Costs

Both anxiety and depressive disorders account for substantial health care costs and thus constitute a major public health and economic concern. Despite an increasing treatment rate of depression in the United States between 1990 and 2000, estimated costs from depression failed to decline and were calculated to be $83.1 billion in 2000, of which $26.1 billion were for direct medical costs, $5.4 billion for suicide mortality costs, and $51.5 billion for work-related costs (Greenberg et al., 2003). Similarly, estimates from the 1990s placed the annual economic burden of anxiety disorders at $63.1 billion (in 1998 dollars), of which nonpsychiatric direct medical costs accounted for 54% of the total, and direct psychiatric care accounted for 31% (Greenberg et al., 1999). Not surprisingly, patients with anxiety disorders are much more likely to see their primary care physicians or utilize emergency services. Patients with pure GAD (i.e., no comorbid medical illnesses), for example, were 1.6 times more likely to have seen a primary care physician four or more times in the past year than those without GAD or depression (Wittchen et al., 2002). Patients with panic disorder were almost twice as likely as controls to have visited an emergency room in the previous 6 months (Roy-Byrne et al., 1999).

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