美国成人双相情感障碍的经济和人文负担。

IF 3.6 3区 医学 Q1 PSYCHIATRY Annals of General Psychiatry Pub Date : 2023-03-24 DOI:10.1186/s12991-023-00440-7
Carole Dembek, deMauri Mackie, Kushal Modi, Yingying Zhu, Xiaoli Niu, Todd Grinnell
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引用次数: 1

摘要

背景:双相情感障碍与功能障碍和健康相关生活质量(HRQoL)下降有关。本研究的目的是估计双相情感障碍患者每年的直接医疗成本、间接成本和HRQoL,根据抑郁症状的严重程度和总体与美国普通人群进行比较。方法:这项横断面研究使用了2020年美国国家健康与健康调查的自我报告数据。在过去12个月内报告双相情感障碍症状和/或诊断为双相情感障碍的成年受访者被确定(双相情感障碍队列),并根据患者健康问卷(PHQ-9)评分进一步按抑郁症状严重程度分类(无/轻度= 0-9,中度= 10-14,重度= 15-27)。年度直接医疗成本和间接成本分别根据6个月的医疗资源利用率和工作生产率计算。一般人群队列采用2:1倾向评分匹配。过去6个月的全因住院、年化直接医疗费用、年化间接医疗费用和HRQoL(如EuroQol 5维健康问卷(EQ-5D))的多因素回归模型控制了混杂因素(人口统计学和临床特征)。结果:在3583名符合预先规定的双相情感障碍标准的成年人中,1401名(39.1%)报告无/轻度抑郁症状,889名(24.8%)报告中度抑郁症状,1293名(36.1%)报告重度抑郁症状严重程度。此外,3285例(91.7%)与普通人群中的6570例成年人相匹配。与一般人群相比,双相情感障碍队列的调整后平均住院率(0.53比0.30)、每位患者年化直接医疗成本(20,846美元对11,391美元)和间接成本(14,795美元对9274美元)显著高于一般人群(所有p结论:在双相情感障碍的受访者中,中度至重度抑郁症患者的直接医疗成本和间接成本更高,HRQoL比轻度或无抑郁症状的患者更差。以减轻抑郁症状为目标的治疗可以减轻双相情感障碍的经济和人文负担。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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The economic and humanistic burden of bipolar disorder in adults in the United States.

Background: Bipolar disorder is associated with functional impairment and diminished health-related quality of life (HRQoL). The purpose of this study was to estimate the annual per patient direct healthcare costs, indirect costs, and HRQoL of patients with bipolar disorder by depressive symptom severity and overall compared to the general population in the US.

Methods: This cross-sectional study used self-reported data from the 2020 US National Health and Wellness Survey. Adult respondents who reported bipolar disorder symptoms in the past 12 months and/or a diagnosis of bipolar disorder were identified (bipolar disorder cohort) and were further classified by depressive symptom severity based on Patient Health Questionnaire (PHQ-9) scores (none/mild = 0-9, moderate = 10-14, severe = 15-27). Annualized direct healthcare costs and indirect costs were calculated from 6-month healthcare resource utilization and work productivity, respectively. A general population cohort was constructed using 2:1 propensity score matching. Multivariate regression models of all-cause hospitalizations in the past 6 months, annualized direct healthcare costs, annualized indirect costs, and HRQoL (eg, EuroQol 5-Dimension Health Questionnaire (EQ-5D)) controlled for confounders (demographic and clinical characteristics).

Results: Of 3583 adults meeting pre-specified criteria for bipolar disorder, 1401 (39.1%) reported none/mild, 889 (24.8%) moderate, and 1293 (36.1%) severe depressive symptom severity. Additionally, 3285 (91.7%) were matched to 6570 adults in the general population. Compared to the general population, adjusted mean hospitalizations (0.53 vs. 0.30), annualized per patient direct healthcare costs ($20,846 vs. $11,391), and indirect costs ($14,795 vs. $9274) were significantly greater for the bipolar disorder cohort (all p < 0.001); adjusted HRQoL (EQ-5D: 0.69 vs. 0.79) was significantly worse (p < 0.001). By depressive symptom severity, adjusted mean hospitalizations (none/mild = 0.30, moderate = 0.50, severe = 0.46), direct healthcare costs ($14,389, $22,302, $21,341), and indirect costs ($10,799, $17,109, $18,470) were significantly greater for moderate and severe compared to none/mild depressive symptom severity (all p < 0.01); adjusted HRQoL (EQ-5D: 0.77, 0.67, 0.59) was significantly worse (p < 0.001).

Conclusions: Among respondents with bipolar disorder, those with moderate to severe depression had greater direct healthcare costs and indirect costs as well as worse HRQoL than those with mild or no depressive symptoms. Treatment targeting reduction in depressive symptoms may reduce the economic and humanistic burden of bipolar disorder.

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来源期刊
CiteScore
6.60
自引率
2.70%
发文量
43
审稿时长
>12 weeks
期刊介绍: Annals of General Psychiatry considers manuscripts on all aspects of psychiatry, including neuroscience and psychological medicine. Both basic and clinical neuroscience contributions are encouraged. Annals of General Psychiatry emphasizes a biopsychosocial approach to illness and health and strongly supports and follows the principles of evidence-based medicine. As an open access journal, Annals of General Psychiatry facilitates the worldwide distribution of high quality psychiatry and mental health research. The journal considers submissions on a wide range of topics including, but not limited to, psychopharmacology, forensic psychiatry, psychotic disorders, psychiatric genetics, and mood and anxiety disorders.
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