Direct costs associated with depressive symptoms in late life – A 4.5-year prospective study

Abstract Aims Late-life depression has substantial impacts on individuals, families and society. Knowledge gaps remain in estimating the economic impacts associated with late-life depression by symptom severity, which has implications for resource prioritisation and research design (such as in modelling). This study examined the incremental health and social care expenditure of depressive symptoms by severity. Methods We analysed data collected from 2707 older adults aged 60 years and over in Hong Kong. The Patient Health Questionnaire-9 (PHQ-9) and the Client Service Receipt Inventory were used, respectively, to measure depressive symptoms and service utilisation as a basis for calculating care expenditure. Two-part models were used to estimate the incremental expenditure associated with symptom severity over 1 year. Results The average PHQ-9 score was 6.3 (standard deviation, s.d. = 4.0). The percentages of respondents with mild, moderate and moderately severe symptoms and non-depressed were 51.8%, 13.5%, 3.7% and 31.0%, respectively. Overall, the moderately severe group generated the largest average incremental expenditure (US$5886; 95% CI 1126–10 647 or a 272% increase), followed by the mild group (US$3849; 95% CI 2520–5177 or a 176% increase) and the moderate group (US$1843; 95% CI 854–2831, or 85% increase). Non-psychiatric healthcare was the main cost component in a mild symptom group, after controlling for other chronic conditions and covariates. The average incremental association between PHQ-9 score and overall care expenditure peaked at PHQ-9 score of 4 (US$691; 95% CI 444–939), then gradually fell to negative between scores of 12 (US$ - 35; 95% CI - 530 to 460) and 19 (US$ -171; 95% CI - 417 to 76) and soared to positive and rebounded at the score of 23 (US$601; 95% CI -1652 to 2854). Conclusions The association between depressive symptoms and care expenditure is stronger among older adults with mild and moderately severe symptoms. Older adults with the same symptom severity have different care utilisation and expenditure patterns. Non-psychiatric healthcare is the major cost element. These findings inform ways to optimise policy efforts to improve the financial sustainability of health and long-term care systems, including the involvement of primary care physicians and other geriatric healthcare providers in preventing and treating depression among older adults and related budgeting and accounting issues across services.

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High‐definition transcranial direct current stimulation—An open‐label pilot intervention in alleviating depressive symptoms and cognitive deficits in late‐life depression

CNS Neuroscience & Therapeutics ◽

10.1111/cns.13253 ◽

2019 ◽

Vol 25 (11) ◽

pp. 1244-1253 ◽

Cited By ~ 2

Author(s):

Hau‐lam Wong ◽

Wai Chi Chan ◽

Yiu‐lung Wong ◽

Sze‐nga Wong ◽

Hui‐yan Yung ◽

...

Keyword(s):

Depressive Symptoms ◽

Direct Current ◽

Cognitive Deficits ◽

Transcranial Direct Current Stimulation ◽

Late Life ◽

Late Life Depression ◽

High Definition ◽

Open Label ◽

Direct Current Stimulation ◽

Pilot Intervention

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Maternal stress and depressive symptoms and adolescents’ body mass index: a prospective study

BMC Public Health ◽

10.1186/s12889-021-10721-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Maaike Koning ◽

Jacqueline Vink ◽

Tommy L. S. Visscher ◽

Junilla Larsen

Keyword(s):

Mental Health ◽

Depressive Symptoms ◽

Prospective Study ◽

Perceived Stress ◽

Maternal Stress ◽

Maternal Mental Health ◽

Cross Sectional ◽

Domain Specific ◽

General Stress ◽

Adolescent Offspring

Abstract Background Growing evidence suggests that maternal mental health issues are associated with (young) children’s weight outcomes. However, most studies have been limited by cross-sectional designs and have been aimed at (younger) children. The current prospective study focuses on the link between maternal mental health (i.e., psychological stress and depressive symptoms) and adolescents’ zBMI development. Methods The participants in the present study were part of wave 1 and 2 of a longitudinal study on Dutch adolescents’ and their parents’ health behavior. Adolescents (aged 10–14) and their parents were recruited through six secondary schools in the South and the East of the Netherlands. For this study, we only included biological mothers and their adolescent children who participated in both waves, with data on the main measures in both waves, leaving a final sample of 336 biological mother-child dyads. Adolescents height and weight were measured, and both parents and adolescents filled in validated questionnaires on perceived stress and depressive symptoms and answered additional questions concerning domain-specific stress. Regression analyses were performed in R to examine longitudinal links between maternal stress and depressive symptoms at baseline (T1) and adolescents’ BMI standard deviation scores (zBMI) 6 months later (T2), corrected for baseline zBMI and covariates. Results Maternal general perceived stress (β = .20, p = .002) at T1 preceded higher adolescents’ zBMI at T2, after controlling for baseline zBMI and other covariates, whereas maternal depressive symptoms at T1 (β = −.05, p = .44) and other domain-specific stress did not (maternal financial stress, maternal stress at work, maternal stress at home). Additionally, lower educational level among adolescents (β = .16, p = .001) and adolescent depressive symptoms (β = .16, p = .001) was associated with a higher zBMI at T2. Conclusions Results suggest that maternal general stress, but not depressive symptoms, may influence adolescents’ weight development. Our findings warrant future investigation on whether and how general stress among mothers may predict weight increases of their adolescent offspring.

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