Could health care costs for depression be decreased if the disorder were correctly diagnosed and treated?

Background The aim of the present study was to assess the general population from two Sardinian areas to ascertain the direct health care costs involved in a diagnosis of major depression, and to verify the hypothesis of an increased expenditure for untreated depressed subjects. Design A case-control study was carried out using the database of an epidemiological community survey. Cases were subjects with a diagnosis of Major Depressive Episode (ICD-10,WHO 1992) in the last year, and controls comprised two groups matched to cases for sex and age, made up of healthy subjects and subjects affected by chronic somatic disorders, respectively. Results Depressed subjects use more health care resources than those affected by chronic somatic disorders or healthy subjects. An increase in health care costs is observed for drugs and hospitalisations in depressed subjects for whom no adequate antidepressive treatment has been prescribed. Conclusions In spite of the limitations of the small sample size, the results seem to confirm an increase of direct health care costs in untreated depressed subjects. In view of the availability of efficient forms of treatment for depression, the findings obtained indicate that depression should be considered a priority question for public health and assigning of resources. Further confirmation should be sought in larger population-based studies representing the entire national context.