Depression subtypes, suicidality, and healthcare costs in older adults: results from a naturalistic study
IntroductionThe burden of depression is increasing worldwide, particularly in older populations. While the impact of depressive disorders on suicide in later life has been clearly identified, less is known about the role of their subtypes and their costs in the elderly.ObjectivesWe aimed to describe...
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Frontiers Media S.A.
2025-06-01
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| author | Ismael Conejero Ismael Conejero Alejandro Porras-Segovia Alejandro Porras-Segovia Lucía Albarracín-García María Luisa Barrigón Jorge Lopez-Castroman Philippe Courtet Enrique Baca-Garcia Enrique Baca-Garcia Enrique Baca-Garcia Enrique Baca-Garcia Enrique Baca-Garcia Enrique Baca-Garcia Enrique Baca-Garcia |
| author_facet | Ismael Conejero Ismael Conejero Alejandro Porras-Segovia Alejandro Porras-Segovia Lucía Albarracín-García María Luisa Barrigón Jorge Lopez-Castroman Philippe Courtet Enrique Baca-Garcia Enrique Baca-Garcia Enrique Baca-Garcia Enrique Baca-Garcia Enrique Baca-Garcia Enrique Baca-Garcia Enrique Baca-Garcia |
| author_sort | Ismael Conejero |
| collection | DOAJ |
| description | IntroductionThe burden of depression is increasing worldwide, particularly in older populations. While the impact of depressive disorders on suicide in later life has been clearly identified, less is known about the role of their subtypes and their costs in the elderly.ObjectivesWe aimed to describe the sociodemographic and clinical characteristics associated with the depression subtypes and suicidality, and their related healthcare costs in older adults receiving mental healthcare.MethodologyThe study was carried out across four psychiatry departments in Madrid, Spain. Adults aged over 60 years were included if they attended the psychiatric inpatient or outpatient services and were diagnosed with Major Depressive Disorder (MDD), recurrent depressive disorder, bipolar depression, or dysthymia. Sociodemographic data and diagnoses according to the International Classification of Diseases, 10th edition were obtained from electronic health records. Lifetime suicidal history, suicidal ideation and suicide attempts in the previous month were identified using the Columbia Suicide Severity Rating Scale (CSSRS). Mean healthcare costs were calculated over one year.ResultsN=2868 patients were included in the analysis. Of these, 550 were assessed with the CSSR. The mean age of the sample was 70.05 years and 75.9% of the patients were women (N=2177). Of the patients assessed with the CSSRS (N=550), 83.2% (N=458) reported suicidal ideation, and 7.3% (N=40) had attempted suicide in the previous month. Psychiatric healthcare costs over the follow-up differed between the depression subtypes (Eta-squared 0.003 CI [0.000 - 0.008]; p<0.001). They were significantly higher in patients diagnosed with bipolar depression, than in those diagnosed with dysthymia (p=0.026), but did not differ from those bearing MDD (p= 0.775) or recurrent depressive disorder (p= 0.129). Recent suicide attempters had a more frequent lifetime history of suicide attempt (OR= 8.434). Suicide attempts were more frequent in individuals aged 71-80 years (OR= 3.433) or over 80 years (OR= 3.322), and in patients with recurrent depressive disorders (OR= 3.529).ConclusionPsychiatric healthcare costs differed between depression subtypes, with a small effect. Furthermore, older age, a diagnosis of recurrent depression, and a history of suicide attempts increased the risk of suicide. Health policies should target these populations to improve mental health outcomes in the older adults. |
| format | Article |
| id | doaj-art-5ed92c655d724a229c4cd2f7e93dc408 |
| institution | DOAJ |
| issn | 1664-0640 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Psychiatry |
| spelling | doaj-art-5ed92c655d724a229c4cd2f7e93dc4082025-08-20T03:21:56ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402025-06-011610.3389/fpsyt.2025.15607191560719Depression subtypes, suicidality, and healthcare costs in older adults: results from a naturalistic studyIsmael Conejero0Ismael Conejero1Alejandro Porras-Segovia2Alejandro Porras-Segovia3Lucía Albarracín-García4María Luisa Barrigón5Jorge Lopez-Castroman6Philippe Courtet7Enrique Baca-Garcia8Enrique Baca-Garcia9Enrique Baca-Garcia10Enrique Baca-Garcia11Enrique Baca-Garcia12Enrique Baca-Garcia13Enrique Baca-Garcia14Department of Psychiatry, Hospital Universitario Fundación Jiménez Díaz, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, SpainDepartment of Psychiatry, CHU Nîmes, Institut de Génomique Fonctionnelle, University of Montpellier, Montpellier, FranceDepartment of Psychiatry, Hospital Universitario Fundación Jiménez Díaz, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, SpainDepartamento de Psiquiatría, Hospital Rey Juan Carlos Móstoles, Madrid, SpainDepartment of Psychiatry, Hospital Universitario Fundación Jiménez