Rice D P, Miller L S
Institute for Health & Aging, University of California, San Francisco 94143-0612, USA.
Br J Psychiatry Suppl. 1995 Apr(27):34-42.
This paper summarises the methods and sources of data used to estimate costs of affective disorders and presents the results.
A timing model employing regression analysis was developed to estimate morbidity costs. This model measures the lifetime effect on current income of individuals with affective disorders, taking into account the timing of onset and the duration of these disorders.
Affective disorders imposed an estimated US$ 20.8 billion burden in 1985 and US$ 30.4 billion in 1990 in the US. Affective disorders represent 21% of the costs of all mental illnesses. Direct treatment costs comprised 58.4% of the total in 1985; morbidity costs, 8.1%; mortality costs, the present value of future earnings lost due to premature mortality, 28.9%, based on a 6% discount rate; and other related costs, including the cost of crime, lost productivity due to incarceration, and caregiver services, 4.6%. Private sources account for 49% of the total direct expenditures for treatment of persons with affective disorders; state and local funds, 26%; and federal funds, 25%.
In light of the high burden of affective disorders on societal resources, more attention should be directed at comprehensive, research-based strategies to reduce the prevalence of these disorders in the United States.
本文总结了用于估算情感障碍成本的数据方法和来源，并呈现了结果。
开发了一种采用回归分析的时间模型来估算发病成本。该模型衡量情感障碍患者对当前收入的终生影响，同时考虑发病时间和这些障碍的持续时间。
1985年，情感障碍在美国造成的负担估计为208亿美元，1990年为304亿美元。情感障碍占所有精神疾病成本的21%。1985年，直接治疗成本占总成本的58.4%；发病成本占8.1%；死亡成本，即因过早死亡而损失的未来收益的现值，基于6%的贴现率计算占28.9%；其他相关成本，包括犯罪成本、因监禁导致的生产力损失以及护理服务成本，占4.6%。私人来源占情感障碍患者治疗直接总支出的49%；州和地方资金占26%；联邦资金占25%。
鉴于情感障碍对社会资源造成的沉重负担，应更加关注基于研究的综合策略，以降低美国这些障碍的患病率。
