Background: Major Depressive Disorder (MDD) is a leading cause of disability worldwide, with significant economic and social burden. However, studies assessing the overall socio-economic burden (direct, indirect and intangible costs) are scarce. This study aims to evaluate the socioeconomic burden imposed by MDD on patients referred to specialist medical centers in Italy. Methods: An observational, multicenter, longitudinal cost of illness study was conducted on patients aged 18-65 years with a diagnosis of MDD starting antidepressant therapy. Healthcare resources consumption and productivity loss were collected over 1-year follow-up to estimate per-patients MDD costs. Depressive symptoms were assessed with various clinical scales. Health Related Quality of Life (HRQoL) was assessed with the EQ-5D-5 L. Results: MDD severity decreased during the observational period, as reported by all clinical scales, with a notable improvement in HRQoL scores. The main costs associated with MDD patients were indirect costs, €386.3 per patient-month at baseline, declining to €179.9 in the last 6 months. Direct medical costs peaked in the first 3 months (€155.9 per patient-month), compared to baseline (€55,09 per patient-month), then decreased. Costs were significantly associated with and increased with the number of depressive episodes (129.71;7.59-251.83) and the augmentation of Quick Inventory of Depressive Symptomatology-Self Rated (QIDS-SR16) score (7.92;2.02-13.82). Conclusion: Our results suggest that MDD is a mental health issue with socio-economic burden that varies with symptoms severity. Indirect costs represent the main expense for MDD patients. These findings highlight the complexity and burden of MDD, emphasizing the importance of prioritizing depressive disorders in public health.
The social and healthcare burden of major depressive disorder in adults: an Italian observational cohort study
Antonazzo, Ippazio Cosimo;
2026
Abstract
Background: Major Depressive Disorder (MDD) is a leading cause of disability worldwide, with significant economic and social burden. However, studies assessing the overall socio-economic burden (direct, indirect and intangible costs) are scarce. This study aims to evaluate the socioeconomic burden imposed by MDD on patients referred to specialist medical centers in Italy. Methods: An observational, multicenter, longitudinal cost of illness study was conducted on patients aged 18-65 years with a diagnosis of MDD starting antidepressant therapy. Healthcare resources consumption and productivity loss were collected over 1-year follow-up to estimate per-patients MDD costs. Depressive symptoms were assessed with various clinical scales. Health Related Quality of Life (HRQoL) was assessed with the EQ-5D-5 L. Results: MDD severity decreased during the observational period, as reported by all clinical scales, with a notable improvement in HRQoL scores. The main costs associated with MDD patients were indirect costs, €386.3 per patient-month at baseline, declining to €179.9 in the last 6 months. Direct medical costs peaked in the first 3 months (€155.9 per patient-month), compared to baseline (€55,09 per patient-month), then decreased. Costs were significantly associated with and increased with the number of depressive episodes (129.71;7.59-251.83) and the augmentation of Quick Inventory of Depressive Symptomatology-Self Rated (QIDS-SR16) score (7.92;2.02-13.82). Conclusion: Our results suggest that MDD is a mental health issue with socio-economic burden that varies with symptoms severity. Indirect costs represent the main expense for MDD patients. These findings highlight the complexity and burden of MDD, emphasizing the importance of prioritizing depressive disorders in public health.I documenti in SFERA sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
