The Costs of Depression: Direct and Indirect; Treatment Versus Nontreatment

Depression is one of the most costly illnesses in the United States today. While managed care oftenfocuses on the costs of treatment, the costs of nontreatment are usually ignored. We have potent treatmentsthat are highly successful, but depression is often undetected or undertreated where it appearsmost commonly—in the primary care setting. When comorbid with other medical problems, especiallycardiovascular disease, depression greatly increases mortality, morbidity, and expense. Sophisticatedpharmacoeconomic analyses can guide our cost/benefit studies, but the real cost savings andhighest quality care will come by investing in educating primary care physicians regarding the recognitionand treatment of psychiatric illness as it presents in their clinical practices.