Benson Carmela, Singer David, Carpinella Colleen M, Shawi May, Alphs Larry
Real-World Value & Evidence, Janssen Scientific Affairs, LLC, Titusville, NJ, USA.
Jefferson College of Population Health, Thomas Jefferson University, Philadelphia, PA, USA.
Neuropsychiatr Dis Treat. 2021 Jan 18;17:111-123. doi: 10.2147/NDT.S229530. eCollection 2021.
Suicidal ideation (SI) is a cardinal aspect of major depressive disorder (MDD); however, patient-reported outcomes data from large-scale surveys are limited concerning SI in the context of MDD. This study aims to understand the association between varying levels of SI and health-related quality of life (HRQoL), work productivity, healthcare resource utilization (HRU), and associated costs in patients with moderately severe/severe MDD.
This was a retrospective, cross-sectional analysis of 2013 national survey data. Patients who self-reported moderately severe or severe MDD and completed the Short Form Survey Version 2 (SF-36v2), Work Productivity Loss and Activity Impairment questionnaire (WPAI), and questions related to HRU were analyzed. Direct and indirect costs were calculated. Patients were categorized and analyzed by the level of SI (no SI, low, moderate, and high) based on their response to Item 9 of the Patient Health Questionnaire-9.
Among 75,000 respondents, 15.3% self-reported receiving a physician diagnosis of moderately severe or severe MDD and 2.8% of the total sample endorsed some level of SI. Patients with high SI showed a higher burden than patients with no SI, reporting lower mean SF-36v2 mental component summary scores (<0.001), higher work productivity loss (=0.039), and higher numbers of per patient per month hospitalizations (=0.002) and emergency room visits (=0.011). High SI was associated with greater per patient per month direct costs ($1220 vs $796; =0.002) and indirect costs ($1449 vs $1058; =0.001) compared with no SI. When patients with low or moderate SI were compared with patients with no SI, the results were mixed.
Higher levels of SI were associated with lower HRQoL, greater HRU, and more work impairment resulting in higher direct and indirect costs compared with patients with MDD but no SI. These results highlight the need to implement effective treatment models and interventions in the employed population.
自杀观念（SI）是重度抑郁症（MDD）的一个主要方面；然而，来自大规模调查的患者报告结局数据在MDD背景下关于SI的内容有限。本研究旨在了解中度严重/重度MDD患者中不同程度的SI与健康相关生活质量（HRQoL）、工作生产力、医疗资源利用（HRU）以及相关成本之间的关联。
这是一项对2013年全国调查数据的回顾性横断面分析。对自我报告有中度严重或重度MDD并完成简式调查第2版（SF - 36v2）、工作生产力损失和活动障碍问卷（WPAI）以及与HRU相关问题的患者进行分析。计算直接和间接成本。根据患者对患者健康问卷 - 9第9项的回答，按SI水平（无SI、低、中、高）对患者进行分类和分析。
在75000名受访者中，15.3%自我报告接受过医生诊断为中度严重或重度MDD，占总样本的2.8%认可某种程度的SI。高SI患者比无SI患者负担更重，报告的平均SF - 36v2心理成分总结得分更低（<0.001），工作生产力损失更高（=0.039），每位患者每月住院次数更多（=0.002）以及急诊就诊次数更多（=0.011）。与无SI相比，高SI与每位患者每月更高的直接成本（1220美元对796美元；=0.002）和间接成本（1449美元对1058美元；=0.001）相关。当将低或中度SI患者与无SI患者进行比较时，结果不一。
与无SI的MDD患者相比，较高水平的SI与较低的HRQoL、更高的HRU以及更多的工作障碍相关，导致更高的直接和间接成本。这些结果凸显了在就业人群中实施有效治疗模式和干预措施的必要性。
