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Article Abstract

Online ISSN: 1099-176X    Print ISSN: 1091-4358
The Journal of Mental Health Policy and Economics
Volume 4, Issue 2, 2001. Pages: 91-100

Published Online: 20 Dec 2001

Copyright © 2001 ICMPE.

Comparing patients with depressive complaints and patients with chronic medical conditions on their functioning and medical consumption
Gerrit T. Koopmans* and  Leida M. Lamers
1Director, 1 Institute of Health Policy and Management, Erasmus Medical Centre, Erasmus University, Rotterdam, The Netherlands

*Gerrit T. Koopmans, P.O. Box 1738, 3000 DR
Rotterdam, The Netherlands;
Phone +31-10-408 8577
Fax +31-10-408 9094
Email: g.koopmans@bmg.eur.nl

Source of Funding: None declared.


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.

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).

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.

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.

Received 11 April 2001; accepted 25 September 2001