The prevalence and economic burden of treatment-resistant depression in Thailand

BMC Public Health

Research

Jirada Prasartpornsirichoke¹  Nuttorn Pityaratstian²  Teerayuth Rungnirundorn²  Naphat Sirinimnualkul³  Sasitorn Phonsit⁴  Nimmavadee Hiranwattana⁵  Tanaporn Ormtavesub⁵  Chayanit Poolvoralaks⁶ 

[1] Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, 1873 Rama IV Road, Pathumwan, 10330, Bangkok, Thailand;Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, 1873 Rama IV Road, Pathumwan, 10330, Bangkok, Thailand;Department of Psychiatry, King Chulalongkorn Memorial Hospital, Bangkok, Thailand;Department of Psychiatry, King Chulalongkorn Memorial Hospital, Bangkok, Thailand;Excellence Center for Sleep Disorders, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand;Department of Psychology, Faculty of Social Sciences, Kasetsart University, Bangkok, Thailand;Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand;Faculty of Psychology, University College London, London, UK;

关键词: Major Depressive Disorder (MDD);    Economic costs of an illness;    Treatment-resistant depression (TRD);    Direct medical costs;    Intangible costs;    Productivity loss, Fail-to-treat;    Antidepressants;    Unpaid caregivers;   

DOI  :  10.1186/s12889-023-16477-y

 received in 2022-11-30, accepted in 2023-08-08,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThe objectives of this study were to investigate the proportion of treatment-resistant depression (TRD) among patients with diagnosed major depressive disorder (MDD) and undergoing antidepressant treatment, to estimate the economic cost of MDD, TRD, and non-treatment-resistant depression (non-TRD), and to examine the differences between TRD and non-TRD MDD in a Thai public tertiary hospital.MethodsThis was a combined study between retrospective review of medical records and a cross-sectional survey. The sample size was 500 dyads of antidepressant-treated MDD patients and their unpaid caregivers. MDD patients’ medical records, the concept of healthcare resource utilization, the Work Productivity and Activity Impairment Questionnaire: depression and mood & mental state versions (WPAI: D, MM), the Class Impairment Questionnaire (CIQ), and the Family Experiences Interview Schedule (FEIS) were applied as the tools of the study. Pearson Chi’s square, Fisher’s Exact test, and independent T-test were employed for statistical analysis.ResultsThe proportion of TRD was 19.6% among antidepressant-treated MDD patients in a Thai tertiary public hospital. The results of the study indicated that several factors showed a statistically significant association with TRD criteria. These factors included younger age of MDD patients, a younger age of onset of MDD, lower body mass index (BMI), a history of suicide attempts and self-harm, as well as frequent smoking behavior. The annualized economic cost of TRD was 276,059.97 baht per person ($7,668.33), which was significantly higher than that of cost of non-TRD (173,487.04 baht or $4,819.08). The aggregated economic costs of MDD were 96.8 million baht annually ($2.69 M) if calculated from 500 MDD patients and unpaid caregivers. This contributed to the economic cost of TRD 27.05 million baht (98 respondents) and the economic cost of non-TRD 69.74 million baht (402 respondents).ConclusionsThe economic burden associated with TRD was significantly higher compared to non-TRD among antidepressant-treated MDD patients. Specifically, both direct medical costs and indirect costs were notably elevated in the TRD group.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

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Fig. 2