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From the same journal

The economic cost of treatment-resistant depression in patients referred to a specialist service

Research output: Contribution to journalArticlepeer-review


  • Paul McCrone
  • Felicitas Rost
  • Leonardo Koeser
  • Iakovina Koutoufa
  • Stephanie Stephanou
  • Martin Knapp
  • David Goldberg
  • David Taylor
  • Peter Fonagy


Publication details

JournalJournal of Mental Health
DateAccepted/In press - 3 Dec 2017
DateE-pub ahead of print (current) - 23 Dec 2017
Issue number6
Number of pages7
Pages (from-to)567-573
Early online date23/12/17
Original languageEnglish


Background: Patients with treatment-resistant depression (TRD) suffer very significant morbidity and are at a disadvantage concerning optimal clinical management. There are high associated societal costs. Aims: A detailed analysis of health economic costs in the United Kingdom in a group manifesting a severe form of TRD in the 12 months before their participation in a major randomized controlled treatment trial. Methods: The sample consisted of 118 participants from the Tavistock Adult Depression Study. Recruitment was from primary care on the basis of current major depression disorder of at least 2 years’ duration and two failed treatment attempts. Service utilization was assessed based on self-report and general practitioner (GP) medical records. Generalized linear models were used to identify predictors of cost. Results: All participants used GP services. Use of other doctors and practice nurses was also high. The mean total societal cost was £22 124, 80% of which was due to lost work and care required of families. Level of general functioning was found to be the most consistent predictor of costs. Conclusions: Severe forms of TRD are associated with high costs in which unpaid care and lost work predominate. Treatments that improve functioning may reduce the large degree of burden.

    Research areas

  • burden, cost economic analysis, Treatment-resistant depression

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