{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T06:40:08Z","timestamp":1785825608024,"version":"3.56.0"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,8,6]],"date-time":"2021-08-06T00:00:00Z","timestamp":1628208000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,8,6]],"date-time":"2021-08-06T00:00:00Z","timestamp":1628208000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100007723","name":"Takeda Pharmaceuticals U.S.A.","doi-asserted-by":"publisher","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}],"id":[{"id":"10.13039\/100007723","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Lundbeck LLC","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Health Serv Res"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>The estimated prevalence of comorbid major depressive disorder (.<\/jats:p>\n                <jats:p>MDD) is 11% in patients with type 2 diabetes (T2D) and 15\u201320% in those with cardiovascular disease (CVD). Comorbid MDD continues to be a significant source of economic burden to the healthcare system.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We assessed the incremental healthcare burden of comorbid MDD in patients with T2D or CVD. This real-world, retrospective, administrative claims study analyzed commercially insured adults with T2D or CVD diagnosed on at least 2 separate claims within 12\u2009months of each other (between January 1, 2011, and September 30, 2018). CVD included congestive heart failure, peripheral vascular disease, coronary heart disease, and cerebrovascular disease. The study compared patients with and without MDD with either T2D or CVD. Study assessments included all-cause healthcare resource utilization (proportion of patients with hospitalization, emergency department [ED] visits, and outpatient visits) and cost.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Patients were matched by propensity score for demographics and baseline characteristics, resulting in similar baseline characteristics for the respective subcohorts. After matching, 22,892 patients with T2D (11,446 each with and without MDD) and 28,298 patients with CVD (14,149 each with and without MDD) were included.<\/jats:p>\n                <jats:p>At follow-up, patients with T2D and MDD had significantly higher rates of hospitalization (26.1% vs 17.4%, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001) and ED visits (55.3% vs 43.0%, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001) than those observed in patients without MDD. The total cost for patients with T2D and MDD at follow-up was significantly higher than for those without MDD ($16,511 vs $11,550, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001). Similarly, at follow-up, patients with CVD and MDD had significantly higher rates of hospitalization (45.4% vs 34.1%, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001) and ED visits (66.5% vs 55.4%, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001) than those observed in patients without MDD. Total cost at follow-up for patients with CVD and MDD was significantly higher than for those without MDD ($25,546 vs $18,041, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Patients with either T2D or CVD and comorbid MDD have higher total all-cause healthcare utilization and cost than similar patients without MDD. Study findings reinforce the need for appropriate management of MDD in patients with these comorbid diseases, which in turn may result in cost reductions for payers.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Trial registration<\/jats:title>\n                <jats:p>Not applicable.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12913-021-06802-9","type":"journal-article","created":{"date-parts":[[2021,8,6]],"date-time":"2021-08-06T13:06:57Z","timestamp":1628255217000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Incremental burden of comorbid major depressive disorder in patients with type 2 diabetes or cardiovascular disease: a retrospective claims analysis"],"prefix":"10.1186","volume":"21","author":[{"given":"Anne","family":"Kangethe","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debra F.","family":"Lawrence","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3021-1197","authenticated-orcid":false,"given":"Ma\u00eblys","family":"Touya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lambros","family":"Chrones","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Polson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Themmi","family":"Evangelatos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,8,6]]},"reference":[{"key":"6802_CR1","volume-title":"Statistics: major depression","author":"National Institute of Mental Health","year":"2017","unstructured":"National Institute of Mental Health. Statistics: major depression 2017. https:\/\/www.nimh.nih.gov\/health\/statistics\/major-depression.shtml. Accessed 15 August 2019."},{"key":"6802_CR2","doi-asserted-by":"publisher","first-page":"216","DOI":"10.1016\/S0006-3223(03)00273-7","volume":"54","author":"WJ Katon","year":"2003","unstructured":"Katon WJ. Clinical and health services relationships between major depression, depressive symptoms, and general medical illness. Biol Psychiatry. 2003;54:216\u201326.","journal-title":"Biol Psychiatry"},{"key":"6802_CR3","doi-asserted-by":"publisher","first-page":"1365","DOI":"10.1093\/eurheartj\/eht462","volume":"35","author":"DL Hare","year":"2014","unstructured":"Hare DL, Toukhsati SR, Johansson P, Jaarsma T. Depression and cardiovascular disease: a clinical review. Eur Heart J. 2014;35:1365\u201372.","journal-title":"Eur Heart J"},{"key":"6802_CR4","doi-asserted-by":"publisher","first-page":"695925","DOI":"10.1155\/2013\/695925","volume":"2013","author":"JC Huffman","year":"2013","unstructured":"Huffman JC, Celano CM, Beach SR, Motiwala SR, Januzzi JL. Depression and cardiac disease: epidemiology, mechanisms, and diagnosis. Cardiovasc Psychiatry Neurol. 2013;2013:695925.","journal-title":"Cardiovasc Psychiatry Neurol"},{"key":"6802_CR5","doi-asserted-by":"publisher","first-page":"166","DOI":"10.1002\/wps.20309","volume":"15","author":"D Vancampfort","year":"2016","unstructured":"Vancampfort D, Correll CU, Galling B, Probst M, De Hert M, Ward PB, et al. Diabetes mellitus in people with schizophrenia, bipolar disorder and major depressive disorder: a systematic review and large scale meta-analysis. 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Circulation. 2019;139:e56\u2013e528.","journal-title":"Circulation."},{"key":"6802_CR8","doi-asserted-by":"publisher","first-page":"1069","DOI":"10.2337\/diacare.24.6.1069","volume":"24","author":"RJ Anderson","year":"2001","unstructured":"Anderson RJ, Freedland KE, Clouse RE, Lustman PJ. The prevalence of comorbid depression in adults with diabetes: a meta-analysis. Diabetes Care. 2001;24:1069\u201378.","journal-title":"Diabetes Care"},{"key":"6802_CR9","doi-asserted-by":"publisher","first-page":"483","DOI":"10.5694\/mja13.10153","volume":"198","author":"DM Colquhoun","year":"2013","unstructured":"Colquhoun DM, Bunker SJ, Clarke DM, Glozier N, Hare DL, Hickie IB, et al. Screening, referral and treatment for depression in patients with coronary heart disease. 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DFL, TE, and LC are employees of Takeda Pharmaceuticals U.S.A., Inc. MT is an employee of Lundbeck LLC. The sponsors were responsible for study design; collection, analysis, and interpretation of data; and the decision to submit the report for publication.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"778"}}