out of role at the societal level of any physical or mental disorder; in the WMH surveys, it accounted for 5.1% of all days out of role, the fourth highest population attributable risk proportion and by far the largest among mental disorders.

    “These studies typically find that MDD is associated with among the highest number of days out of role at the societal level of any physical or mental disorder due to its combination of comparatively high prevalence and comparatively strong individual-level association.60–62 In the WMH surveys, for example, 62,971 respondents across 24 countries were assessed for a wide range of common physical and”

    From The Costs of Depression (2012) · cites this paper as [63]

  • A meta-review reported an almost twenty-fold risk of suicide for persons with depression with a standardized mortality ratio (SMR) of 19·7%.

    “A meta-review 202 reported an almost twenty-fold risk of suicide for persons with depression with a standardized mortality ratio (SMR) of 19·7%.”

    From Time for united action on depression: a Lancet–World Psychiatric Association Commission (2022) · cites this paper as [202]

  • Workplace impairment may contribute to more than 60% of the major depressive disorder-related economic burden.

    “Importantly, it has been suggested that workplace impairment may contribute to more than 60 % of the MDD-related economic burden [47].”

    From Cognitive remission: a novel objective for the treatment of major depression? (2016) · cites this paper as [47]

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Authors
Greenberg, P. E., Kessler, R. C., Birnbaum, H. G., Leong, S. A., Lowe, S. W., Berglund, P. A., & Corey-Lisle, P. K.
Affiliations
  • Analysis Group (United States) (US)
  • Harvard University (US)
  • University of Michigan (US)
ORCID
Venue
The Journal of Clinical Psychiatry
Publisher
Physicians Postgraduate Press, Inc
Published
2003-12-15
Volume
64
Issue
12
Pages
1465-1475
ISSN
0160-6689 (ISSN-L)
DOI
10.4088/jcp.v64n1211
OpenAlex
W2011003051
Cited by
1,280
References
6
Citations by year
2026: 5 · 2025: 10 · 2024: 15 · 2023: 26 · 2022: 33 · 2021: 22 · 2020: 31 · 2019: 42 · 2018: 53 · 2017: 74 · 2016: 76 · 2015: 76 · 2014: 94 · 2013: 94 · 2012: 102
FWCI
53.83
Type
journal article
Language
en
Open access
closed
Locations
  • The Journal of Clinical Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
Keywords
depression, economic burden, direct medical costs, human capital approach, treatment rates
MeSH terms
Costs and Cost Analysis, Cross-Sectional Studies, Depressive Disorder, Health Expenditures, Forecasting, Humans, Suicide, United States, Workplace, Cost of Illness

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