Depression, use of medical services and cost-offset effects

Gregory E. Simon, David J. Katzelnick

Research output: Contribution to journalReview articlepeer-review

68 Scopus citations


This review considers evidence that depression is associated with increased use of general medical services and that more intensive treatment of depression might be expected to reduce medical expenditures. Cross-sectional studies strongly support an association between depression and medical utilization, but cannot establish a causal relationship. Available longitudinal studies lack the sample size and duration of follow-up necessary to examine how changes in depression influence utilization. Some quasi-experimental and experimental studies support a 'cost-offset' effect due to mental health treatment, but no experimental data directly address the specific impact of depression treatment on medical utilization. The available data identify the potential for large cost savings through improved treatment of depression but do not clearly establish that such savings can be realized. Definitive proof of a cost-offset due to depression treatment will require a new generation of experimental studies adapted to assess economic outcomes.

Original languageEnglish (US)
Pages (from-to)333-344
Number of pages12
JournalJournal of Psychosomatic Research
Issue number4
StatePublished - Apr 1997


  • Cost
  • Cost-effectiveness
  • Cost-offset
  • Depression
  • Utilization

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health


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