# Quotes

Here are some quotes from Pincus and Pettit1 that underscore the importance of depression as a cause.

The annual cost of depression in the United States has been estimated at $43.7 billion to$52.9 billion, including costs due to health care, suicide, and workplace losses. The impact of depression on the overall health care system is enormous, including $12.4 billion in direct medical, psychiatric, and pharmaceutical costs. The overall medical costs of the average person with depression are approximately twice as high as those of the average person without depression. On average, depressed patients utilize health care services 3 times more frequently and visit the emergency room 7 times more often. Workplace costs related to absenteeism and reduced productivity have been estimated at$23.8 billion. In a recent survey, approximately 80% of employers reported de- pression as a problem in their work settings, with 40% identifying the problem as moderate or large. Depressed employees incur more disability days than patients with chronic back pain, heart disease, other mental disorders, hypertension, or diabetes. The tremendous negative impact of depression suggests that proper diagnosis and effective treatment are critically needed.

(from page 6)

Note that suicide alone “results in an estimated $12.4 billion in lost productivity and wages per year” (page 6). Here are some quotes from Donohue and Pincus2: • From the abstract (page 7–8): We examined the impact of depression on two of the primary drivers of the societal burden of depression: healthcare utilisation and worker productivity. Depression leads to higher healthcare utilisation and spending, most of which is not the result of depression treatment costs. Depression is also a leading cause of absenteeism and reduced productivity at work. It is clear that the economic burden of depression is substantial; however, critical gaps in the literature remain and need to be addressed. For instance, we do not know the economic burden of untreated and/or inappropriately treated versus appropriately treated depression. • Citing Greenberg et al.: “Total economic costs of depression totalled$US83.1 billion in 2000, up from $US77.4 billion in 1990.” (page 12) The authors note that this should be treated as a lower bound. It is worth noting that for both years, most of the cost was due to workplace-related issues (absenteeism and presenteeism). • The paper also notes a lower estimate ($US31 million for productivity costs; Greenberg et al. estimate this to be \$US52 billion) by Stewart et al. A number of methodological differences are listed that account for this difference. (page 13)