by Becky Ham
Annual costs of general, non-psychiatric medical care for people with persistent anxiety or depressed mood are 70 percent higher than for other patients, according to new research.
Among 10,084 HMO patients, average annual medical costs ranged from $2,272 for those with no psychiatric symptoms to $3,868 for those with four to five symptoms, say Enid M. Hunkeler, M.A., of Kaiser Permanente Northern California's Division of Research, William D. Spector, Ph.D., of the Agency for Healthcare Research and Quality and colleagues.
Symptoms among the patients included brief and persistent anxiety, panic attacks, depressed mood and trouble controlling violent behavior, according to the study, which appears in the May issue of General Hospital Psychiatry.
"The probability of receiving general medical care was greater for persons reporting each of the psychiatric symptoms except panic attacks. The likelihood of receiving medical care increased with an increasing number of psychiatric symptoms," Hunkeler and colleagues say.
"These effects tend to be additive, so that patients with depressed mood, persistent anxiety and widespread impairment have roughly twice the medical care costs of patients without these symptoms or impairments," they add.
Patients who had psychiatric problems that disrupted their home, work or social lives were also more likely to use medical care, according to the researchers.
Hunkeler, Spector and colleagues conducted a telephone survey of a random sample of health plan members of the Kaiser Permanente Northern California HMO, asking participants about a variety of psychiatric symptoms. These data were compared with HMO records on medical care visits and costs for the patients, excluding those related to specialty mental health.
Nearly a quarter of the patients surveyed reported having one or more symptoms of a psychiatric condition, most often brief anxiety or trouble controlling violent behavior. Almost five percent said that the symptoms affected their functioning at work, home or in social situations.
There may be several reasons why patients with psychiatric problems incur greater medical care costs, according to Hunkeler and colleagues. A panic attack may mimic medical conditions like heart trouble, they say, sending patients to the emergency room. Patients with psychiatric problems may also be more worried about their health or have more trouble caring for themselves.
"Psychiatric disorders may also complicate the course of other chronic diseases," say the researchers, noting that coronary artery disease and arthritis are among the conditions known to be aggravated by depression.
The study was supported by the Kaiser Permanente Medical Care Program, Dupont Merck Pharmaceutical Company and Eli Lilly and Company.
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