Díaz, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, SpainInstitute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Instituto de Investigacion Sanitaria Gregorio Maranon (IiSGM), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III (ISCIII), School of Medicine, Universidad Complutense, Madrid, SpainDepartment of Psychiatry, Radiology, Public Health, Nursing and Medicine, University of Santiago de Compostela, A Coruña, SpainDepartment of Emergency Psychiatry and Acute Care, Centre Hospitalier Universitaire Montpellier, University of Montpellier, Montpellier, FranceDepartamento de Psiquiatría, Hospital Rey Juan Carlos Móstoles, Madrid, SpainDepartamento de Psiquiatría, Universidad Autónoma de Madrid, Madrid, SpainDepartment of Psychology, Universidad Católica del Maule, Talca, ChileDepartamento de Psiquiatría, Hospital Central de Villalba Villalba, Madrid, Spain0Departamento de Psiquiatría, Hospital Universitario Infanta Elena Valdemoro, Madrid, Spain1Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain2Department of Psychiatry, CHU Nîmes, Nîmes, FranceIntroductionThe burden of depression is increasing worldwide, particularly in older populations. While the impact of depressive disorders on suicide in later life has been clearly identified, less is known about the role of their subtypes and their costs in the elderly.ObjectivesWe aimed to describe the sociodemographic and clinical characteristics associated with the depression subtypes and suicidality, and their related healthcare costs in older adults receiving mental healthcare.MethodologyThe study was carried out across four psychiatry departments in Madrid, Spain. Adults aged over 60 years were included if they attended the psychiatric inpatient or outpatient services and were diagnosed with Major Depressive Disorder (MDD), recurrent depressive disorder, bipolar depression, or dysthymia. Sociodemographic data and diagnoses according to the International Classification of Diseases, 10th edition were obtained from electronic health records. Lifetime suicidal history, suicidal ideation and suicide attempts in the previous month were identified using the Columbia Suicide Severity Rating Scale (CSSRS). Mean healthcare costs were calculated over one year.ResultsN=2868 patients were included in the analysis. Of these, 550 were assessed with the CSSR. The mean age of the sample was 70.05 years and 75.9% of the patients were women (N=2177). Of the patients assessed with the CSSRS (N=550), 83.2% (N=458) reported suicidal ideation, and 7.3% (N=40) had attempted suicide in the previous month. Psychiatric healthcare costs over the follow-up differed between the depression subtypes (Eta-squared 0.003 CI [0.000 - 0.008]; p<0.001). They were significantly higher in patients diagnosed with bipolar depression, than in those diagnosed with dysthymia (p=0.026), but did not differ from those bearing MDD (p= 0.775) or recurrent depressive disorder (p= 0.129). Recent suicide attempters had a more frequent lifetime history of suicide attempt (OR= 8.434). Suicide attempts were more frequent in individuals aged 71-80 years (OR= 3.433) or over 80 years (OR= 3.322), and in patients with recurrent depressive disorders (OR= 3.529).ConclusionPsychiatric healthcare costs differed between depression subtypes, with a small effect. Furthermore, older age, a diagnosis of recurrent depression, and a history of suicide attempts increased the risk of suicide. Health policies should target these populations to improve mental health outcomes in the older adults.https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1560719/fullolder adultsdepressionsuicidehealthcare costssuicidal ideation |
| spellingShingle | Ismael Conejero Ismael Conejero Alejandro Porras-Segovia Alejandro Porras-Segovia Lucía Albarracín-García María Luisa Barrigón Jorge Lopez-Castroman Philippe Courtet Enrique Baca-Garcia Enrique Baca-Garcia Enrique Baca-Garcia Enrique Baca-Garcia Enrique Baca-Garcia Enrique Baca-Garcia Enrique Baca-Garcia Depression subtypes, suicidality, and healthcare costs in older adults: results from a naturalistic study Frontiers in Psychiatry older adults depression suicide healthcare costs suicidal ideation |
| title | Depression subtypes, suicidality, and healthcare costs in older adults: results from a naturalistic study |
| title_full | Depression subtypes, suicidality, and healthcare costs in older adults: results from a naturalistic study |
| title_fullStr | Depression subtypes, suicidality, and healthcare costs in older adults: results from a naturalistic study |
| title_full_unstemmed | Depression subtypes, suicidality, and healthcare costs in older adults: results from a naturalistic study |
| title_short | Depression subtypes, suicidality, and healthcare costs in older adults: results from a naturalistic study |
| title_sort | depression subtypes suicidality and healthcare costs in older adults results from a naturalistic study |
| topic | older adults depression suicide healthcare costs suicidal ideation |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1560719/full |
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