THE CLINICAL AND FINANCIAL BURDEN OF MOOD DISORDERS - COST AND OUTCOME

Depressive disorders are a chronic, recurrent, and severe burden to bo th patients and their families. Depressive disorders represent a major national public health problem, ranking within the top 10 most costly diseases in the United States. In 1990, depressive disorders afflicte d at least 11 million Americans and cost the U.S. economy an estimated $44 billion. In addition, affective disorders are associated with inc reased accident rates, increased rates of substance abuse (especially alcoholism), increased medical hospitalization, and an increase in som atic illnesses and outpatient medical utilization. Despite their ranki ng as a major health problem, depressive disorders are often underdiag nosed and undertreated. Brief treatment strategies that focus only on acute episodes ale often ineffective and result in chronic impairment, impairing performance at work and socially. Inadequate treatment incr eases costs, suffering, and lost productivity. Recent data suggest tha t effective treatment of depression requires long-term, skillful follo w-up and active pharmacotherapy.