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Depressive symptoms predict medical care utilization in a population-based sample

Published online by Cambridge University Press:  15 August 2002

P. J. ROWAN ,
K. DAVIDSON ,
J. A. CAMPBELL ,
D. G. DOBREZ  and
D. R. MacLEAN
P. J. ROWAN
Affiliation:
Department of Psychology, University of Alabama, Tuscaloosa, Alabama and Mount Sinai School of Medicine, New York, NY, and Northwestern University, Chicago, IL, USA; and Nova Scotia Department of Health, Northwestern University and Dalhousie University, Nova Scotia, Canada
K. DAVIDSON
Affiliation:
Department of Psychology, University of Alabama, Tuscaloosa, Alabama and Mount Sinai School of Medicine, New York, NY, and Northwestern University, Chicago, IL, USA; and Nova Scotia Department of Health, Northwestern University and Dalhousie University, Nova Scotia, Canada
J. A. CAMPBELL
Affiliation:
Department of Psychology, University of Alabama, Tuscaloosa, Alabama and Mount Sinai School of Medicine, New York, NY, and Northwestern University, Chicago, IL, USA; and Nova Scotia Department of Health, Northwestern University and Dalhousie University, Nova Scotia, Canada
D. G. DOBREZ
Affiliation:
Department of Psychology, University of Alabama, Tuscaloosa, Alabama and Mount Sinai School of Medicine, New York, NY, and Northwestern University, Chicago, IL, USA; and Nova Scotia Department of Health, Northwestern University and Dalhousie University, Nova Scotia, Canada
D. R. MacLEAN
Affiliation:
Department of Psychology, University of Alabama, Tuscaloosa, Alabama and Mount Sinai School of Medicine, New York, NY, and Northwestern University, Chicago, IL, USA; and Nova Scotia Department of Health, Northwestern University and Dalhousie University, Nova Scotia, Canada
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Abstract

Background. Several examinations have detected a relation between depressive symptoms and medical utilization. However, selection biases have been involved in most previous examinations. We sought to test the association between depressive symptoms and prospective, increased medical care utilization, in a population-based Canadian sample, while controlling for utilization due to medical illness and controlling for selection bias.

Methods. Data from the Nova Scotia Health Survey 1995, an age- and sex-stratified random sampling of 3227 Nova Scotian adults, included the Center for Epidemiological Studies-Depression scale and items assessing chronic medical conditions and current limitations in daily activities resulting from medical illness. We linked survey data with medical care utilization measures for the year following the survey, including out-patient visits, reimbursement for out-patient services, hospitalizations, and hospitalization days.

Results. After controlling for age, sex, count of medical diagnoses and current medical severity, those with a greater level of depressive symptoms were at greater risk of having increased medical care utilization in the following year. These results remained after removing mental health care utilization costs.

Conclusions. In a population-based sample, depressive symptoms predicted greater medical care utilization, independent of a number of medical severity measures. Whether depressive symptoms are a risk marker or a causal risk factor for increased medical utilization remains to be explored.

Type
Research Article
Information
Psychological Medicine , Volume 32 , Issue 5 , July 2002 , pp. 903 - 908
Copyright
© 2002 Cambridge University Press

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Footnotes

Some of the data in this paper were presented at the National Conference on Health Statistics, held at Washington, DC, USA, from 2 to 4 August 1999.