Fwd: [psychiatry-research] Treatment for depression reduces use of non-routine medical services

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FOR RELEASE: 29 FEBRUARY 2000 AT 00:00 ET US

Center for the Advancement of Health

http://www.cfah.org/

Treatment for depression reduces use of non-routine medical services

Individuals who have been treated for depression reduce their use of

non-routine medical services in the long term, although these

individuals

still use more outpatient medical services than do similar individuals

in

their communities, according to the results of a new 10-year analysis

involving more than 600 people.

The study looked at the relationship between depression and non-routine

outpatient medical utilization in adults who had been treated for

depressive

disorders, compared to a similar group of adults in the same

communities who

had not been treated. Non-routine medical utilization refers to the use

of

medical services beyond regularly scheduled physicals, preventive care,

and

disease monitoring. Study participants in the patient group had been

treated

for depression at a public hospital, a health maintenance organization,

a

university medical center, or a Veterans Affairs Medical Center.

Information was obtained from each study participant about depressive

symptoms they experienced and their use of non-routine outpatient

medical

services in the year before entering the study, and again at one, four,

and

10 years after entry into the study.

" The depressed patients had very different patterns of both depressive

symptoms and medical utilization than the general population over the 10

years, " said Kimerling, PhD, one of the authors of the study.

The patient group reported more non-routine physician visits than did

the

community group at all points over the 10 years, even when age, sex,

marital

status, and medical conditions were considered. Among both patients and

the

community group, more severe depressive symptoms were linked to greater

medical utilization.

The community group's rate of non-routine medical service utilization

was

very low and remained stable at all follow-ups. The patients' rate was

far

higher and did not change until the four-year follow-up, when it

declined

significantly, and then remained unchanged at the 10-year mark. The

study

results are published in the current issue of the ls of Behavioral

Medicine.

As expected, the community group reported low levels of depressive

symptoms

that did not change significantly over time. In contrast, over the

10-year

study period the patient group reported significant decreases in

depressive

symptoms, but not to the levels reported by the community group. This

finding

suggests that a large proportion of people seeking treatment for

depression

experience chronic problems with depression.

" Although treatment of mental health problems, such as depression,

seems to

be associated with a long term reduction in excess medical utilization,

our

study results suggest that treatment for psychological symptoms and

disorders

cannot be considered independently of other areas of medical care, " said

Kimerling. " We suggest that, as both medical and mental health care

systems

increasingly recognize the interconnections between physical and mental

health, associations between mental health interventions and medical

costs

and utilization may become more apparent. "

The research was conducted by scientists in the Veterans Affairs Palo

Alto

Health Care System and Stanford University School of Medicine, with

support

from the U.S. Department of Veterans Affairs Health Services Research

and

Development Service and the National Institute of Mental Health. Dr.

Kimerling is now at the University of California, San Francisco School

of

Medicine.