{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T01:26:44Z","timestamp":1792027604098,"version":"4.4.0"},"reference-count":25,"publisher":"Royal College of Psychiatrists","issue":"6","license":[{"start":{"date-parts":[[2023,10,27]],"date-time":"2023-10-27T00:00:00Z","timestamp":1698364800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["BJPsych open"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:sec id=\"S2056472423005963_sec_a1\">\n\t    <jats:title>Background<\/jats:title>\n\t    <jats:p>There is uncertainty around the costs and health impacts of undiagnosed mental health problems.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472423005963_sec_a2\">\n\t    <jats:title>Aims<\/jats:title>\n\t    <jats:p>Using survey data, we aim to understand the costs and health-related quality-of-life decrements from undiagnosed anxiety\/depression.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472423005963_sec_a3\" sec-type=\"methods\">\n\t    <jats:title>Method<\/jats:title>\n\t    <jats:p>We analysed survey data from two waves of the North West Coast Household Health Survey, which included questions on disease, medications, and Patient Health Questionnaire 9 (PHQ-9) and Generalised Anxiety Disorder 7 (GAD-7) scores (depression and anxiety scales). People were judged as having undiagnosed anxiety\/depression problems if they scored \u22655 on the PHQ-9 or GAD-7, and did not declare a mental health issue or antidepressant prescription. Linear regression for EuroQol 5-Dimension 3-Level (EQ-5D-3L) index scores, and Tweedie regression for health and social care costs, were used to estimate the impact of undiagnosed mental health problems, controlling for age, gender, deprivation and other health conditions.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472423005963_sec_a4\" sec-type=\"results\">\n\t    <jats:title>Results<\/jats:title>\n\t    <jats:p>Around 26.5% of participants had undiagnosed anxiety\/depression. The presence of undiagnosed anxiety\/depression was associated with reduced EQ-5D-3L index scores (0.040 lower on average) and increased costs (\u00a3250 ($310) per year on average). Using a higher cut-off score of 10 on the PHQ-9 and GAD-7 for undiagnosed anxiety\/depression had similar increased costs but a greater reduction in EQ-5D-3L index scores (0.076 on average), indicating a larger impact on health-related quality of life.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472423005963_sec_a5\" sec-type=\"conclusions\">\n\t    <jats:title>Conclusions<\/jats:title>\n\t    <jats:p>Having undiagnosed anxiety or depression increases costs and reduces health-related quality of life. Reducing stigma and increasing access to cost-effective treatments will have population health benefits.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1192\/bjo.2023.596","type":"journal-article","created":{"date-parts":[[2023,10,27]],"date-time":"2023-10-27T08:39:58Z","timestamp":1698395998000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":8,"title":["Investigating the impact of undiagnosed anxiety and depression on health and social care costs and quality of life: cross-sectional study using household health survey data"],"prefix":"10.1192","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3023-8189","authenticated-orcid":false,"given":"Brendan","family":"Collins","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Downing","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Head","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terence","family":"Comerford","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2780-6170","authenticated-orcid":false,"given":"Rajan","family":"Nathan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Barr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"170","published-online":{"date-parts":[[2023,10,27]]},"reference":[{"key":"S2056472423005963_ref23","doi-asserted-by":"publisher","DOI":"10.3399\/BJGP.2022.0353"},{"key":"S2056472423005963_ref17","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2006.07.017"},{"key":"S2056472423005963_ref24","doi-asserted-by":"publisher","DOI":"10.46883\/ONC.2020.3409.0343"},{"key":"S2056472423005963_ref4","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afx201"},{"key":"S2056472423005963_ref10","unstructured":"10 Curtis, LA , Burns, A . 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Published by Cambridge University Press on behalf of the Royal College of Psychiatrists","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e201"}}